In Our Own Backyard

English: Statue of a dragon guarding one of th...

Image via Wikipedia

This New Year’s Day brings us into the Year of the Dragon, and marks my second-year anniversary from the end of chemotherapy.  One more year and my risk of recurrence drops considerably.  But while I think of my great good fortune, in the past month, I have learned of four friends or acquaintances who are now facing a cancer diagnosis for the first time, a somber and increasingly common experience.

In my last post, I summarized global cancer statistics and trends. This time, I’m considering my own proverbial back yard.  The data you see here relate to cancer in the United States and come from Cancer Facts & Figures 2011, published by the American Cancer Society (ACS).

According to the authors of this booklet, “[t]wo major classes of factors influence the incidence of cancer: hereditary factors and acquired (environmental) factors… Environmental (as opposed to hereditary) factors account for an estimated 75%-80% of cancer cases and deaths in the US.”  This percentage breaks down as follows:

  •  Exposure to carcinogens in occupational, community and other settings – 6%
  • Tobacco smoking – 30%
  • Poor nutrition, lack of physical activity, and obesity – 35%

Add up these numbers (71%) and you’ll see that the specific environmental causes of a good number of cases are still unexplained.  (BPA? Pesticides? All those chemicals we ingest or pour into our water sources every year?)

The booklet goes on to note that “even a small percentage of cancers can represent many deaths: 6%…corresponds to approximately 34,320 deaths.”  And “the burden of exposure to occupational and environmental carcinogens is borne disproportionately by lower-income workers and communities, contributing to disparities in the cancer burden across the population.”  The ACS figures that, if racial and economic disparities in the United States were eliminated, there would be 37% fewer deaths from cancer, leading the agency to conclude that poverty is a carcinogen.

Elsewhere in the book, the authors note that “questions remain about the role of exposures to certain classes of chemicals (such as hormonally active agents) during critical periods of human development.” Answers to these questions might eventually explain why birth control pills have not been conclusively tied to cancer but hormone-replacement therapy after menopause has.

Here are some interesting data on the most prevalent cancers – lung, prostate, and breast:

Lung cancer alone is responsible for 27% of all cancer deaths, and is the number 1 cause of cancer deaths for both men and women. The ACS notes that, “[s]ince 1987, more women have died each year from lung cancer than from breast cancer.” And yet, we don’t see nearly the same amount of energy put toward races to cure lung cancer as we do for breast cancer. (See more about this disparity here).

This is just one of many examples of how data about health and disease is skewed by marketing forces. Breasts and the color pink are palatable (though honestly, I’m tired of women being defined by their breasts for any reason and pink being chosen as the color to represent women). Apparently, lungs and their color – pearl – are not so sexy.  Yes, more women are diagnosed with breast cancer, but more die of lung cancer.

Prostate cancer is the second leading cause of cancer deaths in men. Anticipated new cases for 2011 total 240,890, with 33,720 deaths. African-American men and Jamaican men of African descent have the highest rates of prostate cancer in the world, and the disease is more prevalent in North America and northwestern Europe, less so in South America and Asia.

Breast cancer is the second leading cause of cancer deaths in women. For 2011, the ACS estimates 230,480 new cases of invasive breast cancer among women, 2140 in men. This number does NOT include the type referred to as DCIS, which is not usually invasive, and has been referred to as the “good” breast cancer.

Notice the statistics:  In 2011, more men will have been diagnosed with prostate cancer than women with breast cancer, but fewer men die of prostate cancer.

The list of risk factors for breast cancer contains the usual suspects (obesity, physical inactivity, and alcohol, which acts like an estrogen in the body).  But I see that the ACS is finally listing dense breast tissue as a risk factor along with high bone mineral density and a breast irregularity called hyperplasia (especially atypical hyperplasia).  They also note that there is some evidence that women who work night shifts seem to have an increased risk of breast cancer.

But as always with breast, and perhaps other cancers, there is a caveat.  These factors relate primarily to the hormone-driven breast cancers (ER+, PR+ Her/2-, or any combination of these).  Those of us dealing with the triple-negative type might have an entirely different set of risk factors that has not yet been determined.  I’ve seen preliminary reports that a too-low body mass index and having had children at all are risks for triple-negative disease.

