Real stories about skin cancer and skin damage

Real stories about

skin cancer and skin damage

A teaching resource for secondary students

Real stories about skin cancer and skin damage

Writing and development

Paula Flinn

Kerry O’Hare

Karola Belohradsky

Betty Lipparelli

Susanne Line

Acknowledgements

We remain indebted to the late Clare Oliver and her family for allowing the inclusion of interviews with Clare

in this resource.

Thank you to Peter Wallis and Agnieszka Arto who shared their stories to help raise awareness about the

importance of skin protection.

We also thank the following media organisations for granting permission to use their news and current

affairs footage:

Channel Nine – 60 Minutes, National Nine News Perth

ABC – 7.30 Report

Channel Ten – Ten News Perth

The West Australian

Sun-Herald

All newspaper, case stories and journal articles have been printed with permission.

SCIS No: 353507

The Cancer Council Australia

GPO Box 4708, Sydney NSW 00

Level , 0 Chalmers Street

Surry Hills NSW 0 0

t +6 8063 4 00

f +6 8063 4 0

e info@cancer.org.au

www.cancer.org.au

Contents

Information about the teacher guide ....................................................................................................3

Introduction and incidence of skin cancer ............................................................................................4

UV radiation and the UV Alert...............................................................................................................4

Skin cancer ...........................................................................................................................................5

Checking for skin cancer ......................................................................................................................7

Sun protection – what are the messages? ...........................................................................................7

Solariums..............................................................................................................................................8

Vitamin D ..............................................................................................................................................8

Dangers of sun exposure

Worksheet A – What do you know about skin cancer? ................................................................... 0

Answers ..................................................................................................................

Worksheet B – 60 Minutes – Sunburnt Country DVD questions ..................................................... 3

Answers .................................................................................................................. 4

Worksheet C – 60 Minutes – Sunburnt Country DVD discussion/extension questions ................... 5

Answers .................................................................................................................. 7

Worksheet D – Ben’s story – newspaper article and questions ....................................................... 8

Answers ..................................................................................................................

Worksheet E – Myth or fact group activity ......................................................................................

Answers .................................................................................................................. 3

Worksheet F – Skin protection interview activity ............................................................................ 4

Worksheet G – Young people and skin cancer – newspaper article and questions ........................ 5

Answers .................................................................................................................. 7

Worksheet H – Reduce your risk – group activity ............................................................................ 8

Worksheet I – Dangers of sun exposure – group and extension activities ..................................... 9

Dangers of solarium use

Worksheet A – Solariums – how much do you really know? ..........................................................3

Answers ..................................................................................................................33

Worksheet B – 7.30 Report DVD questions and activities ..............................................................35

Answers ..................................................................................................................37

Worksheet C – Solariums – killer tans .............................................................................................38

Answers ..................................................................................................................40

Worksheet D – Solariums – killer tans group activity ......................................................................4

Answers ..................................................................................................................4

Worksheet E – Solariums advertising group activity .......................................................................43

Worksheet F – Solariums – group/extension activity .......................................................................45

Worksheet G – Solarium regulation – newspaper article and questions .........................................46

Answers ..................................................................................................................48

Information about the teacher guide

This resource examines the many issues related to young people and skin cancer and is aimed at

secondary school students. The activities throughout the resource can be used individually or as part of a

comprehensive unit.

The main purpose of the DVD resource package is to help secondary students:

• increase their knowledge about skin cancer

• understand the risks of tanning, being burnt by the sun and solariums

• understand that sunburn and skin damage can occur in as little as 5 minutes in summer

• examine their own attitudes about tanning and skin cancer

• understand the need for SunSmart behaviour now to prevent skin cancer later in life.

The DVD contains the following news items in the order below and we gratefully acknowledge each

source:

•

60 Minutes segment “Sunburnt Country” aired on 0 February 005 ( 3 minutes 0 seconds)

Channel Nine News Perth skin cancer story aired on 9 November 006 ( minute 5 seconds)

7.30 Report segments “Dangers of a deadly tan” aired on August 007 and “Melanoma victim to

change the shape of public health” aired on 30 August 007 ( 3 minutes 4 seconds)

Channel Ten News Perth solarium story aired on 6 October 006 ( minute 0 seconds)

The activities are based on the following real life stories and campaigns:

• 60 Minutes – Sunburnt Country

• Young people and skin cancer

• Solaria – killer tans

• 7.30 Report – “Dangers of a deadly tan” and “Melanoma victim to change the shape of public health”.

