Skin cancer has been on the rise at an astonishing rate in the United States of America over the past 5 decades.

Specifically, these statistics relate to nonmelanoma skin cancers such as Basal Cell Carcinoma and Squamous Cell Carcinoma among other less common skin cancers. Melanoma skin cancers are not a part of these statistics as they are a reportable condition. For all skin cancers that don’t get reported, estimates have been made based on billing records in most studies. If you want to be the best one playing video games click here. 

Because it is more difficult to estimate the total number of US nonmelanoma skin cancers, studies are done less frequently. We’ve compiled the last four major studies based on a scientific journal search on pubmed.gov.

The first publication evaluated skin cancer rates in 1978.

“Currently between 400,000 and 500,000 individuals develop new basal cell or squamous cell carcinomas of the skin each year in the United States.” (1978)

– Scotto, J., T. R. Fears, and J. F. Fraumeni. 1983. Incidence of non-melanoma skin cancer in the United States. NIH Pub. no. 83-2433. Bethesda, MD: U.S. Dept. of Health and Human Services, National Institutes of Health.
http://www.ciesin.org/docs/001-526/001-526.html

Then in a short period of time (16 years) skin cancer rates doubled.

“The projected 1994 incidence of nonmelanoma skin cancer in the United States is 900,000 to 1,200,000 cases, similar in magnitude to the overall incidence of noncutaneous cancers.”

– J Am Acad Dermatol. 1994 May;30(5 Pt 1):774-8.
Nonmelanoma skin cancer in the United States: incidence.
Miller DL1, Weinstock MA.
http://www.ncbi.nlm.nih.gov/pubmed/8176018

The spike in skin cancer rates continued over the next decade.

“From these data, the total number of new NMSC in 2006 was estimated to be 3,507,693.”

– Semin Cutan Med Surg. 2011 Mar;30(1):3-5. doi: 10.1016/j.sder.2011.01.002.
No end in sight: the skin cancer epidemic continues.
Donaldson MR1, Coldiron BM.
http://www.ncbi.nlm.nih.gov/pubmed/21540015

The last major publication of skin cancer rates in the US (in 2012) estimated that there were a staggering 5.4 million new cases each year.

“We estimate the total number of NMSCs in the US population in 2012 at 5,434,193 and the total number of persons in the United States treated for NMSC at 3,315,554.”

– JAMA Dermatol. 2015 Oct;151(10):1081-6. doi: 10.1001/jamadermatol.2015.1187.
Incidence Estimate of Nonmelanoma Skin Cancer (Keratinocyte Carcinomas) in the U.S. Population, 2012.
Rogers HW1, Weinstock MA2, Feldman SR3, Coldiron BM4.
http://www.ncbi.nlm.nih.gov/pubmed/25928283

NICOTINAMIDE

Nicotinamide, also known as niacinamide, is the active form of Vitamin B3 or niacin.  It is a critical component of our body’s defense system and has been proven to help prevent skin cancer and possibly other forms of cancers.  It helps the body repair genetic damage from various sources.

Chemical structure

 Nicotinamide is C₆H₆N₂O.  It has a molecular weight of 122.12464 grams/mol.  Nicotinamide is an important component of the coenzyme NAD or nicotinamide adenine dinucleotide.

Function and Activity

The coenzyme nicotinamide adenine dinucleotide (NAD) is widely found in nature and it is important in numerous chemical reactions in the body and skin.  It is involved in chemical reactions that help decrease oxidative stress and help repair cellular damage.  Niacinamide is a critical component of NAD and NAD is part of PARP-1 or Poly (ADP-Ribose) Polymerase 1.  PARP-1 is an important enzyme involved in DNA damage repair. Niacinamide helps in rejoining broken DNA caused by radiation, chemotherapy or sun exposure.

Manufacturing

Nicotinamide or niacinamide is sold in three grades.  Pharmaceutical grade is fit for human consumption and is available in capsules containing a white powder and is present in small amounts in multivitamins.

Sources of Nicotinamide

Niacin, and thus niacinamide or nicotinamide, is available in small dosages from your diet.  Foods that include niacin in significant amounts are turkey, chicken, tuna and salmon.  Cereals also are fortified with niacin.  Smaller levels of niacin are found in beef, peanuts, lentils, lima beans, bread and pasta.  Even coffee has some niacin in it.  The amount of nicotinamide available from an average diet would be far less than the 500 mg twice a day recommended to help prevent skin cancer.  Niacinamide is available as a dietary supplement with the recommended dose being 500 mg twice a day.  Its anticancer effects will only work while you are taking the vitamin.  It does not have a lasting effect.

Safety and Eye Irritation

Nicotinamide as a loose powder can be irritating to the eye.  Capsules should not be opened; if they are and they get into a person’s eyes, the eyes should be flushed with water or normal saline immediately for at least 20 minutes.