By state, the incidence of breast cancer pretty much follows the trend of national totals for all types of cancer, with California and Florida at the top of the list, followed by New York and Texas. Here in Washington, the projected number of new cases of breast cancer for 2011 is 5,630. In my native Ohio, it’s 8,970.  The number of deaths from breast cancer are also similar, led by California and Florida, then Texas and New York.  In Washington, that number is 800; in Ohio, it’s 1730.

In the flurry of all these numbers, don’t get confused.  The numbers by state may reflect only that one state has a higher population than another, not that there are necessarily more risks tied to location. The number of new cases for each state is pretty high, but the number of deaths is significantly lower, which only means there are many, many survivors of breast cancer out there.

Certainly we know by now how bad smoking can be for us, but here are some interesting details about the exposure to second-hand smoke: “Each year, about 3,400 nonsmoking adults die of lung cancer as  a result of breathing SHS [secondhand smoke]” and “SHS causes an estimated 46,000 deaths from heart disease in people who are not current smokers.”  Perhaps this is because SHS contains about 7,000 chemicals, “at least 69 of which cause cancer.”

In my home state of Ohio, the overall estimated number of new cancer cases for 2011 is 65,060.  In my adopted state of Washington, that number is 35, 360.  Quite a difference, but some of that has to do with population (Ohio has about 11,542,645 residents while Washington has 6,664,195).  The state with the highest overall estimate is California (with 163,480 estimated new cases), followed by Florida (113,400) and Texas (105,000).  Wyoming has the smallest number (2,680).

There is much more information and data in the ACS booklet, so much as to be overwhelming.  To make better sense of the numbers, here’s a wider perspective:

  • Heart disease is still the most common cause of death in the United States, with cancer second.  Cancer has killed about 499,564 people so far this year, but heart disease has killed 593,819.
  •  About 1500 people die of cancer each day, compared to about 2200 for heart disease.
  • As of January 2007, the estimated number of cancer survivors in the United States is 11.7 million, which means about 4% of the population has had the cancer experience.

According to the Stand Up to Cancer organization, 1 out of every 3 women and 1 out of every 2 men are at risk of developing cancer in their lifetime.  I guess I’m one of those who is “experienced.” Now, I’m looking to that dragon to protect me.

Put Down that Cell Phone

Various cell phones displayed at a shop.

Image via Wikipedia

Put down that cell phone, lest you end up with a brain tumor.

So says the International Agency for Research on Cancer (IARC), an agency within the World Health Organization (WHO), which just published a report that cell phones are a “possible” carcinogen. The 31 international scientists involved in this research have concluded that excessive use of cell phones may increase your risk of two types of brain tumors:  gliomas, which are malignant, and acoustic neuromas, which are not.  (Malignant or not, a brain tumor is something you’d rather not have.)

This news, of course, made headlines in newspapers and on broadcasts around the world. After all, the IARC estimates that there are 5 billion cell phones in use globally, and many of us are implicated in that number.  According to the Huffington Post, the declaration about cell phones puts these devices in the same category as coffee, pickled vegetables and talcum powder, all of which are designated “possible” carcinogens.

Just to clarify, the WHO designates three levels when researching substances related to cancer:  possible, probable, and known.  Like coffee and those pickles, cell phones possibly cause cancer, while chemicals used by hairdressers and barbers probably do, and alcohol, tanning beds, and hormone replacement therapy are definitely known to cause cancer.

So what are we to make of the pronouncement about cell phones?

If the conclusion is so indefinite, did the news really deserve the headlines it garnered?

As with much of the news related to cancer, breast or otherwise, the answer is complex.  Maybe cell phones do cause cancer, maybe they don’t. To solve the complexity, there needs to be more research and studies of longer term. Until such studies are concluded, the truth is anyone’s guess, and the volumes of discussion that have taken place just since the announcement a week ago point out the difficulty in coming to any easy conclusions.

Given the numbers of substances and factors that might lead to cancer, perhaps the best we can do is pick which evils to avoid.  Giving up cigarettes seems obvious, and maybe you can forego your morning cup of joe. But even picking among the evils is hard when you consider that Tamoxifen — the prominent drug taken by women with estrogen-positive breast cancer to prevent recurrence — is also a known carcinogen. And one of the risk factors for breast cancer that has not yet been widely recognized is dense breast tissue, which is not something you can choose to avoid.

More complexity.

More confusion.

What’s an enlightened person to do?

The best I can manage is to keep my eye on the research that addresses my specific variety of cancer and cancer research in general to follow the studies and see their results (more on that in the next post).

