Sleep Apnea Predicts Skin Cancer Aggressiveness

You probably wouldn’t think about skin cancer being possibly related to obstructive sleep apnea, but here’s an interesting study that found that the aggressiveness of melanoma is related to the severity of obstructive sleep apnea. What was more surprising was that 60% of these patients with melanoma had obstructive sleep apnea, with 14% having severe levels. 

There have been numerous studies in recent years showing higher rates of cancer from untreated obstructive sleep apnea or even sleep deprivation. Mice subjected to low oxygen concentrations were found to enhance tumor growth.

If you look at stress physiology research, any chronic, long-term sleep problems or repeated apneas can cause low oxygen levels in general. When you’re under stress, certain organs and systems need to shut down. These are called the end-organs, which most often describe the bowels, the reproductive system, hands and feet, and your skin. These areas are not needed if you happen to be running from a lion or in a fight. With less blood flow and nervous system innervation, low oxygen levels can promote cancer, especially if you are already geneticaly susceptible. The real test will occur if you can study patients with melanoma and sleep apnea, and see if treating with CPAP helps to lower aggressiveness or recurrence rates.

How man of you with obstructive sleep apnea also have a skin cancer diagnosis?

Please note: I reserve the right to delete comments that are offensive or off-topic.

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8 thoughts on “Sleep Apnea Predicts Skin Cancer Aggressiveness

  1. I’ve had mult-germ cell testicular cancer, pre-cancerous polyps in rectum and colon. Just went to dermatologist last week with small black spot under toenail! Follow up appointments to come.

  2. All that you say about the stress physiology is true and undoubtedly is a large part of why so much cancer is involved.

    But the first thought that came to mind for me is how much improvement I have seen in my skin since I have started to work toward obtaining a healthy microbiome in and out of my body.

    I think it is likely that sleep apnea originates, in part, from a mistreated microbiome.

    I believe we are very hard on our own microbiome. We eat processed foods whose preservatives are designed to frustrate the growth of microbial bodies. We eat food whose microbial content is changed by the use of chemicals in it’s production, harvest, and storage. We take many pharmaceuticals whose affect on our gut microbiome is untested and therefore unknown. We consume meat where the animals are fed food not native to them (so will form a different microbial base in them) who live and walk on their own excrement and then are kept “healthy” by the chronic use of antibiotics. With the use of antibiotics on our bodies and in our homes we complete the transformation of our own microbiome leading, perhaps, to such things as “leaky gut syndrome” and likely many many other diseases and which frustrate our development and ongoing health also by limiting our internal genetic operational base.

    One of the likely effects of an unhealthy microbiome is chronic inflammation. The connection to Obstructive Sleep Apnea is obivous.

    We cannot do well without the help of our trillions of little friends. I hope we learn how to treat them well and live with them well. The “kill them all” approach produces super bugs and frustrates our own health. We have a lot to learn.

  3. As a add to my first comment, I’ve been a pro-active medically and compliant. The TC was self-discovery pre-dx OSA in early stage, but aggressive vascular invasion. I believe my treatment and recovery were dampened by OSA. The colonoscopy and endoscopy were self pro-active after dx of OSA (prior to age 50) spurred by knowledge of OSA associated risks and GERD/LPRD. I strongly suggest pre-screening Cancer with Severe OSA dx. I also strongly suggest Insurance companies be more pro-active in allowing early age higher risk pre-screening coverage. I had to fudge the symptoms i.e. coding a little to get exams younger than 50, but I saved ins. tons of money and grief by removing polyps and not fighting stage whatever cancer.

  4. Tod;
    OSA is caused by a narrow upper airway, which is relatively present in all humans. the only other animals known to have OSA are flat faced dogs. OSA has been shown to cause elevations in TNFalpha and other inflammatory problems. TNF alpha has been shown to disrupt the cell-cell barrier.

    I think it quite likely that OSA causes leaky gut, as well as disaccharidase deficiencies through damage to the enterocytes, both of which will disturb digestion and the microbiome.

    sure inflammation in general may affect the caliber of the upper airway, but if it wasn’t so narrow in the first place, I doubt that OSA would result. it is more likely that the inflammation in the airway is primarily caused by OSA itself, creating a vicious cycle.

  5. Dr. Deb

    Our current western research models are based upon making one or two changes and looking at one or two outputs (results). Microbiome is much more complicated than what our current research methodologies can handle. Our science must grow greatly to see what is really going on.

    I believe that a lack of genetic activation is most likely responsible for the narrow airways involved in the genesis of OSA. I think the most likely causes of this lack of activation are our inactive lifestyles, our unhealthy microbiome, and pollution in our environments.

