Spending time outdoors being active, enjoying nature and de-stressing is good for you. But more time in the sun means more exposure to its harmful rays, which can damage your skin. Even on overcast days, the sun’s rays can penetrate the clouds. Wearing sunscreen is one of the best ways to protect your skin and help prevent sunburn, skin cancer and premature aging.

Sunscreen is readily available, but in the last decade melanoma skin cancer cases in the U.S. have risen by 42%, according to the Skin Cancer Foundation, resulting in more than 8,000 deaths a year.

What Causes Skin Cancer?

The sun emits two types of ultraviolet rays:

• UVB rays: make up 5% of the sun’s radiation and cause burning
• UVA rays: are more harmful and penetrate deeper into your skin

Ultraviolet radiation is a “proven human carcinogen,” causing squamous cell carcinoma, basal cell carcinoma, which can develop into melanoma, according to the Skin Cancer Foundation.

Up to 95% of all ultraviolet radiation that reaches our skin is UVA rays. These rays, which can pass through glass, are equally intense throughout the year, while UVB rays become more powerful in the spring and summer, especially between the hours of 10 a.m. and 4 p.m.

UVA rays may not burn you, but they are the ones that primarily contribute to skin cancer, which is the most common type of cancer in the U.S. with more than 3.5 million people diagnosed each year. As little as 15 minutes in the sun could damage your skin, even on a cloudy day.

How Can You Protect Yourself?

Sunscreen is the tried-and-true method to protect yourself. But they’re not created equally. The Environmental Working Group (EWG) has investigated sunscreen products for 18 years and found only 25% of more than 1,700 products they’ve investigated offer broad-spectrum protection without troublesome chemical ingredients added to them.

In EWG’s 2024 Guide to Sunscreens report they found 229 products met safety and effectiveness standards. Fifty-one products met their standard for children.

To obtain the EWG’s passing grade, the product must:

• Be “green,” posing little hazard to health or the environment
• List every ingredient on the label, including nanoparticles and fragrances
• Have a sun protection factor (SPF) of 15 to 50
• Not contain ingredients restricted by the European Union and Canada as well as the U.S. Food and Drug Administration (FDA), U.S. Environmental Protection Agency, U.S. National Toxicology Program and California’s Proposition 65 list of known carcinogens and reproductive toxins

The FDA and EWG warn consumers that an SPF higher than 50 is not more effective. They also warn that people less frequently apply sunscreen with an SPF of 50+ because they think it applies more protection, when in fact it does not.

The American Academy of Dermatology recommends using water-resistant products with broad-spectrum protection and SPF of at least 30. Any sunscreen with an SPF less than 15 does not protect against skin cancer.

Ingredients to Avoid

According to a 2020 study by the FDA, oxybenzone is one of six sunscreen chemicals found in the bloodstream of volunteers at levels that exceed safety thresholds after only one day of use.

Oxybenzone was absorbed into the body at 50 to 100 times higher concentration than five other tested ingredients—avobenzone, octocrylene, homosalate, octisalate and octinoxate. Oxybenzone and another chemical, homosalate, then stayed in the bloodstream for seven to 21 days, the study found.

In May 2023, the FDA announced two ingredients—PABA and trolamine salicylate—would not be on the list of ingredients generally recognized as safe and effective.

How to Best Protect Yourself from Skin Cancer

Cooper Clinic Dermatology offers tips to keep you covered from head to toe year-round to help protect against skin cancer.

• Use a broad spectrum (UVA/UVB) sunscreen with an SPF of 30+ for best protection against the sun—be aware sunscreen products can no longer claim to be above SPF 50 because higher numbers are not proven to provide more protection.

• Apply sunscreen 365 days a year—rain or shine—because UVA/UVB rays still shine through on cloudy days.

• Use water-resistant sunscreen to help protect you when you are having fun in the pool or exercising outdoors—remember to reapply every two hours or immediately after swimming or excessive sweating.

• Sunscreen in bottles and lotions are best for our skin as opposed to sprays that may not rub in well—plus you have a better chance of using the recommended 1 oz. needed to cover your skin.