In the meantime, I’ll step away from the cell phone.

Puzzle Pieces

I just caught the opening of the Seattle Seahawks/Chicago Bears playoff football game. I’ve lived near or in both cities, but I’m only one of those fair-weather fans. Out here, we’re all stunned that the Hawks have gotten as far as they have this year. But after I saw the Bud Light ad, with the guys partying in the oil change shop, I figured I’d be better off writing.

This is a column of updates and more pieces to add to the triple-negative breast cancer puzzle.

First, the personal updates:

I had my last 3-month check-up back in November and everything seems to be fine. That abdominal pain I was having turned out to be – besides another trip on the worry train – just a bladder infection. The naturopath has again tweaked the supplements (add vitamin B, drop the CoQ10). At my appointment with him, we discussed our preferences for martini recipes. He prefers gin with a twist AND an olive. Rumor has it that he’s also been known to eat a Pop Tart on occasion. It’s good to know he’s human.

The chemotherapy port was removed before Christmas, and it’s nice not to have that lump on my chest anymore, even if I had to give up a day of skiing to recover properly. The sacrifice let me finish grading essays for my classes, and I am back to teaching again as of this week. We celebrated my daughter’s 14th birthday, Christmas, and New Year’s, and I managed to trigger a mistrial during jury duty in November, all because of some M&Ms. (More on that story later on my other blog, Firefly.)

Here are the news updates from the Breast Cancer Symposium in San Antonio in December:

  • PARP inhibitors still seem promising in treating patients with metastatic triple-negative disease, and there’s more and more evidence that hormone replacement therapy is tied to the development of breast cancer.
  • Obesity negatively affects survival for those with hormone positive tumors, but not for hormone-negative. (Guess I can start gaining weight now.)
  • In the past 10 years, cases of triple-negative disease have almost doubled in women in Brazil while cases of hormone-positive cancer have decreased, though no one knows why.
  • The FDA has pulled the plug on the use of Avastin – a chemotherapy drug – for breast cancer patients, but Avastin shows greater promise in those with triple negative disease. Avastin is also used in patients with other types of cancer.

 

And now the puzzle pieces.

A recent article in the New England Journal of Medicine charted the overlap between triple-negative, basal and BRCA-1 breast cancers. The authors found that triple-negative tumors can also be basal, but aren’t always. They are also often associated with the genetic defect of BRCA-1, but not always. BRCA-1 (often pronounced Brack-ah 1) is the more serious of the two types of genetic defects found in breast cancer (the other being BRCA-2), and can be implicated in ovarian cancer as well. This article got me wondering whether to look into genetic testing for my situation.

As I mentioned many posts ago, I don’t have much of a family history of breast cancer. (Despite what the media lead you to believe, it’s only about 15% of women who do have that family history.)  It appeared only in my maternal grandmother – somewhere back around 1970, long after she went into menopause.  Like most women at that time, she had a total mastectomy and doctors didn’t know anything about hormone receptivity.  She did not have chemotherapy or radiation and lived another dozen years till her death at the age of 85. This illness has not shown up in any of my close relatives. Given that I come from a Catholic family, there’s a lot of relatives (8 aunts/uncles and about 35 first cousins). The recent research shows, though, that it’s not just a pattern of breast cancer that gives away the genetic problem, but a pattern of prostate cancer too.

A misconception is that breast cancer passes through the mother’s side of a family, but this article from Parade magazine shows that the genetic defect often passes through the male line, showing up as either breast cancer (1970 new cases a year) or prostate cancer. A friend of mine followed her instincts when she received her diagnosis at the age of 41. The docs told her there didn’t seem to be a genetic component, but once she investigated she discovered that her paternal grandfather had died of prostate cancer in his 50s. Not only did the gene pass through the male line to her, but it skipped a generation too.

As screening methods evolve – not just for cancer but any serious health issue — it becomes increasingly important to have as full a picture of your family history as possible. There are a number of online tools you can use to chart that history, like this one from the Surgeon General of the U.S.

And finally, there’s the puzzle of light:

An interview in January’s issue of The Sun magazine spotlights Andrew Weil, M.D. Those of you familiar with his work know that he embraces alternative methods of healing and is based at the University of Arizona. In the interview, he comments on the influence of light on cancer: “One detrimental influence on our sleep is our ability to light up the night, which is a significant change in our environment over the past hundred years. There’s a body of literature suggesting that exposure to light at night, even briefly, greatly increases cancer risk, especially risk of breast cancer in women. Women who are blind from birth have very low rates of breast cancer. Women who work night shifts have high rates of breast cancer.” He recommends that, if you need light during the night, use a red Christmas tree bulb, since light at the red end of the spectrum is safest.

