Air Date: Week of September 17, 1999

Skin cancer is one of the few cancers still on the rise in the United States. And while scientists say ozone depletion may be a contributing factor, the major culprit is our behavior. Anna Solomon-Greenbaum has the story on our cultural obsession with the sun.

Transcript

CURWOOD: This is Living on Earth. I'm Steve Curwood. Summer is unofficially over. The kids are back in school. Leaves are turning. And for those of you who've worked all summer to get them, luxurious summer tans are, alas, fading, too. But the consequences of spending too much time in the sun may be lasting, and potentially fatal. Skin cancer is on the rise in the United States, and a new study in New Zealand raises concerns that depletion of the ozone layer is one cause of high rates of skin cancer there. But perhaps just as important a factor is behavior. Living on Earth's Anna Solomon-Greenbaum explains.

(Surf and ambient voices)

SOLOMON-GREENBAUM: Ten-year-old twins Diana and Jacqueline Patchin summer on Rhode Island's Narragansett Beach. The sky and the sea seem endless here, and the sun is bright. But even these girls know too much sun can quickly ruin a vacation.

D. PATCHIN: It hurts.

J. PATCHIN: A lot.

D. PATCHIN: And you can't sit down, you can't touch your arms, and no one can touchyou and you can't go to sleep at night.

SOLOMON-GREENBAUM: Diana and Jacqueline also know a peeling nose can mean troubles ahead.

D. PATCHIN: You might get skin cancer.

SOLOMON-GREENBAUM: The Patchin twins are of a generation in which shampoo and makeup come with built-in SPF, and the UV index comes with the daily forecast. Today, sunscreen options are as numerous as ice cream flavors. There's waterproof or water-resistant, blue or red, glitter or fruit-scented, spray or gel. It's a far cry from the days when the sun was touted for its health benefits, and baby oil and reflectors for speedier tanning were standard beach equipment.

(Music. Man's voice-over: "Don't hide it, flash them, your Coppertone tan!" Sings: "Flash them, the dark tan. Flash them, the fast tan. Flash them, the Coppertone tan.")

SOLOMON-GREENBAUM: In the last few years, major health groups, including Centers for Disease Control, the American Academy of Dermatology, and American Cancer Society, have begun warning the public about the dangers of the sun. The reason? Skin cancer is the fastest growing cancer in the United States. Most cases are basal or squamous cell carcinomas, and are usually treatable if detected early. But its deadliest form, melanoma, kills more than 7,000 Americans a year.

WEINSTOCK: We know that going back as far as we have accurate measures of melanoma incidents, which is back to the late 1930s, that ever since then it's been rising quite substantially to the present day.

SOLOMON-GREENBAUM: Dr. Martin Weinstock is a professor of dermatology at Brown University and chair of the American Cancer Society's Skin Cancer Advisory Group.

WEINSTOCK: And in the late 1930s, in a typical town of 100,000 people, you'd have about one melanoma a year. And now you have about 15 or 20. So it's been a huge, huge rise over those 60 years or so.

SOLOMON-GREENBAUM: Dr. Weinstock attributes the increase in melanoma to shifts in cultural, economic, and fashion mores. At the end of the last century, the elite stayed indoors and pale while the working classes labored out in the fields. The Industrial Revolution turned the tables. Workers moved into factories. The wealthy took up sunbathing, and bronze skin came into vogue. More people began exposing more of themselves to the sun more often. Sometimes with dire consequences.

FAHNLEY: I did not even know what melanoma was when the doctor called me, but then found -- I had a surgeon calling, on the heels of that phone call, saying he needed to see me right away. He had just lost a patient, same age as myself, two weeks earlier. So I went into a complete panic.

SOLOMON-GREENBAUM: Kim Fahnley was 29 when she was diagnosed with melanoma. One year later her friend Ruth Ann Molyneaux also got the bad news.

MOLYNEAUX: Your first reaction is that you will be extremely, you know, cautious. You will never let this happen to you again. You will do whatever you have to do not to have it happen again. And so, when it's time to go get the mail, or it's time to go out and get your newspaper, you think you just need to cover up from head to toe, because you're so struck with fear.

SOLOMON-GREENBAUM: Kim and Ruth Ann always spent a lot of time outdoors. Kim owns a horse farm. Ruth Ann gardens. After their diagnoses, Kim and Ruth Ann didn't stop going outside, but it wasn't the same. They felt compelled to apply sunscreen every few minutes, and wore longsleeved shirts in the middle of August. Worse, they say, people just didn't understand.