• Sunscreen that protects you from both UVA/UVB rays is best to help prevent burns and premature aging.

• Limit time in the sun, especially between the hours of 10 a.m. and 4 p.m., when the sun’s rays are most intense.

• Wear clothing to cover skin exposed to the sun, such as long-sleeved shirts, pants, sunglasses and broad-brimmed hats.

Prevention is key. Cooper Clinic recommends having a thorough, full-body skin cancer screening annually. It’s also important to do a self-check at home every month.

For more information about Cooper Clinic Dermatology’s skin cancer screening with a board-certified dermatologist or to book your screening, visit cooperclinicdermatology.com or call 972.367.6000.

When you think of bettering your health, the focus tends to be on exercising and eating nutritious food. “People forget that getting good quality sleep plays a vital role in your overall health,” says Sonya L. Merrill, MD, PhD, FACP, Sleep Medicine Physician at Cooper Clinic. “People don’t value or prioritize sleep—it’s seen as an afterthought. Sleep is the foundation on which good health is built. Diet and exercise cannot be as successful if you are exhausted.”

Having interrupted or poor-quality sleep can contribute to numerous medical conditions such as:

• High blood pressure
• Coronary artery disease
• Diabetes
• Obesity
• Impaired immune system
• Dementia

But what causes someone to have poor sleep? Dr. Merrill explains there are several reasons. “Pain can be a significant reason why someone isn’t able to sleep well, including back pain, joint pain and headaches. Urinary frequency also can wake you up multiple times throughout the night.” Environmental factors such as sleeping with the television on and sleeping with pets and children can disturb sleep. Substances such as caffeine, nicotine, alcohol and some medications are other factors.

Sleep Apnea

Undiagnosed sleep disorders such as sleep apnea can negatively impact sleep. Sleep apnea is a condition where an individual experiences repeated interruptions in air flow due to collapse of the upper airway. Symptoms include:

• Snoring
• Gasping
• Pauses in breathing or irregular breathing
• Night sweats
• Nocturia (urinary frequency at night)
• Daytime sleepiness
• Mood changes
• Forgetfulness
• Fatigue

Dr. Merrill shares, “Obstructive sleep apnea occurs because there is a decrease in muscle tone during sleep; the tongue and upper airway muscles relax, so the airway blocks partially or completely for 10 seconds or longer at a time.”  An individual’s anatomy contributes to the risk of obstructive sleep apnea. “Those who have small, crowded upper airways are more at risk, as well as people who are obese,” says Dr. Merrill.

Sleep Studies

If you struggle with symptoms of sleep apnea, the next step is to take a sleep test. At Cooper Clinic, we offer both at-home and in-lab studies.

• Home Sleep Apnea Test (HSAT): performed at home with a device that tracks your breathing while you sleep
• Polysomnography: an in-lab sleep study conducted by a sleep technologist to obtain comprehensive, accurate information about breathing as well as other aspects of sleep including sleep stages and limb movements

Dr. Merrill explains the differences and benefits of each test to help you determine the best option for you in our Considering a Sleep Study? Which One is Best for You? article.

Treating Sleep Apnea

The “gold standard” treatment for sleep apnea is continuous positive airway pressure (CPAP). A CPAP machine generates a continuous flow of pressurized air which keeps the airway from collapsing. CPAP typically reduces the number of apnea episodes by 90% or more.

Another treatment option is an oral appliance; this type of dental device moves the lower part of the jaw forward to stabilize and open the airway mechanically. A hypoglossal nerve stimulator implant may be an option for patients who are unable to tolerate CPAP. Finally, the FDA recently approved Zepbound (tirzepatide) to facilitate weight loss in obese patients with moderate to severe obstructive sleep apnea.

In addition to these treatments, Dr. Merrill also recommends 10 Tips for Better Sleep to help you establish a healthy sleep routine.

Bettering your sleep can do wonders for your health, both mentally and physically.

Cooper Clinic offers a comprehensive range of sleep medicine services—including lab-based studies and in-home testing. Visit the Cooper Clinic Sleep Medicine web page to learn more or call 866.906.2667.