If you’re one of those who hasn’t yet put away the Christmas lights, here’s your excuse.

 

 

Life Amid the Treatment

I”m a bit late getting this out. Goodness, December already.  Feels like it outside today, and the mountain is obscured by clouds. Lots of snow up there and the ski resorts opened early this year.

Teapot dropped by for a quick lunch just now, and the Jehovah’s Witness found his way to my door this morning to leave me his message and a couple of Watchtowers to read. I’m slurping down some homemade vegetable soup a gracious neighbor brought, trying to be conscious of eating healthful things, though I must confess I snarfed down some potato chips a couple days ago (salt and vinegar). Good thing I don’t work at the Cleveland Clinic.  An article in the current Newsweek notes that the CEO has banned potato chips from the vending machines there, and he actually refuses to hire people who smoke. At least he’ll keep employees from freezing to death on smoke breaks during those cold Cleveland winters.

The Popsicle Report:  I felt like branching out.  Same brand, different flavor: strawberry lemon.  Pretty darn tasty.

On the iPod, in addition to the regulars, was Cecilia Bartoli singing Bizet songs in her nimble, gorgeous voice; Moby, who’s nimble in a different way; Charlie Barnet and some big band music; Trout Fishing in America, a classically trained duo now playing family music; and Gato Barbieri, an Argentinian tenor saxophone player of free jazz, who had a Muppet fashioned after him.

Speaking of Muppets, they do a grand interpretation of Queen’s Bohemian Rhapsody here: http://www.youtube.com/watch?v=yVB4kUK6UY8

Beelzebub has a muppet set aside for me.

Infusion #20 down (#8 of the Taxol), 4 more to go. White cell count is above normal at 15, meaning I can probably skip that Neupogen shot this week. The red cells are still quite low at 8.7, but increased from the 8.4 of last week, so the B vitamins must be doing their work. No sign of neuropathy or any new problems beyond what I’ve had so far. My fingernails have more spots, but I haven’t lost any, something the naturopath warned me could happen. I just have to keep on keepin’ on, trying to finish the chemo part of the treatment by the end of the year.  After the New Year comes 6 weeks of radiation, but I’m not able to wrap my brain around what that entails just yet.

The infusion center was quite lively this week.  I was anchored to the Barcalounger in the far back corner. Not much of a view out the window, but a direct line of sight to the large stainless steel box that warms the blankets they put over patients, and the tall stack of colorful fleece blankets someone had donated for the season. In the opposite corner of the room, a man reclined in his chair while talking with the Cancer Society reps. about what it would be like to go up to Seattle for a stem cell transplant, as he would be doing soon. The male rep. described his harrowing experience of several years ago, about how they used the chemotherapy to wipe out his immune system so they could do the transplant, how he was in the hospital for 3 months.  But there he stood, if not hearty, well very much alive, and I was again reminded of how much more some of these patients have had to experience than I have.  President Nixon signed the National Cancer Act into law back in 1971.  Thirty-eight years later, cancer is still with us, but there are numerous veterans of the war still here too.

Next to the man preparing for the stem cell transplant sat an elderly woman hunkered down in her wheelchair, getting ready for her 5-hour session, peering out at the room through large glasses that over-magnified her eyes.  She seemed frail, needing help to go to the bathroom, but she was definitely of strong mind. When another man joined her pod, she asked the nurse if she could be moved elsewhere because her area was too full of men.  I told the nurse that the lady, Jean, could come sit near me, but she had to keep her assigned place since all chairs in my pod were already reserved. The best the nurse could manage was to turn Jean so she could see over into my pod.

As I was waiting for my blood count to come back, a tall thin man with gray hair took a seat in one of the chairs opposite me. He wore a black baseball cap stitched with gold letters spelling out US Army, a dark T-shirt, and jeans. With him came his wife, a small stout woman neatly dressed in subtle shades of brown and cream. As soon as he entered the pod, the man began to joke loudly with the nurse who takes vital signs, saying he didn’t like her new hair color and she ought to change it back from brown to blonde. And so began a conversation about hair (he’d lost his too in the previous 3 years he’d been coming to the center), during which I noticed the man was missing his top front teeth. I asked the man if he knew how much time and money it took for a woman to be a blonde. Indicating himself, he responded, “Well we pay for it, so we should be able to say what color it is!”  His wife sat beside him smiling serenely. Her hair was strawberry blonde.  When he got up to leave after his blood draw, he gently took his wife’s hand as they moved out into the passageway.

