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As I have a fairly extreme snake phobia, Australia has never been high on my list of places to visit; from what I see and hear that’s my loss! However, for all its virtues Australia also has one of the highest rates of skin cancer in the world, and two in three Australians will be diagnosed with some form of skin cancer by the time they are 70 [1].

Ever aware of this, Associate Professor Diona Damian and her group at the Sydney Cancer Centre, Royal Prince Alfred Hospital, Sydney, have been studying the suppressive effects of sunlight on the skin’s anti-tumour defences for many years. In their search for nontoxic, inexpensive agents that might prevent UV-induced immune suppression, and in turn avoid the development of skin cancer, they began to investigate nicotinamide (vitamin B3), which has been previously shown to reduce skin cancers in mice [2].

When they assessed the use of oral nicotinamide for skin cancer prevention (poster) in human participants who had multiple premalignant actinic keratoses (AKs), they found relative reductions in AKs of around 30-35% compared with a placebo. “Nicotinamide appears to work by replenishing cellular energy levels, which are depleted by UV exposure, and by enhancing the repair of UV-damaged DNA,” Damian says.

Surprisingly, they also found that in their small sample of 75 people, rates of new cancers were also significantly less among those taking nicotinamide, with only four patients growing new cancers, compared with 20 patients on the placebo.

A Phase III randomized controlled trial of a larger group of skin cancer patients is next on the cards for the group. Damian notes that, if results from this confirm those of the original study, “we will have a safe and already widely available agent to help reduce the skin cancer burden in our highest risk patients, all at a cost of less than $10 per month.”

I may yet visit Australia one day… nicotinamide in hand, of course!