The Sun Does Not Cause Melanoma

How to pick a fight with a dermatologist

Leland Stillman, MD
Jul 7 · 10 min read

Manufacturing Disease, Episode 8

“The incidence of malignant cutaneous melanoma has been increasing for more than 50 years, and is now rising more rapidly than that of any other cancer. This increase is not explicable by changes in the physical environment, particularly by any observed increase in UVB radiation (290–320 nm).”

Translation: melanoma rates have been increasing for fifty years, faster than any other cancer, and this is definitely not due to changes in our exposure to ultraviolet-B light.

I could not have said it better myself. I have spent the last few weeks pouring over the literature on melanoma and trying to make sense of it. Jack Kruse clued me into this paradox years ago with a controversial blog he authored on the topic. I confirmed much of what he wrote there, which I wrote about in my last blog.

This blog will focus on what other factors may be at play in the development of melanoma. I will also discuss why such important risk factors have remained outside the limelight of melanoma prevention. “Everyone knows” (by which I mean that “everyone has been told”) that the sun causes melanoma. As it happens, the literature is clear that sun exposure is just one of many factors. If the sun causes melanoma, then spoons make people fat. Despite this, the public health dogma and advice remains out of date. How did this happen? What can you do to reduce your risk of melanoma?

What is melanoma? Melanoma is the most aggressive skin cancer. Seven thousand Americans die each year from melanoma. Many more melanomas are cut out before they can kill the victim. Melanomas arise from melanocytes, which are the skin cells that produce melanin. Melanin is your natural sun-protection. The darkness of someone’s skin is a function of the amount of melanin their skin has. The more sun you get, the more melanin your melanocytes will produce to protect you from it. This process is meant to be gradual and in many humans is highly adaptive. Humans who live in extreme latitudes tend to have lighter skin. Lighter skin allows sunlight to penetrate more deeply, which in excess can cause what we call sunburn. This is due to damage induced by strong sunlight that overwhelms the skin’s protective mechanisms.

Melanoma occurs when a melanocyte turns into a cancer. Melanoma is known for growing extremely fast and spreading aggressively to bone and brain. I covered the paradoxical relationship between melanoma and sunlight in my last blog. I implied in that blog that we didn’t have the whole story on melanoma. We are being told a half-truth. One of the most consistent risk factors I was able to identify from the literature on melanoma was intermittent sun exposure, specifically resulting in sunburns. In other words, if you rarely see the sun and, when you do, you get sunburned, then you are maximizing your risk of melanoma. Many melanomas, such as those on non-sun exposed skin, are known not to be due to melanoma. One study I cited in the last blog suggested a figure as high as 20% of melanomas. The sun is clearly not the answer. If it is anything, it is the last straw in a series of complex events.

One of the primary functions of the skin is to receive signals from the environment, relaying them to the brain, and to modify itself to protect the body from external threats. We “tan” to prevent our bodies from burning. Calluses form to protect us from repetitive wear on our hands. Our skin is both a shield from and an antenna for the world we live in. In considering cancers of the skin, we might start by asking, what conditions are we exposing the skin to? Sunburns are obvious. What is less obvious are how all the other environmental changes we have made in the past fifty years might be contributing to melanoma generation.

The mid-1950’s saw the completion of a nation-wide power grid that could power new heating and air-conditioning units. For the first time in history, people were more comfortable indoors than outdoors. Indoor living prior to this had been plagued by smokey fireplaces and chimneys, or sweltering and inescapable heat. With air-conditioning and heating came artificial light. Artificial light contains zero ultraviolet light and has, over the past decades, been engineered to exclude the red and infrared portions of the spectrum. This is why new lightbulbs are so “bright.” The soft glow of incandescent bulbs has been replaced by the harsh glare of LEDs and fluorescent lights. Modern lighting subjects life to increasing levels of blue and green light, both of which reduce melatonin levels. These are colors that are only present during daylight. If melanocytes are stimulated by sunlight, specifically ultraviolet light, then what effect might blue light have on them?

Uveal melanoma provides an interesting subset of melanomas that are recognized as not being due to sun exposure, due to their anatomical location. Uveal melanoma is now widely recognized as being associated with excessive blue light exposure. One meta-analysis of studies on risk factors for uveal melanoma reported the following modifiable risk factors as significant.

  1. Welding
  2. Occupational cooking
  3. Propensity to sunburn

Why would these three risk factors stand out from all others? Clearly, this is not only about the sun, but light of all kinds.

Welders are exposed to extremely bright light in the torches they use. If you have ever seen a welding-torch in action, you probably remember that it took your eyes moments to recover. This is why welders use helmets and protective goggles. This is also why your dentist, who uses blue light in certain procedures, has you wear special goggles sometimes too.

