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Re: Keep out of sun

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Alan - they now make clothes that help block UV rays. I'd

check an outdoor/camping type store or ask at your local

cancer center. The ones I've seen are simple shirts and

pants- would work well on the golf course or in your car

with a hat of course. Be sure to cover your ears. Happy

golfing!

Pat

Alan Goldstein wrote:

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Hi Alan,

As a result of your CLL and FCR treatment, you are

immunosuppressed: low numbers and systemic ineffectiveness

of B-cells, CD4+ & CD8+ T-cells, and cutaneous dendritic

cells (another important immune cell in the lymphoid

lineage), The anti-viral/anti-bacterial prophylaxis

increases vulnerability to sun damage to your skin. Overall

result is that your immune system is far less effective than

a non-CLL person's in detecting and attacking cancers before

they develop beyond the single-cell stage. For that reason,

secondary cancers of many types are far more common in CLL

patients than in the general population.

CLL'ers, and especially those who have had treatment,

develop skin cancers with 8 times or more the frequency in

the general population.

I have had 1 basal cell and 2 squamous cell lesions since

finishing FCR in Dec, 2009. Many others who post here have

had many more, including melanoma. You may hear from them as

well. Also developed prostate cancer in 2010. So the box

score is immune system 0, post-treatment cancer types 3.

Your pharmacist is a highly trained and capable

professional, but is not a dermatologist. Beyond that, most

dermatologists, like community practice hemo/oncs, do not

see much CLL and may well be unaware of CLL'ers'

vulnerability to skin cancers. Nonetheless, a (your)

dermatologist is the proper authority on this risk question.

I found and provided info on the CLL - skin cancer link on

the internet and provided it to my dermatologist. She has

been very attentive since, including 6-month whole body

scans, and biopsies for any suspicious lesions and Mohs

surgery for the malignant ones.

The information is widely available. One good starting

source would be CLL Topics at

http://clltopics.org/index.php . Enter " skin cancer " in the

Search Box; several excellent articles will pop up. You

might check CLL Canada, as well.

So, that's the long answer.

The short (my non-medically qualified) answer is: 1. Stay

out of the sun as much as possible - you are already holding

the short end of the stick. 2. Establish a medical

relationship with a dermatologist soon.

Regards,

Tim Klug

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Alan, I would recommend that you stay out of the sun or get

some sun protective clothing. I spend 3 months in Norway

every summer, where the days are long and people use every

opportunity to enjoy the sunshine. Well, last summer I ended

up with a very itchy rash all over my body, apparently due

to a reaction between sunlight and the three antibiotics I

am on due to a chronic lung infection. This year I am much

more careful, sitting in the shade and using long sleeves

and long pants. I never had this problem in Arizona, where I

live, perhaps because it gets warmer there and the days are

shorter. I also get screened twice a year for skin cancer,

and have had a few such incidents.

Bente

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Quite a few styles of upf clothing are available now online

for a variety of activities for both men and women. I

highly recommend it, as the breathability of the fabrics has

improved since the early days, and it really works. I still

miss being able to be outdoors wearing real summer clothing,

but it's worth it to me to be able to rest easy without

having to lather sunblock over such a wide area of skin.

(Colder fall and winter weather typically allows more

layers, which together can block rays.)

Best to all,

Karni

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Some outdoors/sportsmen's stores and cancer centers with

shops which carry items specific to the needs of patients

carry them, also. You might try Patagonia, which is local

for me, but does a lot of on-line business.

Pat

Karni wrote:

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We enjoy outdoor activities and have found LL Bean (online)

to have a good selection of tropical weight clothing with UV

protection built into the fabric. My husband has long sleeve

shirts that can be converted to short sleeves, as well as

long pants that can be zipped off into shorts. He also has

what I refer to as his " foreign legion " hat that has a flap

that covers his ears and neck when there is no shade

protection.

Stella

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Tim's point about chemo vulnerability is I think very good

advice to discuss with your hematologist; I'm sure he knows

whereof he speaks. I developed basal cell carcinomas on two

different occasions on my nose and both times, as I remember

I was either in treatment or had recently finished.

But for those in w & w or long remissions (now includes me), I

do think the brain is the best sunscreen. According to

recent conclusions by Mayo Clinic researchers, there's a

strong likelihood that Vitamin D is a factor that effects

the speed of CLL progression to treatment and more and more

researchers believe that D may play a much more significant

role with other cancers as well, though how and which ones

is far from being established.

Calcium needs no introduction either — and the best

information I've read is that a combination of healthy

eating (with calcium/D awareness), supplements and some sun

exposure is the most effective combination for deriving the

benefits of both D & Calcium.

I believe that's true. So I try to get about 20 minutes of

sun exposure as often as I can (I started out with 10). But!

I rotate frequently and keep my nose covered, and I confine

my exposure to 20 minutes. The more sunscreen and clothing

and hats you wear, the less amount of D & Calcium absorption

is taking place. That's a question of your own comfort level

and judgement.

It's been several years since I had chemo. I think waiting a

while before sun exposure is good advice -- hopefully your

oncologist may be able to guide you a bit as to how long a

while to wait. I think balance is the key. And even though I

have less use of my brain since chemo and age set in, what's

left is " cherce, " (choice) as a Spencer character said.

Frances Dx'd 1998 CLL/SLL

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