WARNING – Important information for teachers relating to the stories in the DVD

There are images and stories in this DVD that could upset students. This DVD talks about the

consequences of cancer and shows footage of surgical procedures. It is recommended that you watch

the DVD beforehand to ensure it is suitable for students in your class.

We also recommend that you familiarise yourself with school procedures for managing students who

may become upset during the lesson. Issues that could emerge in the class include:

• students who have experienced cancer in some way

• students who react emotionally to the stories in the DVD

•

students who have real concerns about skin cancers on their own body.

If you have any queries or need further information call The Cancer Council Helpline on 13 11 20 (local call

cost anywhere in Australia).

Introduction and incidence of skin cancer

Skin cancer in Australia

Australia has the highest rate of skin cancer in the world with one in two people developing skin cancer at

some time in their lives. Every year, 374,000 people are diagnosed with non-melanoma skin cancer and more

than 9500 people with melanoma. Annually more than 600 people lose their lives to skin cancer, the majority

from melanoma, which accounts for about 80% of skin cancer related deaths. Melanoma is the most common

cancer diagnosed in young Australians ( 5-44 yrs).

Skin cancer is a disease that develops when the skin has been damaged by ultraviolet (UV) radiation. Sun

exposure during the first 8 years of life has a significant impact on the likelihood of developing skin cancer

later in life. Children and teenagers in particular need to be protected as their delicate skin can be damaged

by the sun much quicker than adults.

UV radiation and the UV Alert

Although our senses can easily detect sunlight and infrared radiation (heat), they cannot detect the level of

UV radiation from the sun. UV radiation cannot be seen or felt and can damage skin on cool, cloudy days as

well as hot, sunny ones.

While UV radiation comes directly from the sun, it can also be scattered by particles in the air and reflected

by surfaces such as buildings, concrete, sand, snow and water. It can also pass through light cloud.

The Global Solar UV Index is a rating system that indicates the amount of the sun’s UV radiation that reaches

the earth’s surface. The higher the index value, the greater the potential for skin damage.

The UV Index has five categories:

Low ( – )

Moderate (3–5)

High (6–7)

Very high (8– 0)

Extreme ( and above)

Whenever UV Index levels reach 3 (moderate) and above skin protection is required. At that level UV

radiation is intense enough to damage the skin and contribute to the risk of skin cancer. UV Index levels

reach their peak in the middle of the day, so extra care should be taken to reduce exposure. In fact around

70% of the daily UV radiation from the sun is received between 0 am and 3 pm and is most intense

between these times. People with fair skin need to take particular care at all times. Skin protection should

always be used in alpine regions, or near highly reflective surfaces like snow or water.

The SunSmart UV Alert

The SunSmart UV Alert is a quick and easy tool that helps people

know specifically when UV levels will be high enough to damage

the skin and skin protection measures are needed. The Bureau of

Meteorology issues the SunSmart UV Alert when the UV Index is

forecast to reach 3 or above. It is reported daily on the weather

page of newspapers around Australia, some mobile phone and radio

weather forecasts and on the Bureau of Meteorology website at

www.bom.gov.au/weather/uv.

SunSmart UV Alert example

Skin cancer

Structure and function of the skin

The skin is the largest organ of the body. It has several important functions. It acts as a protective layer

against injury and disease and also regulates our body temperature and maintains hydration.

•

The skin consists of three

layers – the epidermis or

the outer layer, the dermis

or the inner layer and the

subcutaneous fat layer.

The epidermis is made

up of cells that produce

keratin, a substance that

covers the outside of

the skin and resists heat,

cold and the effects of

many chemicals.

The melanocyte cells

in the epidermis also

produce melanin, the

substance that gives our

skin its colour.

Melanin is able to absorb

ultraviolet light and

provide some protection

from its damaging effects.

What is cancer?

Cancer is a disease of the body’s cells. Normally the body’s cells grow and divide in an orderly manner

so that growth and healing of injured tissue occurs. Occasionally some cells behave in an abnormal way

and may grow into a lump which is called a tumour. Tumours can be non-cancerous (benign) or cancerous

[malignant]. Benign tumours do not spread to other parts of the body.

