European Journal of Cancer: Highlights of Issue 37:18

Self-reported tanning habits in Sweden

Using data collected as part of a long-term skin cancer control programme in Stockholm, Sweden, Boldeman and colleagues have examined in this issue the tanning habits of this population. A random sample of 6000 adolescents (aged 13-19 years) and 4000 adults (aged 20-50 years) were selected and mailed a questionnaire asking about their outdoor tanning habits at home and abroad, sun-bed use and experience of ultraviolet (UV)-induced erythema (burn). As might be intuitively predicted, younger women generally reported more outdoor tanning, more frequent use of the sun-bed and related burns. The non-response rate to the questionnaire was 32%. However, these non-responders were followed-up later on in the year by telephone where they were asked some of the questions from the questionnaire. The results for the non-responders did not differ greatly from the responders with the exception of a significantly reduced number of males using sun-beds in the non-responders group. Overall, 14% of the study group reported sunburn every year as a result of outdoor tanning. This suggests, as advocated by the authors, that initiatives need to be taken to promote sun awareness.

Study of the mechanism of action of ⁸⁹SrCl₂ in pain palliation

⁸⁹SrCl₂ is a radiotherapeutic agent that is commonly used for the palliative treatment of painful osseous metastases. However, its mechanism of action is unknown. In this issue, Davis and Pither have studied both the direct radiotoxic effects of the agent in the human prostate adenocarcinoma cell line, PC3, and its biosynthetic activity in murine pre-osteoblast MC3T3-E1 cells. Their results showed that tumour radiotoxicity is probably not the sole mechanism for the pain-relieving effects of ⁸⁹SrCl₂. Interestingly, the levels of Prostaglandin E₂ (PGE₂) were increased within 2h of exposure in a concentration-dependent manner, while no increase was observed following treatment with X-rays. Interleukin-6 (IL-6) was also produced by a PGE₂-mediated pathway as this production of IL-6 was inhibited by indomethacin, a cyclo-oxygenase inhibitor. Both PGE₂ and IL-6 have significant roles in bone biology. The authors concluded that 'the mechanism of pain palliation by ⁸⁹SrCl₂ is likely to result from a complex interaction of direct and indirect radiation-induced effects'.

Oral clodronate significantly reduces chemotherapy-induced bone loss in primary breast cancer patients

Although adjuvant chemotherapy significantly improves the survival of pre-menopausal breast cancer patients, the majority of these patients experience ovarian failure and rapid bone loss often resulting in the development of osteoporosis. In this issue, Vehmanen and colleagues have studied the effects of oral clodronate treatment (1600mg daily for 3 years) in primary breast cancer patients who had been treated with adjuvant cyclophosphamide, methotrexate and 5-fluorouracil (CMF) chemotherapy. In 73 pre-menopausal patients the bone loss rates at 3 and 5 years were compared between the groups that were still menstruating and those that became amenorrhoeic during the study (74% of the women). Their results showed that the changes in bone mineral density (BMD) significantly correlated with the menstruation status, with bone loss being significantly less marked in the group of women that continued to menstruate. The 3-year treatment with clodronate also resulted in significantly less bone loss when compared with the control group that did not receive clodronate and this significant difference was still observed at 5 years, 2 years after the termination of clodronate treatment.

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