A little while later, Jean’s granddaughter came to sit with her during the infusion. They talked awhile about the confusion of Jean’s transportation that morning (a van had come to pick her up before the granddaughter was scheduled to do so), and then the granddaughter pulled out the Trivial Pursuit game sitting on the shelf nearby.  As she started to read questions from the cards, the men in the pod perked up and began answering, and I chimed in with a few answers as well. (Quick now, the City of Light is ______.  And what was the fate of the three blind mice?).  Jean perked up considerably during the game and fell into conversation with the men about movies they had seen, and a new book that had come out. Maybe she decided men weren’t so bad if they knew answers to trivial questions.

So you see, life goes on even in the midst of serious illness.  And illness incorporates itself into everyday life.  Those of you dealing with chronic illness know this more than I.  Doing a weekly update about my health might indicate that cancer has taken over my life. As a matter of fact, when my internist called back in June to check in with me, she said, “Managing this disease will be a full time job.” (This was one of many times in life my brain consciously refused to believe the words I’d just heard.) It seemed that way at first with the appointments, the surgery, and even now it takes more time to deal with than I like.

But just how much of your life should any chronic illness — or any other life issue — take up?  Initially there are the cycles of grief, loss, anger, bargaining and numbness that you need to go through, and that recur even years later.  Yes, I’m spending a  lot of time reading and thinking about cancer in general and breast cancer specifically. This week, I’m puzzling over the news of a woman winning her lawsuit against the manufacturer of Prempro, that one-time popular hormone replacement therapy. She ended up with breast cancer and the jury has awarded her 3.5 million dollars. And I wonder: what’s the difference between hormone replacement therapy, which is now implicated as a cause of breast cancer, and birth control pills, which don’t appear on the lists of risk factors for getting the illness.

This disease caught me by surprise, sneaking up on me without warning while I was planning for heart disease, osteoporosis, hypertension, or any of those other illnesses that show up in my family tree. But every morning there are the two runs to the bus stop for the kids, managing appointments, mail, and phone calls (even scheduling the plumber and talking with the piano teacher during the infusion session), meals and dishes, cleaning out gutters, supervising newspaper students, preparing for my daughter’s birthday, planning holiday events. The illness has obviously made time for me, but I don’t have time for it. (Oh, go ahead, quote John Lennon if you must.)

But while we’re on the subject of time and seasons —

While putting away our Thanksgiving decorations this week, my son and I were taking down the garlands of shiny fall leaves we’d wrapped around the stair banisters.  The garlands are old and the leaves sparse, and as we worked more leaves fell off, leaving mostly a long shiny string bereft of foliage. I commented to him that maybe we should just get rid of the garlands, since they are so bald now.

He responded, “Not as bald as you, mom!”

Nothing like a 9-year-old to keep things real.

Here’s an inventive musical interpretation to start your Christmas season right:
http://www.metacafe.com/watch/2825215/glass_harp_dance_of_the_sugar_plum_fairy_tchaikovsky/

The Politics of Cancer Drugs

Another gorgeous day with The Mountain. We’re having a lucky string of beautiful days, but it can’t be Indian summer yet (she says, fingers crossed) because we haven’t had a frost.

The happy drugs are still at work, so I feel good and managed to do this morning ALL those dastardly exercises I’m supposed to be doing every day.  I’ve been frustrated at the slow progress of regaining full arm motion and getting rid of residual numbness and pain. The surgery was back in mid-June, after all. But the physical therapist says chemotherapy slows everything down, so she thinks I’m doing fine.

The Popsicle Report:  Doesn’t matter what shade it is — light, medium or dark — green is a yucky flavor.

I passed the halfway point of chemo yesterday (yeah!) with the last infusion of the Adriamycin, and will finish off the Cytoxan this week. White cells are at 3.8, a little low, but still manageable for continuing treatment.  I should be getting a flu shot, but would like to wait till the white cells are back up into normal range.

