Hung Doan, M.D., Ph.D., Associate Professor, Dermatology [00:00:05] Hi, I'm Dr. Hung Doan, a dermatologist here at UT MD Anderson. I'm joined today by my colleague, Dr. Susan Chon, also a dermatologist here at UT MD Anderson. And this is the Cancerwise podcast. Good morning, Dr. Chon.  

Susan Chon, M.D., Professor, Dermatology [00:00:18] Good morning, Dr. Doan. Thanks so much for having me.  

Hung Doan, M.D., Ph.D., Associate Professor, Dermatology [00:00:20] We're here today to talk about sun protective strategies. Summer's around the corner, and living in Texas, we always have to remind ourselves and our patients about what the best measures are that they can do to protect themselves. We'll talk today about sun protective clothing, what UPF means. But before we get to that, let's talk about sunscreen, SPF, what that means and what you tell your patients.

Susan Chon, M.D., Professor, Dermatology [00:00:41] So, this is something we talk about almost daily with our patients in the Cancer Prevention Clinic, so something that many of my colleagues think is really important. And actually, sharing a lot of this knowledge is what we love to do every day. So, sunscreen, the way it is currently rated is with an SPF factor, which is a sun protection factor. And that primarily measures the UVB rays, which are the ones that contribute probably the most to skin cancer formation. So, with UVB, the rating can be like SPF 30, and that's kind of the minimum that we recommend for patients. That blocks about 97% of UVB. But UVB is not the only part of the story. So, UVA is also really important. UVA and UVB both contribute to what we know as, you know, cancer-causing kind of effects, but also all the sun damage you recognize, like wrinkles or skin sagging or just brown spots or discoloration. So, we recommend that patients look for, you know, any kind of sunscreen that says broad spectrum or UVA, UVB coverage with an SPF of 30, which blocks about 97% of UVB. So, beyond that, what does that mean? What do I look for? The most important thing I have to explain to patients is really the main ingredient. I tell them to look for zinc oxide sunscreen, and that means it's a mineral-based sunscreen. It's called a physical sunscreen. And if you're still not sure, you can always turn over the packaging and look at the back. On the back, it says active ingredients. You're looking for zinc oxide of at least 6% and sometimes in combination with titanium dioxide, which is another sunscreen that is a mineral sunscreen.  

Hung Doan, M.D., Ph.D., Associate Professor, Dermatology [00:02:08] That's a great tip that you have for your patients, too. I also noticed that there are some sunscreens that have tint in them. Can you explain more about tinting and if that contributes to sun protection?  

Susan Chon, M.D., Professor, Dermatology [00:02:19] So, back in the 70s when people think of zinc, it's like this white thick paste they put on their face. And you know, lifeguards wore it, you know.  

Hung Doan, M.D., Ph.D., Associate Professor, Dermatology [00:02:26] Only the nose!  

Susan Chon, M.D., Professor, Dermatology [00:02:25] Yeah. But now it's, you know, so much better formulated. It's much more cosmetically elegant. There are lots of different sunscreens that are now zinc oxide based, and they don't have to look and show a white cast. So, these tinted sunscreens, especially in the past few years, have really come online and they have some iron oxides in them, which actually contribute to more possible blocking of the UV wavelengths. But it also makes it easier to wear on a daily basis. So, I have some on right now. And it's actually, you know, really nice because it kind of blends with my skin tone and they have different shades. So, I think, you know, this is another way to really encourage patients to wear it, because sometimes it's more the fact they don't like it, the appearance. So, we really tell them like look for ones that match you match your skin tone better.  

Hung Doan, M.D., Ph.D., Associate Professor, Dermatology [00:03:06] Absolutely. Because we don't restrict sunscreen usage to any particular skin type. All patients can benefit from any amount of UV protection from sunscreen as well. So, I advocate for that. And so, the most important thing that I tell my patients is that it matches your skin tone. And you know, the best sunscreen is the one that you use that you are the most comfortable with. So, Susan, you bring up some great tips about the, you know, the importance of sunscreen and just what it means for the patients. But what about how much we need to use on a daily basis? What do you recommend for your patients?  

