(RxWiki News) A new discovery could change the way doctors treat patients at high risk for skin cancer.
A new study from the University of Sydney in Australia found that one year of treatment with a vitamin B-3 derivative called nicotinamide may significantly lower the risk of non-melanoma skin cancer in high-risk patients.
Due to the over-the-counter availability and low cost of nicotinamide, this finding has the potential to decrease the heavy health and economic burden of skin cancer, according to the authors of this study.
"This is the first clear evidence that we can reduce skin cancers using a simple vitamin, together with sensible sun protection," said senior study author Diona Damian, PhD, a professor of dermatology at the University of Sydney and Royal Prince Alfred Hospital, in a press release. "We hope that these findings can be immediately translated into clinical practice. However, people at high risk of skin cancer still need to practice sun safe behavior, use sunscreens and have regular check-ups with their doctor."
Victoria Sharon, MD, DTMH, director of dermatology inpatient consultation service and assistant professor of dermatology and dermatologic surgery at the University of California, Davis Medical Center, warned against using these findings as a reason not to adhere to sun-safe practices.
"Although this [study] suggests a potential role of nicotinamide for a small reduction in the development of certain types of non-melanoma skin cancers, it does not demonstrate a reduction in one of the most deadly forms of skin cancer, melanoma," Dr. Sharon told RxWiki News. "Therefore, nicotinamide is not a substitute for diligent sun protective behavior, including the use of sun-protective clothing and sunscreen."
The primary cause of non-melanoma skin cancer is ultraviolet (UV) exposure from the sun's rays.
The most common types of of non-melanoma skin cancer are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Typically, these cancers can be treated with a relatively simple surgery. If the cancer is very small, medicated creams prescribed by a doctor, cauterization (burning), cryosurgery (freezing) or laser surgery may be used.
In some cases, SCCs can spread to the lymph nodes or internal organs. BCCs rarely spread, but these cancers can cause cosmetic problems, as they often occur on the face.
For this study, Dr. Damian and team looked at 386 patients with a history of skin cancer (at least two non-melanoma skin cancers in the last five years). These patients were 66 years old on average.
Taken as a twice-daily pill for 12 months, nicotinamide was tied to a 23 percent lower risk of new non-melanoma skin cancers when compared to placebo. Nicotinamide similarly appeared to lower the risk of precancerous sun spots by about 15 percent.
Nicotinamide was also well-tolerated among patients, with no difference in adverse events, blood results or blood pressure found.
According to Dr. Damian and team, the reason behind nicotinamide's protective effects may be that the vitamin enhances the repair of DNA in damaged skin cells. Nicotinamide may also protect the skin's immune system from UV radiation by providing skin cells with an extra energy boost when they are in "repair-mode" after sun exposure.
Dr. Damian and team noted that this study was not designed to test whether nicotinamide may benefit patients without a history of skin cancer, or whether it may lower the risk of melanoma (an aggressive type of skin cancer).
While these researchers said they plan to investigate these questions in the future, there is currently no evidence that nicotinamide may lower skin cancer risk in these settings.
This study was published Oct. 21 in the New England Journal of Medicine.
The National Health and Medical Research Council of Australia funded this research. No conflicts of interest were disclosed.