Five percent of people will be diagnosed with colon cancer in their lifetime. As Cooper Clinic Gastroenterologist Andrew Gottesman, MD, says, that’s a big deal.

“In medicine, 5% is a huge number. It’s one in 20 people.”

“The good news is colon and rectal cancer is largely a preventable disease,” Gottesman said. “In the United States, it is the fourth most common cause of death and the second most common cause of cancer deaths. Only lung cancer kills more people. It’s important to be proactive to reduce the risk of colon cancer.  This includes lifestyle changes such as quitting smoking, limiting alcohol, controlling obesity and minimizing red meat consumption. It is also important to schedule a colonoscopy, beginning at age 45.”

Colon cancer, or colorectal cancer, is a disease in which cells in the colon or rectum grow out of control. It usually arises from abnormal growths, called polyps. Over time, colon polyps may become malignant. This usually takes 5 to 10 years to occur. Not all polyps are of equal importance. When a colonoscopy is performed, all polyps are removed. Statistically, pre-cancerous polyps are identified in 30% of patients undergoing screening colonoscopy. With their removal, the likelihood of developing colon cancer is significantly reduced. 

The incidence of colon cancer is increasing in patients under the age of 50. Many patients are diagnosed at later stages, so patients of average risk should begin routine screening colonoscopy at age 45. Some physicians advocate for screening at an even earlier age.

The results of your screening colonoscopy will determine the next time you’re screened. If no pre-cancerous polyps or malignant polyps are found, the next colonoscopy should be scheduled in 7 to 10 years, unless you have a family history of colon cancer or polyps.  In this situation, follow-up colonoscopy is recommended in five years.

If pre-cancerous polyps are found, follow-up colonoscopy is recommended in three to five years, depending upon the size, number and microscopic appearance of the polyps. Occasionally, one year follow-up is recommended.

When a Diagnostic Colonoscopy may be Needed

Colonoscopy is also performed to evaluate gastrointestinal symptoms such as anemia, weight loss, abdominal pain and to detect a variety of diseases such as colitis, inflammatory bowel disease and diverticulosis. This is a diagnostic colonoscopy. 

• Family history: If a close relative (parent, sibling or child) less than 60 years old has been diagnosed with colon cancer or pre-cancerous polyps, colonoscopy should be performed at the earlier of age 40 or 10 years younger than the affected relative.
  

• Blood on or in your stool: Talk to a health care provider if you notice blood in your stool or on the toilet tissue, or if your stool looks dark or bright red. It’s important to remember blood in your stool doesn’t mean you have colon cancer. Other things—from hemorrhoids to anal tears to eating beets—may change your stool’s appearance. But it’s always best to check with a health care provider any time you notice blood in or on your stool.
  

• Persistent changes in your bowel habits: Talk to a health care provider if you have persistent constipation and/or diarrhea.
  

• Abdominal pain: Talk to a health care provider if you have abdominal pain with no known cause that doesn’t go away. Many things may cause abdominal pain, but it’s always best to have unusual or frequent abdominal pain evaluated.
  

• Bloated stomach: Similar to abdominal pain, many things may make you feel bloated. Talk to a health care provider if your bloated state lasts for more than a week, worsens or you have other symptoms such as vomiting or blood in or on your stool.
  

• Unexplained weight loss: This is a noticeable drop in your body weight when you’re not trying to lose weight.
  

• Fatigue and feeling short of breath: These can be symptoms of anemia, or loss of blood. Anemia may be a sign of colon cancer.

What Causes Colon Cancer?

Like all types of cancer, colon cancer happens when cells grow and divide uncontrollably. All cells in your body are constantly growing, dividing and dying. That’s how your body remains healthy and working as it should. In colon cancer, cells lining your colon and rectum keep growing and dividing even when they’re supposed to die. These cancerous cells may come from polyps in your colon.