Susan Chon, M.D., Professor, Dermatology [00:03:39] Yeah, so that's the hard part. I think most people don't apply enough. You know, we recommend a golf ball size amount, you know, for the body. And it's actually quite a bit, especially to the unexposed areas which are going to be like your arms and legs but also your face. It's, you know, it's, it's a lot. So, you know, part of the problem is that patients may under apply. And so, we really recommend that they have to reapply. So, if they're outside and they're sweating a lot or if it's a, you know, water activity, it's going to come off fairly easily. So, you really want to actually, you know, reapply it every couple of hours if possible. Again, the sunscreen to me is just a part of a bigger sun protection plan. So, these are the areas that can't be covered other in other ways.  

Hung Doan, M.D., Ph.D., Associate Professor, Dermatology [00:04:22] I agree with you completely. I tell my patients the same thing about a golf ball size or sometimes we, I use a teaspoon rule. It's kind of a, an old timey rule, but basically a teaspoon for the face. Each arm gets a teaspoon, the torso, the front and the back, each gets a teaspoon, and each leg gets two teaspoons. So, that's nine teaspoons if anyone can remember that.  

Susan Chon, M.D., Professor, Dermatology [00:04:44] That's good I like that.  

Hung Doan, M.D., Ph.D., Associate Professor, Dermatology [00:04:44] Yeah, yeah. It's a teaspoon rule. But then, you know, again with the application, every two hours - that's what the academy recommends. The American Academy of Dermatology recommends that. But I also wanted to highlight that with water-resistant or waterproof or water-resistant sunscreens, a good feature is that they truly are water resistant up to about 80 minutes or so from what I've read, and that means that they could become pretty water resistant or the minute that you put on your skin. But we recommend about 30 minutes after applying before you hop back in the water, should that be the case.  

Susan Chon, M.D., Professor, Dermatology [00:05:18] Yeah, I think it helps stay. It helps it to stay longer on the skin. Yeah.  

Hung Doan, M.D., Ph.D., Associate Professor, Dermatology [00:05:21] Our next topic we're going to discuss a little bit about UPF clothing and sun protective clothing and what that means. And, you know, I'd like to open up the discussion by asking what have your patients asked you about?  

Susan Chon, M.D., Professor, Dermatology [00:05:32] Yeah, I think people always go, "Well, does clothing work?" You know, is it effective? Should I be doing it? And I'm like, absolutely. It's not just sunscreen or just staying indoors. You know, when you're outside and you're going to be out for a long time, clothing is the most reliable and consistent way to block the sun. And as an example, I just came back from a two-day golf tournament where we screened a lot of the players and caddies and public who were there. And you know, what you notice right away is these very sharp tan lines. And these guys are wearing baseball caps, so their forehead is perfect and they're wearing T-shirts or, you know, kind of golf shirts. So, their, you know, upper arms are pale and they're wearing shorts, so right below the shorts they're tan. So, clothing does work. And I think explaining, you know, what that means is really important. For sun protective clothing, they have a factor, a rating factor much like sunscreen has SPF. Clothing has a UPF which is an ultraviolet protection factor.  

Hung Doan, M.D., Ph.D., Associate Professor, Dermatology [00:06:28] Right.  

Susan Chon, M.D., Professor, Dermatology [00:06:29] And you know, it can be anywhere from UPF of, you know, 30 to 50. And it really kind of tells you how much sun is getting through. So, like UPF 50 allows 1/50 or 2% of light through the, through the clothing. So, it blocks like 98%. And then UPF 30 is, you know, 1/30. That's about three and a third percent. So, maybe.  

Hung Doan, M.D., Ph.D., Associate Professor, Dermatology [00:06:49] 96 - 97%.  

Susan Chon, M.D., Professor, Dermatology [00:06:49] 96% is getting through. So, it works pretty well. And, you know, whereas like maybe a plain white T-shirt is like a UPF of like six, so it allows about 16% through, so maybe 84% blockage. So, you know, there's gradations. But overall clothing does work pretty well. And so, you can, you know, buy clothing that actually has, you know, these rating factors. And they can make a huge difference, especially when you're someone who's outdoors consistently or for long periods of time. UPF, UPF-rated clothing is really great.  

