By Cynthia Billhartz Gregorian
Lee Newspapers | Posted: Tuesday, April 21, 2009 12:00 am
ST. LOUIS - Seven years ago, Stephanie Lickerman's brother, Mike, died of melanoma. He was 36.
During his final weeks of life, he asked Lickerman, now a graduate nursing student at St. Louis University, to do something about the rising number of skin cancer cases. She promised she would.
Each year, 1 million Americans are diagnosed with skin cancer, making it the most common cancer nationwide.
And while the incidence of a lot of other cancers is falling, that of melanoma - the most deadly form of skin cancer - continues to rise significantly.
Experts say it's due to an increase in exposure to ultraviolet rays from the sun and tanning beds.
Since her brother's death, Lickerman has waged a battle against tanning on two fronts: by forming Sun Protection Outreach Teaching by Students, a program that educates students in St. Louis-area middle and high schools about the dangers of tanning, and by pushing for Missouri state legislation that would prohibit children younger than age 16 from using tanning beds (which is the law in Wisconsin). More than a dozen states have similar bills pending.
"I thought let's start with young people to change their behavior and hopefully, when they're 40 or 50 they won't be going through this," Lickerman said. "Plus, I have three sons."
The Indoor Tanning Association in Washington, which represents indoor tanning manufacturers, distributors and facility owners, has a beef with the bills to ban tanning.
Executive director John Overstreet believes that laws should not replace parents when it comes to deciding what's appropriate for children.
"These places already require parental consent," he said. "There's already a couple of precautionary steps in place, because parents have to sign off, and then you have trained staff to make sure the teens don't get a sunburn or get overexposed. Plus this has a direct impact on these local businesses."
Overstreet also maintains that tanning beds are safer because they use UVA rays, which don't burn your skin and because they allow for tanning in a controlled manner.
"When you go outside, whether you'll tan or burn depends on the time of day, time of year, what latitude you're at, cloud coverage, and that's why it's so easy to get sunburned," he said.
Health experts, including Lickerman, say sunburns are warning signs of too much radiation. But you don't need to burn to damage the skin.
Moreover, said Lickerman, "kids can take those consent forms out to the parking lot, sign their parents' signature and bring it back in. And a lot of salons hire teens as employees who let their friends in."
Talking to teens
Not long after her brother's death, Lickerman began talking to teens about the dangers of tanning as a volunteer for the Melanoma Hope Network. Her school presentations became so popular, that she couldn't keep up with demand. In 2005, she and a group of medical students and dermatology faculty from the medical schools of St. Louis University and Washington University in St. Louis created SPOTS.
The program has trained nearly 200 medical and public health students from St. Louis University and Washington University to talk to teens about how tanning can be deadly, what skin cancer looks like and how to properly use sunscreens and sunless tanning lotions.
Andrea Behr and Trevor McCotter, both fourth-year medical students at SLU, stood before a large classroom at Eureka High School one recent afternoon.
They showed slides of cancer warning signs in the form of moles gone bad and persistent non-healing sores. Behr, 26, cracked at one point that self-examinations for skin cancer give students an excuse to get naked and look at their bodies.
And if cancer wasn't scary enough for the students, maybe aging would be. So they showed photos of young actor Robert Redford next to wrinkly Robert Redford, who also had skin cancer. Behr later invited the students to use a skin analyzer that reveals hidden sun damage.
Perhaps the most effective portion of the presentation is a video of two young people who had melanoma. One of them is a charismatic 18-year-old with braces on his teeth.
His name was David Timothy Long, and he died three months after the video taping ended.
Erica Van Cleave, a 16-year-old sophomore, said after the presentation that she had no idea teens could get skin cancer and die from it.
"I grew up in South Africa, and it was natural to use a tanning bed there," she said. "But I'm going to be a lot more careful now. Plus, I don't want to look too tan, just a natural glow."
Corbin DuCharme, 16, a junior who plays on the Wildcats baseball team, said he uses sunscreen during practice and games. When his younger sister wanted to use a tanning bed, he discouraged her, he said. But a lot of his peers turn a deaf ear to such advice.
"They want to live worry-free at the moment and are confident they will deal with difficulties later," DuCharme said.
Lickerman is confident that the SPOTS message is getting through. Students, she said, have told her that after hearing and seeing it, they decided that they and their friends would go to a movie rather than a tanning salon.
"Kids this age go to tanning salons as entertainment. It's kind of scary," Lickerman says. "It's a night out to get their nails done and then tan."