History of skin cancer

1979 TO TODAY: WE'VE COME A LONG WAY

The Way It Was

Twenty-four years ago, the majority of melanomas and other skin cancers came to the attention of physicians when they were advanced and difficult to treat. It is not hard to see why. The deeply suntanned faces and bodies of fashion and cosmetics models appeared in the advertisements of every consumer magazine, while the word "cancer" appeared only in professional publications. On beaches and at poolside, bikini-clad sun worshippers lay exposed to the sun, turning over periodically in order to be evenly baked. Most people who used sunscreens--and many did not--favored minimally-protective products so as to get a better tan. Metallic reflectors to intensify UV radiation were not uncommon, while broad-brimmed hats were a rarity. Most children had at least one blistering sunburn each summer. That is the way it was ... and is no more.

The Way It Is

Turn to any national magazine, and you will see how much paler the models have become in the years that have passed since The Skin Cancer Foundation came into being in 1979. "Although traditionally a tan has been considered attractive, less color is now viewed as more desirable not only by dermatologists, but also by members of the fashion industry," says Linda Wells, Editor-in-Chief of Allure, who has banned all tan models from the pages of her magazine. She has also eliminated the term "healthy tan" from its editorial pages. Skin cancer is now a part of major feature articles read by the lay public. Sunscreens are incorporated in moisturizing creams and lotions, tinted makeup, lipstick, hairsprays, and even nail polish. Those who still want to be tan are advised to achieve that look with self-tanning lotions or other topical products.

The scene on the beach and at poolside is altered, too. The sunscreens being applied are most often SPF 15 or higher, and wide-brimmed hats are in fashion. The danger of severe sunburns in childhood is so well recognized that a dermatologist recently accused a summer camp director of "child abuse" for allowing campers to become sunburned.

Dermatologists and their patients are discovering more skin cancers in the earliest stage when a cure is almost always possible. As fewer cancers metastasize, radical surgeries carrying a risk of disfigurement are less frequent. Also, cost savings are obtained, since early cancers are far less expensive to treat than those in more advanced stages.

Why the Change?

What has happened in these years to bring about such a revolutionary change? One thing we know: for more than two decades, The Skin Cancer Foundation has led the way in creating innovative educational programs that have stimulated sun-protective behavior and highlighted the importance of early detection. The Foundation is the first and still the only national and international organization dedicated solely to the most common of all cancers worldwide. Over the years, it has developed major programs and served as a catalyst to those who have joined in the fight against skin cancer.

Perry Robins, MD, Chief of the Mohs Micrographic Surgery Unit at New York University Medical Center, together with a nucleus of concerned physicians and patients, founded The Skin Cancer Foundation in 1979. Under Dr. Robins' leadership, the first national education program on skin cancer was introduced and public information materials were distributed widely to physicians and their patients, the media, and the general public.

Seal of Recommendation

One of the first actions of the newly-formed Foundation was the development of a Seal of Recommendation for sunscreens, and it rapidly became a standard for the industry. The Seal helped make SPF 15 or greater the minimum rating adopted by the scientific and medical community. The program has since been expanded to cover sunglasses and other sun protection products, and an International Seal has been earned by many products distributed throughout the world. Those granted the Seal have met the rigorous criteria of the Foundation's Photobiology Committee.

Research and Training

A Grants Review Committee to select and fund significant research projects each year was formed early in the history of the Foundation. The initial grant award in 1981 supported pioneering research into the development of a melanoma vaccine. This work continues today, and recent clinical trials show improvement in the length of recurrence-free survival.

Postgraduate fellowships in surgery and oncology have also been granted to outstanding applicants.

Melanoma Awareness Campaign

The Foundation has been at the forefront of the effort to combat melanoma, the most deadly form of skin cancer. The early warning signs of moles and melanomas, known as the ABCDs, are portrayed in brochures, posters, and video. They were at the center of the first National Campaign on Prevention and Early Detection of Skin Cancer and a subsequent Campaign on Self-Examination of the Skin.

As part of its medical education agenda, the Foundation co-sponsored Cutaneous Melanoma: A Clinical Symposium for Primary Care Practitioners in 1997.

The Melanoma Letter, the first of many publications on this cancer, is now in its twentieth year. A handbook, Understanding Melanoma, by Drs. Robins and Maritza Perez, was published in 1996, offering guidance to all who are at risk or are concerned about the disease, and in 1997 and again in 2000, the Worldwide Melanoma Update provided reports gleaned from the international literature.

Sun Safety

Sun safety has been a primary focus of the Foundation since its inception. The first media seminar, The Sun and Your Skin, took place in 1982, and the Foundation has been a major resource for the media ever since. The quarterly newsletter, Sun & Skin News, is now in its nineteenth year of publication, and in 1990, Sun Sense, a Complete Guide to Prevention, Early Detection, and Treatment, a 248-page book by Dr. Robins, was published.

Celebrities have been active participants in our campaigns, and range from Danny Kaye, the Foundation's first Honorary Chairman, to Tom Selleck, who holds that position today, to Regis Philbin, Maureen Reagan, and most recently, TV newscaster/anchor Michelle Charlesworth. An annual Media Award for outstanding coverage of skin cancer has been received by Jane Brody of The New York Times and Sam Donaldson of ABC News and by the consumer magazines, Vogue, Redbook, McCall's, Self, and Allure. An Excellence in Broadcasting Award was given to "20/20," ABC News.

An annual Skin Sense Award honors exceptional achievement in the skin care field and in public education about sun protection. Recipients include Estee Lauder and the Lauder family, Arie L. Kopelman of Chanel, Peter England of Elizabeth Arden, Andrea Jung of Avon, Isao Isejima of Shiseido Cosmetics, and most recently, Jack Stahl of Revlon and Pete Born of Women's Wear Daily.

Children's Sun Protection Program

All programs warning against unprotected sun exposure are of the utmost importance, but the Foundation has a particularly strong commitment to the Children's Sun Protection Program. The recognition that sun protection must begin at birth and be continued throughout childhood and the teenage years has been a cornerstone of many innovative and groundbreaking campaigns.

Millions of schoolchildren and their teachers received three separate editions of an interactive educational poster, Sun Day News. A newsletter, Flash, Hot News About You and the Sun, for 9-to-12-year-olds, has been distributed to Girl Scouts and others in this age group nationwide. In the Sunny States of America, schoolchildren entered a contest to create a map/mural showing sun protection state by state.

Community Action

Outreach is a major principle driving the Foundation's Sun Alert America program. As part of this effort, a series of public education seminars, Exposing Skin Cancer: Spot It! Screen It! Stop It! was held in ten cities across the nation.

The influential Blueprint for Community Action tells how to provide sun protection at swimming pools, parks and playgrounds, day-care centers, schools, and the workplace. It offers strategies to community activists, municipal and union officials, parents and other caregivers.

International Outreach

Global awareness of skin cancer and sun protection is essential to halting the epidemic of skin cancer. The First World Congress on Cancers of the Skin took place in 1983. Conducted biennially, the Congress has been held in the United States, Germany, Argentina, Italy, and Switzerland, and the Ninth is scheduled for May, 2003, in Spain.