As countries across the globe experience extreme weather events due to climate change, Arizona faces its own heat and sun-related challenges. To combat sun and heat exposure risks in the state, the University of Arizona has developed a skin cancer detection tool. Simultaneously, the Arizona Burn Center released their annual “Streets of Fire” report relating to contact burns.
The Arizona Department of Health Services extended its active excessive heat warning to Friday and Saturday for certain counties, with daytime highs of 119 degrees to be expected. Valleywise Health, home of the Arizona Burn Center, shared the report to highlight consequences of extreme heat during summertime.
Dr. Kevin Foster, the director of the center, said in a press conference that over the last several years, there has been an increase in the number of patients who received contact burns from hot pavement, which can reach 180 degrees on hot days.
“It started with the pandemic, and it tended to be elderly patients going down and not being able to get up, and that particular population is still a problem for us,” Foster said. “More recently, we are seeing problems with methamphetamine use—methamphetamine is contaminated with fentanyl, and that causes people who are using methamphetamines to become unconscious, and they fall down and oftentimes, there’s nobody around to help them up.”
Foster anticipates heat-related contact burns will continue to worsen as temperatures continue to rise. Individuals who are experiencing homelessness are disproportionately impacted, and make up about 30 percent of burn center patients, according to Foster.
Last year, the burn center recorded 85 admissions from heat-related burn injuries from June to August, and seven of those patients died from their injuries while others became hyperthermic, with body temperatures over 108 degrees. The burns covered anywhere from five to 23 percent of the patients’ bodies, and 33 percent of patients required intensive care—of which 70 percent required mechanical ventilation. The average patient remained hospitalized for 16 days.
“These injuries are preventable, and we encourage people to not go outside in the heat of the day. If you do have to go out, please be careful. Wear protective clothing: hats, long sleeve shirts, wear shoes certainly, and make sure people know where you’re going or take someone with you.”
— Foster
As the Arizona Burn Center focuses on educating the public about contact burns and saving lives, the University of Arizona’s Health Sciences’ Skin Cancer Institute is tackling the issue of skin cancer via their newly developed tool PRIT, which stands for Patient Registry, Imaging, and Tissue Bank. Dr. Clara Curiel, co-director of the Skin Care Institute, spoke with State of Reform about the innovative tool.
“There’s more skin cancers than all cancers combined, especially in the US. In fact, there’s five times more skin cancer than any other cancer, so it’s quite significant,” Curiel said. “It’s a significant burden. As far as the cost of skin cancer, we know that more than 98 percent is driven by exposure to sunlight—UV rays—so that is a very clear carcinogen.”
Curiel explained how the United States only has a skin cancer registry for melanoma, which makes up two to four percent of all skin cancer types. She said that the need for PRIT was formed due to the gap in the skin cancer field to develop new technology that can assist with diagnosing all skin cancer types—not strictly melanoma—in a noninvasive manner.
“In order to be able to develop technologies and push science forward, it is critical to have the basic database—all sorts of information—to build these technologies. PRIT is about combining different information all across, which is fully linked between patient data, the image of that particular lesion, and tissue corresponding to that particular lesion. Therefore, scientists and even the industry can step in and say, ‘Hey, we want to develop XYZ technology,’ which is based on a combination of these particular resources of information.”
— Curiel
Curiel said PRIT is not technology that will go into practice, but rather the resource for scientists, engineers, and the industry to build tools based upon PRIT information, which will then be available in clinics. She said in order to make it into clinics, scientists will need to use combined data and develop algorithms. Once developed tools reach clinics, Curiel said providers can more easily tell if a suspicious lesion requires a biopsy or not.
“Part of the challenge is trying to understand which was the best database that allows to host, mostly images, in a way that they could be linked with other databases,” she said, adding that the database needs to be low maintenance in terms of upkeep over the long term.
The institute spent significant time working with softwares that have interoperability between tissue data, imaging, and patient information. Curiel said the institute has begun receiving requests for accessing data and is going through the process of evaluating what projects are underway, how that data would be used, and the potential for success in order to maximize the use of the PRIT database.
Curiel said she’s excited about opening the door to the future with PRIT, and is excited to revolutionize skin cancer detection via minimally invasive and noninvasive practices. Minimizing biopsies alleviates stress and fear for patients and drives down costs for patients.
“To me, the capacity to decrease the number of unnecessary biopsies our patients go through in order to find one skin cancer, we need to do that.”
— Curiel
Until skin cancer detection tools reach clinics, Curiel recommends Arizonans avoid UV rays or seek shade when outside. She also said it’s important to cover one’s skin through hats, long sleeves, sunglasses, and sunscreen. Curiel addressed recent reports of sunscreen causing cancer, which has circulated across media this past year.
“As far as sunscreens causing cancer, the data is quite controversial. To be honest with you, this came mostly from experimental studies in mice. It has not ever been proven in humans,” she said. “As far as we know, in humans, this data is not applicable at this point in time.”