FAHNLEY: I very early on learned not to talk to anybody about skin cancer,
because people, their attitude, well that's you, so sorry about you and your situation, but I've got to get off to the beach now or get on with my day. Because I tan. I look okay.
(Speaking to a customer) Yeah, here are some of the designs that we have, and you can just feel the fabric...

SOLOMON-GREENBAUM: Today Kim and Ruth Ann run their own company, called Sun Solutions. They make protective clothing, designed to let people be sun smart without looking like fashion geeks.

MOLYNEAUX: ... because this has venting in the back ...

SOLOMON-GREENBAUM: Even with the reality of cancer, Ruth Ann says it's difficult getting used to the idea of not getting brown come summer time.

MOLYNEAUX: For the first few years, actually, after I had my diagnosis, I did the sunless tanning, the lotions. And actually, this is the first year that I have not done that. And that has taken a comfort level for me, to feel comfortable about who I am and how I look. And yet, I would not wear a pair of shorts because I still feel self-conscious, not to myself but out in public, that I would definitely feel as though I would stand out.

SOLOMON-GREENBAUM: It isn't always easy to change people's habits, even if they know the facts about skin cancer. But scientists say 80 percent of melanoma cases could be prevented with adequate sun protection before age 18. Lifeguards at Cunningham Park in Milton, Massachusetts, teach young swimmers the basics of safety in the sun.

(Children's voices and splashing)

WOMAN: So who needs to protect their skin from the sun? Just me, just you, or like everybody?

CHILDREN: Everybody.

WOMAN: Everybody, that's right.

CHILD: Everybody in the whole universe.

WOMAN: That's right, sweetie. Awesome.

SOLOMON-GREENBAUM: There is some evidence that sun smart programs can work. You can find it down under.

SINCLAIR: Australia has the highest rates of skin cancer in the world. Our levels of ultraviolet radiation here are as high as they are in the Sahara Desert. Yet we have a population that is predominantly fair-skinned.

SOLOMON-GREENBAUM: Craig Sinclair manages the Sun Smart Campaign for the Anti-Cancer Council of Victoria. Two out of three Australians, he says, will get some form of skin cancer during their lifetime. And a national effort is underway to bring those numbers down. In an area of the world where the protective ozone layer is thin, tree plantings have increased shade at schools and parks. Sun protection policies for outdoor workers are standard in many precincts. And sunscreen is now tax-free. The initial results are promising. In Victoria, the Sun Smart Campaign reports a 50 percent decrease in sunburning since 1988, and rates of non-melanositic skin cancers in some age groups have dropped by 11 percent since 1985.

SINCLAIR: It's an intrinsic part of our lifestyle here, and it's now as commonplace for parents to tell their child to put on sunscreen as it is to make sure they brush their teeth.

SOLOMON-GREENBAUM: It can take up to 20 years for melanoma to develop, so it's too early to tell if sun protection campaigns in the United States are working. Some of the current evidence isn't encouraging. Sunburn rates in the U.S. have increased by a third in the last decade. In 1997, Americans paid more than $500 million to treat newly-diagnosed melanoma. And while sales of SPF 15 or higher have increased considerably since 1991, the tan enhancer brands that offer little or no SPF protection are doing a brisker business. Meanwhile, some scientists worry that continued ozone depletion will only boost melanoma-related deaths. Still, Dr. Martin Weinstock of the American Cancer Society says Americans are headed in the right direction.

WEINSTOCK: I do see change happening here in the United States already. We are seeing signs that the models in fashion magazines are not as tanned as they used to be, and that is an indicator that there is the beginnings of a cultural change. We certainly have a long way to go. So I'd say the change will be gradual, but I do think it will occur, and I do think it's starting to occur.

SOLOMON-GREENBAUM: For Living on Earth, I'm Anna Solomon-Greenbaum.

CHILD 1: Mermaids need sunscreen. There's a thing called -- you know the stuff that you can hear the ocean from?

CHILD 2: The shell?

CHILD 1: Yeah.

CHILD 2: A conch shell.

CHILD 1: Conch, yeah. And before that, the thing that makes the shell is
like these little icky huge snail. And then the mermaids put it on them when they go up to the surface and become human. So --

WOMAN: And that's for sunscreen?

CHILD 1: Uh huh.

WOMAN: Really! Where did you hear that?

CHILD 1: Oh, we made it up.

WOMAN: I like that.