Toxicity

Niacinamide is felt to be safe by the United States per our federal regulations.  If the powder is loose and inhaled it can cause a cough and can cause redness and eye pain if introduced into the eye.  There is very limited toxicity in humans with dosages under 1.5 – 3 grams per day.  Overdosage can result in nausea.  Nicotinamide has not been found to be carcinogenic; in fact, it has potent anticancer activity that is well documented.

Importantly nicotinamide, unlike nicotinic acid or niacin, does not cause flushing, itching or burning sensations in the skin.  Patients who have taken niacin or nicotinic acid from their cardiologist frequently experience these side effects.

Niacinamide or nicotinamide in dosages beyond what is recommended can cause some dizziness, headaches, diarrhea, liver function elevation and elevated blood sugars.  At 500 mg twice a day none of these side effects are seen.

Nicotinamide’s Effect on Humans

There are many claims regarding nicotinamide that have limited scientific proof.  A well-known disease, pellagra, comes from a deficiency of niacin which causes many problems in the human body including rashes, diarrhea, dementia and even eventually death.  Clearly, niacin and niacinamide are important to our health and thus should be part of everyone’s diets, look at this website here.

There are ongoing studies on the use of nicotinamide to improve the body’s immune system to resist infections, cancers, and even diabetes.

Nicotinamide and Cancer Prevention

Nicotinamide has been studied for a number of years as a chemo-preventative agent or something that can possibly prevent cancer in humans.  Nicotinamide helps the body fight cancer-causing effects in cells including removing oncogenes which are genes that cause cancer.  It can also suppress free radicals which can cause cancer.

Nicotinamide and Prevention of Skin Cancer

There have been a number of studies showing that regular dosages of nicotinamide can decrease ultraviolet-induced DNA damage.  Niacinamide helps reduce inflammation in the skin.  Inflammation in the skin can cause damage to cells and contribute to cancer formation.

A critical paper published recently in the New England Journal of Medicine by a large group of researchers in Australia demonstrated a 23% decrease in the number of basal and squamous cell carcinomas in patients taking 500 mg twice a day over a one-year period when compared to the previous five years of their lives.  The number of precancerous actinic keratoses also decreased by up to 20%.  This anticancer effect worked even in patients who were not using sunscreens.  Sunscreens, sun avoidance and hats are well-known to help prevent skin cancer.

Conclusion

Nicotinamide or niacinamide is a precursor for NAD and is critical for PARP-1 activity which will decrease inflammation and improve repair of DNA particularly in ultraviolet light-damaged cells.

Nicotinamide has been shown to decrease the number of skin cancers and precancers by over 20% when taken regularly at 500 mg twice a day.  Nicotinamide combined with sun avoidance, hats and sunscreens will improve this anticancer effect, although strict sun avoidance can lead to Vitamin D deficiency which also plays a role in the development and progression of skin cancers.  SOLDERM™ is a unique combined product of niacinamide and Vitamin D to help facilitate adequate dosaging of both critical vitamins in the most convenient form.

References:

https:\\pubchem.ncbi.nlm.nih.gov

http:\\www.gpoaccess.gov\ecfr

Prevention of Cancer by Vitamin B3 (nicotinamide and nicotinic acid), A proteus ACE inhibitor Available in Pure Form by Walter Troll and Ann R. Kennedy, found in the Book Proteus Inhibitors as Cancer Chemopreventive Agents.

Journal of Nucleic Acids, Volume 2010, Article ID 157591 titled “Role of Nicotinamide in DNA Damage, Mutagenesis and DNA Repair” by Surjana et al, April 2010.

A Population Based Study of Skin Cancer Incidence and Prevalence in Renal Transplant Recipients, British Journal of Dermatology, Volume 154(3), pgs 498-504, 2006 by Maloney et al.

Inflammation, Gene Mutation and Photo Immunosuppression in Response to UVR -Induced Oxidative Damage Contributes to Photo Carcinogenesis, Mutation Research, Volume 571, No 1-2, pgs 107-120, 2005 from G. M. Halliday.

A Phase 3 Randomized Trial of Nicotinamide for Skin Cancer Chemoprevention, Andrew Chen et al, New England Journal of Medicine, 2015; 373:1618-1626, October 22, 2015.

Vitamin D3

Vitamin D3 is a derivative of Vitamin D formed by ultraviolet light in the skin. It is critical to bone formation and may have many other important roles in the body that are still being studied and discovered. Low Vitamin D can affect your cancer risk and Vitamin D supplementation may play a role in preventing skin, colon, prostate and breast cancers. It may also have some role in preventing diabetes, high blood pressure, multiple sclerosis, rheumatoid arthritis and even heart disease.