Hung Doan, M.D., Ph.D., Associate Professor, Dermatology [00:07:20] Absolutely. And with the UPF-rated clothing, the UPF rating actually is tested by some outside agencies and essentially, it's rated based on the density of the weave, and that's what gives it its protective factor. Additionally, with the density of the weave, I've read that it tends to be a little more luxurious in feeling anyway, so that's with a little more high-quality materials too. And then on top of that, we find that darker colors tend to protect better than lighter colors, because some of the dyes actually absorb the UVs that gives it its color. So, in combination with all that, UV-protective clothing can be very effective, and part, as you say, of a comprehensive skin protective strategy. One thing I want to emphasize to my patients also is that we're not trying to limit your activities. We're trying to ensure that you're protecting yourself in your daily activities and all the fun stuff that you do. And also, I always recommend to my patients that the tighter the fit, the better it is, so that there's no loose clothing that could allow a little bit of UV to pop through, or that it's not providing the protection it needs.  

Susan Chon, M.D., Professor, Dermatology [00:08:22] I think the other factor that's really important is actually the fabric. So, the nylons...  

Hung Doan, M.D., Ph.D., Associate Professor, Dermatology [00:08:28] Very true.  

Susan Chon, M.D., Professor, Dermatology [00:08:28] You know, the polyester and even the spandex and elastane, all of these might sound somewhat familiar. A lot of this is in clothing that's recommended for like athleisure or for like, sports. So, again, like fishing shirts, golf shirts, biking clothes. These are sports where you're really outdoors for a long time. And the consistency that clothing provides is really superior. And it doesn't matter, you know, how you apply it or, you know, if you reapply it, it's there. And also, it doesn't change when it gets wet. It still stays very protective. So, this is why I think clothing is something that people should kind of add into, like, their routines. You want to live your life, you got to go outdoors, right?  

Hung Doan, M.D., Ph.D., Associate Professor, Dermatology [00:09:05] Right.  

Susan Chon, M.D., Professor, Dermatology [00:09:05] But if you're going to walk, you know, twice a day with the dog, you know, you could throw on a very light fishing shirt over your tank top, you know, and give yourself this protection immediately and then take it off when you come in. I've been recommending this a lot to patients is using the solar sleeves. Players and caddies in golf tournaments, it's a big push and they started using it more and more over the past years. But I recommend them to everyone, people who garden a lot, you know, they don't like putting sunscreen on because then it's on their hands and then and then dirt.  

Hung Doan, M.D., Ph.D., Associate Professor, Dermatology [00:09:30] They might get the dirt and everything.  

Susan Chon, M.D., Professor, Dermatology [00:09:31] Leaves start sticking on them. I mean, it's just not a great feeling. And then they definitely don't have the time or the inclination to reapply. So, these solar sleeves are great. They pull them on, they go do their stuff, and then when they come in, they just pull them right off. So, it's really, really convenient and kind of like what you said. We talked about this before, too. You know, when people use them for driving. Do you want to talk about that a little bit?  

Hung Doan, M.D., Ph.D., Associate Professor, Dermatology [00:09:49] Yeah, absolutely. So, with driving, there's even driving gloves. Some of the clothing manufacturers make specific driving gloves. And it's it's actually very interesting because we drive a good portion of our day, our activities, even throughout the day. Sometimes we put sunscreen on, if you think about it with your palms, but you might not even strike the back of your hands. I find skin cancers tend to occur on the left arm, especially for my male patients, where they stick their arms out the window. So, it's a very curious finding, but you slap on like a little sleeve or even some driving gloves. It's great. The only caveat is to make, make sure that it fits them well, and that it doesn't interfere with their grip on the wheel. We want safety first always.  

Susan Chon, M.D., Professor, Dermatology [00:10:26] Right. Some of the driving gloves are really awesome because they actually have open palms. So, they'll put them on and just toss them back into the side of the door. So, it's very convenient. You can always remember to put them back on because they're in your car and ready to go.  

Hung Doan, M.D., Ph.D., Associate Professor, Dermatology [00:10:38] Speaking of which, do you also recommend sunscreen in addition to the sun protective clothing?  

Susan Chon, M.D., Professor, Dermatology [00:10:43] Yes, and I'll tell you why. Because when we look at these patients, I can see exactly where their clothing ends, you know? So, you know they're working and it's always the same areas. You know, it's always the head and neck area. You know, we definitely are not a huge hat culture. So, even for, you know, people, they like to wear baseball caps. And it does wonders on their forehead. They have like baby soft skin there. But then, like, their ears are exposed, their, their face, the lower half of their face, the neck, the back of the neck, the V of the chest, the arms, the forearms, the dorsal hands or the tops of the hands. There's so sun damaged because, you know, it's just been years in the making. And the best part is people go, "Oh, I just have old skin." And I'm like, actually, no. We turn over their forearm, and the inside is like, perfect. It's beautiful.  