“Occupational cooking” presumably means working in a restaurant kitchen. The vast majority of cooks operate in this environment. Cooks and chefs lead artificially lit lives, constantly under bright lights in kitchens and rarely out in the sun. They are often going to bed when the sun is coming up, and if they aren’t, they are getting ready to go into work, where they will work until long after the sun sets. They are exposed to high intensities of artificial light for long periods of time.

What sort of person has the greatest propensity to sunburn? Anyone with pale skin who rarely sees the sun, which describes a vast proportion of the modern world. We live 95% of our lives inside today, which means that even in tropical environments with year-round UV light, we are “tanning” just 5% of the time. Add sunglasses and a hat, and you are getting practically zero ultraviolet light.

What does fake light do? Fake light shuts down melatonin. What does melatonin do? It repairs cells and it destroys cancer cells. Melanoma is no exception to this axiom. This is why shift-work is a risk factor for all cancers, and is even recognized as such by the World Health Organization.

What does ultraviolet light do when it hits the skin? UV-B light helps the body to produce vitamin D, triggers the release of endocannabinoids and endorphins, and modulates levels of steroid hormones. This is why animals are seasonal breeders — they need the stimulus of strong light to mate and conceive. This is why we feel so happy and tired after a day at the beach — sunlight is getting us high on endorphins and endocannabinoids. Vitamin D, like melatonin, also destroys cancer cells. Endocannabinoids and endorphins play complex roles in whether or not cells live, or die. Cancerous cells are cells that should die, or commit suicide. If the endorphine and endocannabinoid pathways are improperly regulated, might we see increasing rates of cancer? Could this explain the anecdotes we hear of people curing cancer using CBD? Steroid hormones like testosterone, estrogen, and progesterone all have complex effects on cells, including cells of the skin. Changes in skin coloration and tone that occur in puberty have to do with sex steroid hormone levels. If you change what determines levels of vitamin D, endocannabinoids, endorphins, and steroid hormones, would you expect to see increases in the rates of certain diseases?

Melanoma rates are rising all over the world. Everyone is busy avoiding the sun, but if uveal melanoma is any indication, then fake light and lack of sunlight are to blame.

When will the sun set on the meme that the sun causes melanoma?

How did we get this so wrong? Why are experts telling us to avoid the sun when the data on sun avoidance is paradoxical at worst and suspect at best?

If you want to find out why something isn’t working, you have to follow the money.

Who is making a fortune on melanoma? The sunscreen industry. Who is making a fortune on fake light? Some of our biggest economic players, like General Electric, home improvement stores, power companies, the entertainment industry, and many, many more. No one wants to hear about the dangers of fake light and the benefits of sun exposure. The sun does not hand out fat speaking fees for those who defend it. We are instead presented with a parade of drug company representatives selling us drugs to mitigate diseases that are often due to technology.

Why has this happened? Where are the watchdogs who are supposed to keep researchers and doctors on track with their advice? Sadly, they are being ignored. Many of the papers I have reviewed on this topic clearly state that sun exposure is not the culprit, so much as improper exposure (sunburn) is. There are many other risk factors, like exposure to radios and cell phones, that remain contentious, but important.

The experts who are tasked with protecting the public from things like melanoma do not have any skin in your game. In fact, their profit comes when they cut out one melanoma, or suspected melanoma, after another in a day at the clinic. Their wallet gets hit if they miss a case or don’t practice the standard of care. Can you blame them? If they make a mistake when it comes to melanoma, they can lose their license for negligence. If they give you bad or incomplete advice on melanoma prevention, they stand to lose nothing.

Experts who do not have skin in the game frequently persist in delusions about what is, and what is not. What is causing melanoma is modern, indoor, blue-lit, microwaved lifestyles. Why else would the incidence have been increasing since the 1950's? Why else would uveal melanoma be associated with welding, shift work, and sunburn? Why else would the data on sun exposure in melanoma be so mixed, with some studies showing benefit and others showing harm?

We have a medical establishment that is built on a myth that funding equals progress and money equals benefit. Nothing could be a more dangerous over-simplification of the truth. Perhaps what we need to do to get some sense out of our experts is to put their skin in the game. What if dermatologist reimbursement were tied to melanoma incidence and deaths in their zip codes? If they could sit back and just cash checks if their patient population didn’t develop or die of melanoma, do you think they might figure out how to prevent it?