There are thought to be multiple causes for colon cancer. Diet and genetics play a role. To reduce the risk of colon cancer, limiting the consumption of red meat and alcohol is recommended. Eating fruits and vegetables has been shown to reduce the risk of colon cancer. Low dose aspirin has also been shown to be useful in some patients, though this is not generally recommended due to the long-term side effects of aspirin use.

When You Might Need an Endoscopy

Routine screening of the upper gastrointestinal tract (esophagus, stomach and small intestine) is not generally recommended. However, for patients with chronic reflux, difficulty swallowing or in patients with an abnormal lining of the esophagus, upper endoscopy can be performed at the same time as colonoscopy.

During the procedure, following sedation, an endoscope (a thin tube with a light and a camera at the end) is inserted into the mouth and slowly passed through the esophagus, stomach and small intestine. The camera then sends video images to a monitor, allowing the doctor to see inside the body and diagnose any issues.

An endoscopy may be needed for the following conditions.

• Gastrointestinal bleeding: An endoscopy may be used to identify the source of gastrointestinal (GI) bleeding. It can help to determine the cause of the bleeding, such as an ulcer in the stomach or small intestine. An endoscopy can also treat the bleeding by cauterizing or injecting a substance to stop the bleeding.
  

• Gastroesophageal reflux disease: Endoscopy can be used to diagnose and treat gastroesophageal reflux disease (GERD) which can develop as a result of chronic heartburn or acid reflux. An endoscopy can help identify any damage to the lining of the esophagus caused by stomach acid and can also be used to take biopsies of the tissue.
  

• Ulcers: An endoscopy can be used to diagnose and treat ulcers in the stomach or small intestine. Because of the size and flexibility of the endoscope, your doctor can view the ulcer and take biopsies of the tissue.
  

• Gastrointestinal obstruction: An endoscopy can be used to view obstructions and diagnose and treat blockages in the digestive tract. This procedure can also be done to remove food or foreign objects stuck in the upper GI tract.
  

• Barrett’s esophagus: Your doctor may recommend an endoscopy to diagnose and treat Barrett’s esophagus. This condition occurs when people who have chronic GERD also experience regular acid reflux which damages the lining of the esophagus. In this scenario, the endoscope can view the abnormal cells and take biopsies of the tissue.
  

• Celiac disease: The diagnosis of celiac disease is often confirmed by biopsy of the small intestine through an upper endoscopy.
  

Cooper Clinic Gastroenterology provides on-site colonoscopy and endoscopy using the latest technologies. Our practice surpasses the national standard. Andrew Gottesman, MD, a board-certified gastroenterologist, and our nursing staff, with nearly 30 years of experience, provide personalized care and a clear picture of our patients’ health. A limited number of patients are seen daily with flexible scheduling and thorough pre- and post-procedure follow-up.

To schedule a GI consultation, colonoscopy or endoscopy, call 972.560.3255.

Can brushing your teeth and attending regular dental visits help your heart? “Yes, your mouth is the entrance of gastrointestinal tract. It is important to make sure your teeth, gums and tongue are healthy,” says Kim  H. Allen, MD, Preventive Medicine Physician at Cooper Clinic. The mouth has multiple places where bacteria can accumulate, for example between your teeth and at the gumline. The types of bacteria found in the mouth include:

• Naturally occurring bacteria
• Bacteria that is inhaled
• Bacteria that is consumed

If you have an open wound in your mouth, such as a small cut, bacteria can enter the bloodstream and cause an infection inside your body. “Those who have been diagnosed with a moderate or advanced stage of gum disease are at greater risk of heart disease,” says Dr. Allen. Periodontal or gum disease is an infection that affects the tissues surrounding your teeth. If bacteria from the teeth or gums enter the bloodstream, it can travel to the heart and cause infection of the heart and damage of the heart valves. These types of infection can affect multiple organs and lead to complications including stroke, heart failure and kidney failure.