Hung Doan, M.D., Ph.D., Associate Professor, Dermatology [00:11:26] Right where the sun protects it.  

Susan Chon, M.D., Professor, Dermatology [00:11:27] Right. And they're like, oh, you're right. I'm like, that's the same age. The other side is because of all the chronic sun exposure. And they're like, oh, I get it now. So they do see that when you give them that kind of like, you know, example that's so visual, like, oh, this is my skin and it looks great.  

Hung Doan, M.D., Ph.D., Associate Professor, Dermatology [00:11:41] Absolutely. And you know, we have to remind our patients that because I also have plenty of cyclists and they could wear their outfits, but their legs are exposed, and they can't reapply because they're in competition or they're riding too. So, we always recommend sunscreen where you cannot have clothing on. And in Texas, sometimes it can be hard to wear long trousers during the summertime, but patients still want to be out, so that's a good use of sunscreen in addition to sun protective clothing.  

Susan Chon, M.D., Professor, Dermatology [00:12:06] Yeah, and I'm going to make a plug for something else because I feel like everyone like, oh, you know, I don't do my legs. It's too much of a bother. And I get it. There's a lot more, like, surface to be covered. So, another thing that's been more, you know, available I feel like, you know, across drugstores and grocery stores is spray zinc. So, I tell them and there's even a foam zinc, which I love because it's so easy to apply. But basically, you know, spray it all over, you know, outside your house and, and then rub it in and then you've got some good zinc oxide on these larger surface areas of your legs. That's one area I feel like patients neglect to. People come in with very deeply tanned legs, but their face is a totally different shade, you know?  

Hung Doan, M.D., Ph.D., Associate Professor, Dermatology [00:12:44] That's a good point.  

Susan Chon, M.D., Professor, Dermatology [00:12:45] So trying to keep up all the protection all the way down.  

Hung Doan, M.D., Ph.D., Associate Professor, Dermatology [00:12:47] I always notice that patients have, they, they're very well put together in terms of their skin protection and so forth, sort of like neck up because you're looking at the mirror, you think about that, but you also have to remember the rest of your body.  

Susan Chon, M.D., Professor, Dermatology [00:12:59] Absolutely. Yeah. There's a disconnect between a lot of people's faces and even at the V of their chest, I'm like apply deeper, you know, lower. Go down more, because it's like such a stark contrast. But a lot of this, you and I are in the business of like cancer prevention, so we are really pushing that. But many people are concerned with the way they appear. And so much of it is easier if you prevent it from happening than having to spend tens of thousands on the back end trying to undo it.  

Hung Doan, M.D., Ph.D., Associate Professor, Dermatology [00:13:25] Repair it. Undo it.  Yeah. This is why, you know, opportunities like this podcast make it great to spread the message too.  

Susan Chon, M.D., Professor, Dermatology [00:13:31] People are always like, well, where am I going to find this closing? Where do you get this at? So, you can look at a lot of these large, kind of, athletic stores, you know, where you can buy a lot of athletic equipment. They have those kind of clothing.  

Hung Doan, M.D., Ph.D., Associate Professor, Dermatology [00:13:43] Sporting goods stores, too.  

Susan Chon, M.D., Professor, Dermatology [00:13:44] Sporting goods stores.  

Hung Doan, M.D., Ph.D., Associate Professor, Dermatology [00:13:44] Where you could buy your fishing equipment.  

Susan Chon, M.D., Professor, Dermatology [00:13:46] And definitely a lot of the athleisure lines. These big athleisure lines, they actually have a lot of UPF-rated clothing because they're trying to lead you to a healthier lifestyle. So, they're like for tennis clothes or for running or for, you know, hiking. A lot of these clothes are rated. So, looking at those areas, it's easy to find. And actually, MD Anderson's partnered with a very well-known clothing line. And you can buy MD Anderson-branded products on Shop.MDAnderson.org.

Hung Doan, M.D., Ph.D., Associate Professor, Dermatology [00:14:13] There you go. Absolutely..  