Manufacturing disease is all about making sure that causes remain hidden, and ensuring that effective solutions never make it to the public. It is easy to appeal to people to fund melanoma prevention campaigns that tout the same tired, out-dated, and incomplete dogma that the sun causes melanoma. The sunscreen industry will happily sell you sunscreen, as much as you can possibly use. What is needed is not more funding, more government control, or more experts. We have plenty of all three in healthcare, yet melanoma rates continue to increase. Einstein said that the definition of insanity was, “doing the same thing over and over again, and expecting different results.” If the sun causes melanoma, then why have we all moved inside, adopted sunscreen use and sunglasses, and yet seen fifty years of rising melanoma rates? Why would we be hairless if the sun were out to kill us? Why would we have such high vitamin D requirements for normal growth and metabolism, if we were meant to cover up our skin, preventing its production? 2 + 2 does not equal 5, no matter how many experts say it does.

What is the solution to this manufactured disease? Necessity, often in the form of greed, is the mother of invention. Medicine only progresses when doctors have skin in the game, when necessity drives them to discover what really works. Melanoma rates will continue to increase, as will the death toll, until dermatologists, ophthalmologists, and oncologists have skin in the game of cancer prevention, rather than making fortunes off of cancer proliferation. Until then, I advise you to keep your skin in the game and to avoid fake light, fake food, and to eat your fish and shellfish.

Cites:

Stang, A., Anastassiou, G., Ahrens, W., Bromen, K., Bornfeld, N., & Jöckel, K.-H. (n.d.). The Possible Role of Radiofrequency Radiation in the Development of Uveal Melanoma. Epidemiology. Lippincott Williams & Wilkins. https://doi.org/10.2307/3703672

Stang, A., Anastassiou, G., Ahrens, W., Bromen, K., Bornfeld, N., & Jöckel, K.-H. (n.d.). The Possible Role of Radiofrequency Radiation in the Development of Uveal Melanoma. Epidemiology. Lippincott Williams & Wilkins. https://doi.org/10.2307/3703672

Field, S., & Newton-Bishop, J. A. (2011). Melanoma and vitamin D. Molecular Oncology, 5(2), 197–214. https://doi.org/10.1016/J.MOLONC.2011.01.007

Geller, A. C., Colditz, G., Oliveria, S., Emmons, K., Jorgensen, C., Aweh, G. N., & Frazier, A. L. (2002). Use of sunscreen, sunburning rates, and tanning bed use among more than 10 000 US children and adolescents. Pediatrics, 109(6), 1009–1014. https://doi.org/10.1542/peds.109.6.1009

Behar-Cohen, F., Martinsons, C., Viénot, F., Zissis, G., Barlier-Salsi, A., Cesarini, J. P., … Attia, D. (2011). Light-emitting diodes (LED) for domestic lighting: Any risks for the eye? Progress in Retinal and Eye Research, 30(4), 239–257. https://doi.org/10.1016/J.PRETEYERES.2011.04.002

Nayman, T., Bostan, C., Logan, P., & Burnier, M. N. (2017). Uveal Melanoma Risk Factors: A Systematic Review of Meta-Analyses. Current Eye Research, 42(8), 1085–1093. https://doi.org/10.1080/02713683.2017.1297997

Logan, P., Bernabeu, M., Ferreira, A., & Burnier, M. N. (2015). Evidence for the Role of Blue Light in the Development of Uveal Melanoma. Journal of Ophthalmology, 2015, 386986. https://doi.org/10.1155/2015/386986

Setlow, R. B., & Woodhead, A. D. (1994). Temporal changes in the incidence of malignant melanoma: Explanation from action spectra. Mutation Research/Fundamental and Molecular Mechanisms of Mutagenesis, 307(1), 365–374. https://doi.org/10.1016/0027-5107(94)90310-7

Horn-Ross, P. L., Holly, E. A., Brown, S. R., & Aston, D. A. (1991). Temporal trends in the incidence of cutaneous malignant melanoma among Caucasians in the San Francisco-Oakland MSA. Cancer Causes and Control, 2(5), 299–305. https://doi.org/10.1007/BF00051669

Lee, J. A. H., & Scotto, J. (1993). Melanoma: linked temporal and latitude changes in the United States. Cancer Causes and Control, 4(5), 413–418. https://doi.org/10.1007/BF00050859

Westerdahl, J., Ingvar, C., Måsbäck, A., & Olsson, H. (2000). Sunscreen use and malignant melanoma. International Journal of Cancer, 87(1), 145–150. https://doi.org/10.1002/1097-0215(20000701)87:1<145::AID-IJC22>3.0.CO;2-3

Leland Stillman, MD

Written by

Allergy and Immunology, University of Mississippi 2021. Quantum biology. StillmanMD.com.

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