    As I have studied and worked against OSA I have come to believe that OSA has as part of its base changes in our brain chemestry and function. These in turn affect our ventilatory, sensory, and muscle activations and are likely part of the cause of OSA.

    Our gut, working with our microbiome contents, are where many of the key components of our brain chemistry come from.

    I would love to hear about any research that you have come across that deals specifically with the genesis of OSA.

    Thanks!

    Tod

  6. Tod;
    read this paper:
    http://www.ncbi.nlm.nih.gov/pubmed/14592320
    yes there are a lot of brain chemistry and body chemistry/hormonal changes in OSA, but I believe they are all downstream from the anatomical problem. I do think that epigenetic factors have made the jaw problem worse, and that environmental factors as well as OSA during pregnancy contribute to this. it is a downward spiral that I fear we cannot stop.
    Deb

  7. Hi again Deb,

    Deb said: “ Tod;
    read this paper:
    http://www.ncbi.nlm.nih.gov/pubmed/14592320

    Just as our western research culture looks at one or two inputs (changes) and then looks at one or two outputs (results) I think there is a tendency to get caught up into looking at one thing as being the cause of a result.

    But I believe that the truth is that there are many things contribute to a given result.

    We do come into this world with a basic structure. The question is what will we do with the basics we are given!!

    Deb also said: “ yes there are a lot of brain chemistry and body chemistry/hormonal changes in OSA, but I believe they are all downstream from the anatomical problem. “

    So you are saying that OSA is all due to genetic disposition?

    I would recommend that you spend some quality time looking at bodybuilders. They have the same genetic disposition as the rest of us but seem to be able to, in major and very noticeable ways, modify their structure. Count the receded chins if you can!

    Then spend some quality time looking at obesity and time lines along with changes in transportation and our food production methods during those times. Apparently moving less coupled with chemical, genetic, and microbial changes in our food supply tend to make big changes in us!!

    Deb also said: “ I do think that epigenetic factors have made the jaw problem worse, “

    I agree with you.

    Deb also said: “ and that environmental factors as well as OSA during pregnancy contribute to this. “

    So we actually agree and differ only in emphasis.

    I do think that pregnancy should be a time that we monitor for OSA very very much more closely!

    Deb also said: “ it is a downward spiral that I fear we cannot stop.
    Deb “

    I think that the reason that western medicine has very limited success in treating OSA is due to its tendency to treat with a single point splint based approach. One slightly understood “golden standard” against a disease that likely comes from multiple sources.

    For myself I am treating my OSA with well monitored CPAP (see explanation below) while pursuing an active lifestyle as well as healthy food high in microbial diversity. I am also looking into what eastern medicine and culture has to contribute. In spite of the fact that the big “60” is shortly looking me in the face I see better health year to year.
    I think I remember hearing William Headapohl say that he believes that if we can find the cause of OSA we can cure OSA and I tend to agree. I do not think, however, that we will ever find that cause with research that looks at so few inputs and outputs. Our tools need to expand to be able to see a much larger picture in motion to catch what is really going on.

    One way or another, we do have a very long way to go.

    Tod

    How I monitor my CPAP:

    I check my CPAP data several times a week. I use software that allows me to zoom in on my flow data and also shows minute volumes. Anymore my AHI numbers are so low that they are not what I normally spend my time looking for (they are well under an AHI of 2/h). So these days I spend my monitoring time looking for times of ventilatory instability. I look for times when the flow data chart becomes wider and more variable. Times when I am using more air and where the volume of air used varies, often widely. Periodic breathing is a real red flag. Minute volumes increased and more variable are also red flags.

    It is often useful to zoom in on the flow data around an event to help see what kind of event brought the change. This year I think I see obstruction being the cause of the ventilatory instability about a third of the time. I will probably first treat with anti-inflammatory foods and perhaps raising the head of the bed a bit further (it changed when I moved furniture in my bed room).

    Mid September seems to be a time of year for me that my breathing becomes more unstable. Indeed, it currently is (but AHI is still well under 2 – morning feel is variable and over all performance is less). I am using EERS (see: http://www.ncbi.nlm.nih.gov/pubmed/21206741 ) to help limit this and am looking into increasing my pursuit of active lifestyle, better healthy foods, and eastern helps to perhaps do better than last year. Since this seems to happen when the sun is notably less I hope to establish some good light therapy in my home this year.

  8. Occam’s razor.

    do chimpanzee’s have OSA? no.
    do cows have OSA? no. even when we pump them full of antibiotics.

    it’s anatomy.
    I hope you can find the complete PDF for that paper as it is fascinating.