Susan Chon, M.D., Professor, Dermatology [00:14:14] I looked through their website, and they are really nice clothing. They have like hoodies and shirts.  

Hung Doan, M.D., Ph.D., Associate Professor, Dermatology [00:14:18] And hats too, right?  

Susan Chon, M.D., Professor, Dermatology [00:14:19] Yeah. And some. Yeah. And some hats. They have, they still have baseball caps and bucket hats and wide brim hats. And they also have lots of nice, you know, pants. So, really like the whole range. But beyond that there is, there are a lot of really reputable, sun protective clothing lines online that you can search, and they have even a broader array of products.  

Hung Doan, M.D., Ph.D., Associate Professor, Dermatology [00:14:39] There's just more awareness, and I appreciate that. And so, our patients have way more opportunities and way more ability to find these products easily.  

Susan Chon, M.D., Professor, Dermatology [00:14:48] Yeah. Yeah.  

Hung Doan, M.D., Ph.D., Associate Professor, Dermatology [00:14:49] Regarding hats, though.  

Susan Chon, M.D., Professor, Dermatology [00:14:50] Yeah.  

Hung Doan, M.D., Ph.D., Associate Professor, Dermatology [00:14:51] I always, I mean, we love the ball caps for sure. Any type of hat, head covering is better than no head covering.  

Susan Chon, M.D., Professor, Dermatology [00:14:58] Absolutely. I agree with that.  

Hung Doan, M.D., Ph.D., Associate Professor, Dermatology [00:14:59] But I also have to remind my patients think about the areas that are exposed. Tops of your nose, tops of your ears, back of your neck. And I think the men feel a little more modest because everyone's used to the ball cap look. But we could say, like, wide brimmed hats are just much better than a ball cap. But anything will do for sure.  

Susan Chon, M.D., Professor, Dermatology [00:15:17] Yeah. And I think, again, like I mentioned, you know, we're not as used to wearing hats and it does kind of feel like they're hotter. But there are, again, these hats now that are made with really nice sun protective fabric, which is real thin and breathable and like clothing, has a Dri-FIT aspect to it which actually wicks some of the moisture. So, it works. But the main thing is trying to buy a hat that has, you know, wide enough brim maybe a few inches to give you some shade. And then, you know, people say, well, it doesn't stay on. And yes, it may not be the most hip looking thing, but sometimes if you're on a boat, one that has some kind of, you know, little like, kind of a neck, kind of tie thing around under the chin to kind of.  

Hung Doan, M.D., Ph.D., Associate Professor, Dermatology [00:15:56] Absolutely. Yeah  

Susan Chon, M.D., Professor, Dermatology [00:15:57] Secure it. But also, there's hats, you know, when you're really out, maybe hiking a mountain, you know, you might want some of the hats that have a flap on the back or like the gaiters that some people wear around their neck when they're fishing.  

Hung Doan, M.D., Ph.D., Associate Professor, Dermatology [00:16:07] Because the UV can reflect off the water too. Yeah.  

Susan Chon, M.D., Professor, Dermatology [00:16:10] Absolutely. I think people forget like how much reflection comes off surfaces. So, they go, "I was under an umbrella the whole time on the beach." And I'm like, yeah, but the water reflected it. The sand reflected it. Or people come back with a, you know, a sunburn on their face from a skiing trip because they had goggles on and they had this nice raccoon look because all this light was reflected off the snow back onto their face.  

Hung Doan, M.D., Ph.D., Associate Professor, Dermatology [00:16:29] Right. That's right. Actually, you reminded me a good point, too. UV protective sunglasses.  

Susan Chon, M.D., Professor, Dermatology [00:16:34] Yes.  

Hung Doan, M.D., Ph.D., Associate Professor, Dermatology [00:16:35] I wanted to highlight that with sunglasses, even the ophthalmologists and optometrists recommend UV protection with sunglasses. The rating with sunglasses is UV400.  

Susan Chon, M.D., Professor, Dermatology [00:16:46] Yes.  

Hung Doan, M.D., Ph.D., Associate Professor, Dermatology [00:16:46] And that blocks about 99 to 100% of UV. There's this misconception that sunglasses can affect melatonin secretion. However, I want to emphasize that's just a myth. It's not been proven. And in fact, you just need 30 minutes of sunlight, not cumulatively, but throughout the day. That could really entrain your circadian rhythms. So, let's put that to rest. Sunglasses are great. They're protective for the, for the skin around the eye. They're protective for the eye, for the vision as well.  