Chemical Structure

Vitamin D3 is C27H44O. It is also called cholecalciferol or calciol and is different from Vitamin D2 or ergocalciferol. Vitamin D stores itself in fat and body tissues, thus blood levels do not necessarily accurately measure a person’s Vitamin D level.

Function and Activity

Vitamin D3 is a steroid hormone that is important in maintaining blood calcium and phosphorous levels and in bone formation. It also binds receptors to modulate gene expression which may be how it helps prevent the formation of cancers.

Manufacturing

Vitamin D3 can be manufactured safely by taking cholesterol from wool wax alcohols and subjecting it to a four step process to make the precursor to Vitamin D3. This is then irradiated with ultraviolet light similar to how it is made in the skin producing cholecalciferol or Vitamin D3 to be taken as a supplement. Vegetarian sources are also available made from lichens instead of wool wax alcohol.

Sources of Vitamin D

Vitamin D3 is best obtained from the sun. Very few foods contain Vitamin D, although small amounts are found in liver, cheese and egg yolks. Most of the United States’ milk supply is fortified with Vitamin D to avoid deficiency.

Safety and Eye Irritation

Just as in niacinamide, the loose powder within the capsule can irritate eyes and the respiratory tract if inhaled.

Toxicity

Excess Vitamin D can cause weight loss and heart arrhythmias. It can also raise the blood levels of calcium which can lead to calcification of the heart, blood vessels and kidneys including increasing the risk of kidney stones, particularly if Vitamin D is taken with calcium. Most toxicity occurs in patients taking in excess of 10,000 international units of Vitamin D a day. Megadosaging of Vitamin D should be avoided. Vitamin D intake of 4,000 international units per day should be satisfactory to obtain normal levels of Vitamin D without inducing toxicity. Of course younger children should take lower dosages. The recommendation from the National Institutes of Health suggest children should have less than 4,000 units to less than 1,000 units per day depending on their age.

Vitamin D3’s Effect on Humans

Vitamin D3 is critical to bone formation. A deficiency of Vitamin D causes a disease called rickets and osteomalacia (bone softening). This will cause failure of bone to form normally with skeletal deformities, particularly in children. People who have problems absorbing nutrients such as those with celiac disease, Crohn’s disease or ulcerative colitis can become Vitamin D deficient due to lack of absorption. People with limited sun exposure, such as our skin cancer patients who avoid the sun and use sunscreens, hats, long sleeves and pants, can develop Vitamin D deficiency.

Vitamin D and Cancer Prevention

There are many studies that indicate Vitamin D plays a role in the prevention of certain skin cancers, colon, prostate and breast cancers.

Vitamin D and Prevention of Skin Cancer

Vitamin D might help prevent cancers by decreasing cancer cell growth and reducing cancer blood vessel formation. It also promotes cellular differentiation which keeps cells healthier. Vitamin D has activities against melanoma cell lines in mice and has been used in humans to help prevent melanoma from coming back in patients who are at risk for metastasis. Vitamin D supplementation has been shown to decrease the occurrence of non-melanoma skin cancer as well.

Conclusion

Vitamin D is a critical element for a healthy lifestyle and may have very important roles in preventing skin cancer as well as other cancers. Strict sun avoidance, hats, clothing, and sunscreens) may make patients Vitamin D deficient, thus supplementation is often very important in our society. Adequate dosaging for Vitamin D is difficult to determine as blood levels are not always accurate and recommendations keep changing. We recommend 4,000 units of Vitamin D a day. SOLDERM™ is a unique combined product of Vitamin D and niacinamide to help facilitate adequate dosaging of both critical vitamins in the most convenient form.

References

Pubchem Open Chemistry Data Base, https:\\pubchem.ncbi.nlm.nih.gov

National Institute of Health, Office of Dietary Supplements, https:\\ods.od.nih.gov

Vitamin D and Cancer: Current Dilemmas and Future Needs, Nutr Rev 2007;
65:S71-S74 by Davis et al

Overview of the Cohort Consortium Vitamin D Pooling Project of Rarer Cancers, American Journal of Epidemiology 2010; 172:429

The National Cancer Institute, Vitamin D and Cancer Prevention, www.cancer.gov

The Role of Vitamin D in Cancer Prevention, Garland et al, American Journal of Public Health 2006, February; 96(2): 252-261

Adjuvant Therapy with High Dose Vitamin D Following Primary Treatment of Melanoma at High Risk of Recurrence: A Placebo Controlled Randomized Phase 2 Trial B and C Cancer 2014;14:780 October 24

Inverse Association Between Serum 25 (OH) Vitamin D Levels in Non-Melanoma Skin Cancer in Elderly Men, Tang et al, Cancer Causes Control 2010, March; 21(3):387-91

Calcium Plus Vitamin D Supplementation With The Risk of Fractures, New England Journal of Medicine 2006, 354:669-83, Jackson et al

Science Lab.com Material Safety Data Sheet Cholecalciferol MSDS