Warning Signs

So, what does poor oral health look like? While many may believe it’s bad breath, Dr. Allen shares five major symptoms associated with poor oral health:

• Tooth decay
• Gum inflammation, pain or bleeding
• Bad breath
• Tooth sensitivity
• Tongue changes or coating

Poor oral hygiene can be caused by numerous factors, not just by forgetting to brush your teeth. “Certain medications, chronic health conditions such as diabetes, autoimmune diseases and dry mouth may also be factors associated with an individual’s poor oral health,” says Dr. Allen. Smoking and consuming excessive amounts of alcohol also cause inflammation and further decay.

Dr. Allen explains that while we can often see and feel these warning signs ourselves, it’s important to visit your dentist because they are equipped to see well into the oral cavity.  A dental professional, when seen regularly, can see changes in your mouth such as space between the teeth, inflammation and an abscess. If your dental professional identifies issues of concern, they can address and help treat them and also recommend you see a doctor for further diagnosis if needed.

Dr. Allen explains, “a person can go to the dentist for their regular check-up and not know they have an illness. For example, during the examination, a dentist may find an abnormality like excessive bacterial/plaque accumulation bleeding or dry mouth. These abnormalities may be a result of an autoimmune disorder the patient would not have known of before the dental visit.”

Proper Oral Hygiene

To help prevent inflammation, discomfort and other oral issues, Dr. Allen recommends four steps for good oral hygiene:

1. Brush and floss your teeth, tongue and gums twice a day.
2. Floss two to three times a day.
3. Use oral rinses but avoid ones that have high alcohol levels.
4. See a dentist at least two times a year.

For those who have health conditions such as diabetes, Dr. Allen recommends visiting the dentist at least three times a year due to their increased risk of gum disease.

To learn more about your overall health, schedule a comprehensive preventive health exam at Cooper Clinic by visiting cooper-clinic.com or calling 866.906.2667.

Whether you want to get in shape, eat a diet rich in fruits and vegetables or live an overall healthier lifestyle, setting goals can help get you there. Yet breaking your long-term goals into smaller, shorter-term goals may be more beneficial.

Cooper Clinic Platinum Physician  Michael Chapman, MD, explains why your small steps can help yield big results.

The Smaller, the Better

“When discussing weight loss with my patients, many feel they are facing a mountain if I tell them they need to lose 30-50 pounds,” explains Chapman. “In cases like this I tell them to set a short-term goal of one pound per week. If they can stay focused on their weekly goal, the long-term goal will eventually come into place.”

The same is true when you’re planning to run a marathon. Chapman recommends developing daily and weekly goals. “Setting and achieving mini-goals can create a feeling of accomplishment, which is empowering.” Feeling successful at the end of the day can motivate you to continue with your goal the next day.

Monday Motivation

Do you suffer from a “case of the Mondays?” If so, try changing your mindset about the start of a new week.

“Setting Monday resolutions can help ensure you start out with a clean slate each and every week,” says Chapman.

Did you eat poorly over the weekend? Did you skip several workouts the week before? Using Monday as a fresh start can help reset your mind to have a positive outlook on the week.

“Monday comes around every seven days, so you have 52 chances a year to stay on track,” says Chapman.

Looking for inspiration? Follow the Monday Campaigns and start looking at Monday in a whole new light.

Celebrate

You’ve hit your daily and weekly goals and now you’ve achieved your long-term goal, too. Before you tackle your next venture, Chapman says it’s important to celebrate your successes.

“When you achieve a goal, take the time to enjoy the satisfaction of having done so,” says Chapman. “Reward yourself with a new pair of shoes you’ve been wanting or enjoy a weekly massage. This can help you build the self-confidence you need to set even bigger goals in the future.”

Are you ready to set a new goal? Follow the SMART plan:

• Specific. State what you’re going to do.
• Measurable. Use metric or data targets.
• Achievable. Make sure it’s an attainable goal, given the timeframe.
• Relevant. The goal makes sense for your lifestyle.
• Time-bound. Set a specific date to accomplish your goal.

To learn more about how to create SMART goals, watch this video with Meridan Zerner, MS, RDN, CSSD, LD, CHWC, Cooper Clinic Registered Dietitian Nutritionist.

For more information about Cooper Clinic, visit cooper-clinic.com or call 866.906.2667.