Susan Chon, M.D., Professor, Dermatology [00:17:16] And I will emphasize that, you know, really having that kind of sunlight exposure early in the day really does help to set that circadian rhythm well. So, it doesn't take much. I mean, people often will be running errands or taking a walk, and all of those things will really help you to like establish that. One of the problems is that, you know, like you mentioned, we get cancers around the eyes and people don't put sunscreen up close to their eyes because it bothers it.  

Hung Doan, M.D., Ph.D., Associate Professor, Dermatology [00:17:40] Absolutely.   

Susan Chon, M.D., Professor, Dermatology [00:17:40] So, you really do need the sunglasses and the sunglasses do, you know, protect the skin around the eyes. You don't squint as much, so you might not get those crow's feet that people don't like.  

Hung Doan, M.D., Ph.D., Associate Professor, Dermatology [00:17:49] That's a great point.  

Susan Chon, M.D., Professor, Dermatology [00:17:50] But also damages the surface of your eye and also the lens, and even even deeper into the eye. So, wearing the sunglasses is really important. And I do recommend the UV400, which blocks all the wavelengths. That's what the 400 stands for. So, it blocks UVA and UVB. Sometimes it just says 100% UVA-UVB protection and that is great. And people say, well, but if it's really dark it works. Right. And actually that's that's a myth because the darkness doesn't mean that you have that protection because they just are stylish, you know? So, you actually need to look for that specific labeling. And also, you know, bigger sunglasses are kind of, you know, cool looking. People like that style. But it's actually even more beneficial. It's protecting more of that real estate around your eyes. And also, I think it's something that, again, you just kind of have to get used to. But I know a lot of people later on they're like, oh, I wish I'd, I had worn sunglasses more often, you know, or started sooner. One thing I also like about sunglasses, which personally I look for polarized. Polarized also is a myth. It doesn't protect your eyes; it's just cutting out the glare. And so, it's really nice if you're outdoors and say you're playing tennis, I don't know. Or if you're a golfer, you know, things where you're actually trying to use your eyesight while you're out there is it really will give you a better kind of.  

Hung Doan, M.D., Ph.D., Associate Professor, Dermatology [00:19:00] Clarity.  

Susan Chon, M.D., Professor, Dermatology [00:19:01] Clarity and contrast. So, I think the tinted like polarized ones that have a blue or green tint are really supposed to accentuate that contrast and help you have a better kind of acuity outside. But it actually, you know, I like having also beyond the sun protection. I like the polarization of my sunglasses. So, it's just another aspect of like sunglasses.  

Hung Doan, M.D., Ph.D., Associate Professor, Dermatology [00:19:19] Kind of like a side note. Also, we dermatologists, we use this tool called a dermatoscope. And it, and I enjoy using the polarized feature of it. So, it reduces the glare so I could examine the skin lesions better.  

Susan Chon, M.D., Professor, Dermatology [00:19:31] Exactly.  

Hung Doan, M.D., Ph.D., Associate Professor, Dermatology [00:19:31] So, I already am so attuned to using polarized lenses. And also because of the lenses, and it's a myth about the tint. I mean, we have to think about safety glasses as well. Outdoor workers.  

Susan Chon, M.D., Professor, Dermatology [00:19:42] Oh absolutely wear the sun protective clothing. They may or may not wear the tint, but at least it needs to have that UV400. And I'm sure that their, you know, their companies provide that for them too. And then speaking of sunglasses, visors and ski visors always, you know, like keep that in mind whenever they're purchasing that equipment as well. Thank you so much again, Susan, for joining me today. This has been a wonderful discussion regarding sun protective strategies for our patients.  

Susan Chon, M.D., Professor, Dermatology [00:20:08] Thanks so much, Dr. Doan. I really enjoyed it.  

Hung Doan, M.D., Ph.D., Associate Professor, Dermatology [00:20:10] And thank you for tuning in today. If you enjoyed this episode, be sure to follow or subscribe on Apple Podcasts, Spotify, YouTube, or wherever you get your podcasts. And don't forget to comment or review. For more information or to request an appointment, call 1-877-632-6789 or visit MDAnderson.org. Thanks for listening to the Cancerwise podcast from UT MD Anderson.