Many people love the warm sun, beaches, and gardens in full bloom, but along with those long beautiful summer days comes the threat of sun damage. What does this mean for GIST patients? It means it’s time for summer safety: to be informed and protect your sensitive skin as you are on medications which may cause sensitivities.
Some of the possible side effects of imatinib (Gleevec) include rashes, heat sensitivity and dry skin. Side effects that may impact the skin for Sutent and Stivarga are like those for Gleevec, and may include rash or dry skin (Sutent and Stivarga) or redness, swelling or pain of the skin (Stivarga). GIST patients have also, reported that Gleevec and similar drugs seem to increase sensitivity to the sun, which then increases the possibility of sunburn.
Sun exposure facts:
- Ultraviolet (UV) radiation from the sun and from tanning beds is classified as a human carcinogen by the U.S department of Health and Human Services and the World Health Organization.
- The US Environmental Protection Agency (EPA) estimates that the sun causes 90 percent of all nonmelanoma skin cancers, and other research links it to 65 percent of all melanomas.
- Each year, an estimated five million or more new cases occur in the US of the nonmelanoma skin cancers basal and squamous cell carcinoma (BCC and SCC) which are the first and second most common forms of skin cancer.
- An estimated 87,110 new cases of invasive melanoma, the most dangerous form of skin cancer, will be diagnosed in the US in 2017, with nearly 9,730 resulting in death, according to the American Cancer Society.
- UVA rays penetrate the skin more deeply leading to photoaging or UV-induced skin aging.
- Excessive unprotected exposure to the sun’s ultraviolet (UV) light damages the fibers in the skin called elastin. When these fibers breakdown, the skin begins to sag, stretch, wrinkle, have a leathery texture, and hyperpigmentation (so-called “aging spots” or “liver spots” that are really the result of sun damage).
- Sunburn is caused by UVB rays, resulting in sun-induced inflammation and/or blistering of the skin. When immune cells called mast-cells race to the injured skin site in response to the damage, the blood vessels dilate and produce erythema (reddening), edema (swelling), burning and stinging sensations as part of the healing process. This DNA damage can be the first step towards skin cancer.
- Intermittent, intense UVR exposure, often producing sunburn, is believed to be more closely associated with melanoma than is chronic sun exposure.
- One blistering sunburn in childhood or adolescence doubles the risk of melanoma later in life; five sunburns by any age doubles the risk as well.
- UVR weakens immune surveillance mechanisms, allowing tumor cells to proliferate more freely. This effect adds to the immune suppression induced by other causes, including cancer chemotherapy and anti-rejection drugs for transplants.
Summer Safety tips for GIST survivors:
- Limit your direct exposure to the sun by staying in the shade, especially between 10am and 4pm, when UV rays are strongest.
- Cover up when you are out in the sun; wear light, breezy clothes to soothe your sensitive skin and avoid overheating.
- Wear hats with at least a four-inch brim to keep your head, ears and neck protected, and wear sunglasses that block at least 99% of UV light.
- Apply lip balm with a SPF 30+ and broad spectrum to protect against sun damage.
- Consult with your dermatologist or GIST specialist to decide which sunblock is right for you, taking into consideration your individual side effects and skin issues. As a rule, use a sunblock with an SPF rating of at least 30, and one that provides both UVA and UVB protection. These are also referred to as “broad spectrum” sunblock. Choose a sunblock that has tested the best in UVA and UVB protection, has low toxicity and remains stable in the sun.
- Avoid tanning beds and sunlamps: both can cause serious long-term skin damage.
- Avoid walking or exercising during the hottest part of the day. If there’s a heat advisory you may want to move your workout indoors.
- Drink plenty of water and other fluids. The key is to stay hydrated. Adults should drink eight 8- ounce glasses of water each day and may need more on hot humid days.
- When your skin is more sensitive and your body’s immunity is low, you might experience a more severe itching, swelling or reddening reaction to insect bites. Ask your doctor to recommend an insect repellent to use, and especially apply it at dusk when insect populations are high.
- Examine your skin head to toe every month and if you see anything that looks odd, let your health care provider know.
Remember as the temperature rises, practice strategies from your treatment specialist and sun safety tips so you can enjoy all that summer has to offer.