My next lesson in chemistry comes with the drug I switch to next week — Taxol.  This drug was developed beginning in the 1960s from the bark of the Pacific yew tree (a more appealing source than the red dirt Adriamycin came from!). The original tree, Taxus brevifolia, was found in a forest north of the town of Packwood, out here in Washington, so it seems I’m in the neighborhood of its origin. But there were delays along the research road, which included fights, even in Congress, over who had fair claim to it and its trademarked name, and ecological concerns about the destruction of the trees for the sake of collecting the bark. So the drug only came into use in the late 1980s. Fortunately, alternate sources for Taxol have been developed, so the Pacific yew tree is safe once more.  Taxol is also used to treat lung, ovarian, and head/neck cancer.

The messy details of the drug’s development give some credence to the claim by pharmaceutical companies that drugs are expensive to research and produce (thus justifying their high costs), but it’s sad to see how politics and greed get in the way of important drugs reaching patients.  On the other hand, there’s the problem of drugs being released before there is sufficient follow-up data to be sure they’re safe. A recent example are the reports that are starting to surface about the Gardasil vaccine for the HPV virus. This one doesn’t affect me directly, but my daughter falls into the age group it’s being recommended for.

As with Adriamycin and Cytoxan, Taxol goes after rapidly dividing cells, so again there are the side effects of hair loss and mouth sores, along with the added possibility of neuropathy (tingling, burning and other nerve problems) in fingers and toes. The infusion will take about an hour, longer than what I’ve been having, but I don’t know if that time includes a Popsicle. There are other side effects, some of which are related not to the drug but to the solution the drug is suspended in for infusion. So along with my happy drug, dexamethasone, I’ll also have to take some Benadryl and Zantac before the infusion to prevent an allergic reaction. The nurse said she’d need to sit with me for the first 15 to 20 minutes of the first infusion to monitor for any reaction. Apparently, if it’s going to happen, it happens the first time, but not after that.  (Gee, nothing like a little heightened anxiety for making the switch.)  But she also said that, compared to the drugs I’m on now, Taxol is “a walk in the park.” Makes you wonder what kind of parks these nurses walk in.

As cancer-treating drugs go, Taxol does seem a bit safer than Adriamycin and Cytoxan, which both show up as known or probable carcinogens on the list put out by the American Cancer Society. If you want to see what else is on the list, you can find it at:  http://www.cancer.org/docroot/PED/content/PED_1_3x_Known_and_Probable_Carcinogens.asp

You’ll recognize some of the standard elements we’ve heard about: asbestos, formaldehyde, radium, and mustard gas.  But there are some surprising items listed too: betel nut, Chinese-style salted fish.  And chimney sweeps and furniture manufacturers beware — your whole profession can induce cancer.

Other cancer-fighting treatments show up on the list as well.  Tamoxifen, widely used in treating certain types of breast cancer (but not mine) is there, as is arsenic, which the infusion nurse tells me is used in minute amounts for a certain type of leukemia.  People undergoing that treatment get a small dose every day (including weekends) over the course of a year.  This idea of using cancer-inducing substances to treat cancer is a bit like the “hair of the dog” cure for a hangover. “Here, take some of what can make you sick. You’ll feel better!”  (By the way, alcohol consumption shows up on the carcinogen list too.)

Two other items that show up on the list are birth control pills and hormone replacement therapy (HRT), estrogen being the culprit behind both. If you look at lists of risk factors for breast cancer published for the general public (for example: http://www.mayoclinic.com/health/breast-cancer/DS00328/DSECTION=risk-factors), you’ll see HRT there. But the use of birth control pills is conspicuously absent from that list. So here is yet another gray area in the world of medicine and science with respect to cancer. What do we really know about the causes (because all of us with this diagnosis rack our brains trying to figure out how we got it) and why is there so much conflicting information about it?

The harder you look, the more elusive the answers.

So I comfort myself by looking at the surprising connections arising from my situation.  During a bout of warm sunny weather a few weeks back, I was basking out on the deck, head uncovered, taking care of paperwork, phone calls, etc. The hummingbirds had no interest in me this time, but the next morning I noticed my scalp was pink.  A bit of a sunburn there.  As I was describing the situation to my dad on the phone later that day, he said “Yeah, that happens to me every year.”  And in a different phone conversation, my brother admitted that he has the same problem, adding “just wait till it starts to peel.”

Never thought I’d be commiserating with my male relatives about a sunburned head.