A malignant tumour is made up of cancer cells. These cells have the ability to spread beyond the original

site and if left untreated may invade and destroy surrounding tissue. Sometimes cells break away from

the original (primary) cancer and spread to other organs. When these cells reach a new site they may form

another tumour often referred to as a secondary cancer or metastasis.

What is skin cancer?

Skin cancer is a type of cancer that begins in the basal layer of the epidermis. There are three main types of

skin cancer: basal cell carcinoma, squamous cell carcinoma and melanoma. Melanomas start in the pigment

cells [melanocytes] while basal and squamous cell carcinomas develop from the epidermal cells. [Carcinoma

is a term used for some types of cancer]. As skin cancers are visible, they can be seen and checked as soon

as they develop.

Basal cell carcinoma [BCC]

Basal cell carcinomas are the most common but least dangerous type of skin cancer. They grow slowly over

months to years, but if left untreated a deep (rodent) ulcer may form. Fortunately they very rarely spread to

other parts of the body. If you have one basal cell carcinoma you may have others, either at the same time or

in later years. Basal cell carcinomas are most commonly found on the face, neck and upper trunk. They appear

as a lump or scaly area and are pale, pearly or red in colour. They may have blood vessels on the surface.

Squamous cell carcinoma [SCC]

Squamous cell carcinomas are less common but more dangerous than basal cell carcinomas. They usually

grow over a period of weeks to months. These cancers may spread to other parts of the body [metastasis]

if not treated promptly. Squamous cell carcinomas appear on areas of the skin most often exposed to the

sun. They have scaling, red areas which may bleed easily and ulcerate, looking like an unhealed sore. These

common skin cancers generally occur in people over the age of 40. However basal cell carcinoma can occur

in younger adults. The major cause of these skin cancers is sun exposure over many years.

Melanoma

Melanoma is the rarest but most dangerous skin cancer. If left untreated melanoma can spread to distant

parts of the body to form secondary cancers or metastasis. Melanomas can appear anywhere on the body,

even areas not exposed to the sun. The first sign of a melanoma is usually a change in a freckle or mole or

the appearance of a new spot on normal skin. Changes are normally seen over a period of several weeks

to months, not over several days. The changes are in size, shape or colour. Melanoma can occur from

adolescence onwards and is the most common cancer in the 5–44 year age group. In rare instances it may

develop in children.

Diagnosis

If a doctor suspects a skin cancer, a biopsy may be performed. A biopsy is the removal of all or part of the

affected skin, generally under local anaesthetic. It is a simple procedure that can be done by your family

doctor or you can be referred to a specialist. The piece of skin that has been removed is then examined

under a microscope. In many cases the whole tumour is removed and a specimen is then sent to a

laboratory for diagnosis.

Causes of skin cancer

The major cause of skin cancer is exposure to the sun’s ultraviolet rays.

Sunlight exposure

Childhood exposure to the sun is an important factor in the development of skin cancer later in life.

Research also suggests there may be a link between sunburn during childhood and melanoma in adulthood.

Who is at risk?

Everyone is at risk of skin cancer, although fair skinned people who have lived in Australia all their lives and

have skin that burns easily and rarely tans are at the greatest risk. Those who burn and tan are also at high

risk if they do not protect their skin. Unprotected skin, whether tanned or not, is likely to be damaged by the

sun and may develop skin cancer later in life.

Skin types

Skin cancer is seen most often in fair skinned people who have lived in Australia all their lives. However,

no skin type is immune to skin cancer. No matter what your skin type, colour or family background, living in

Australia with such high UV levels puts all skin types at risk. For further information about skin types see the

following websites:

•

www.hpa.org.uk/radiation/understand/information_sheets/solar_index.htm

www.who.int/uv/publications/en/GlobalUVI.pdf (p 7)

http://anthro.palomar.edu/adapt/adapt_4.htm

Eye damage

Eyes can also be damaged by UV radiation. Damage includes degenerative changes, cataracts and pterygia.

Sunglasses and wearing a hat are recommended to reduce UV exposure to the eyes.

Checking for skin cancer

Checking skin regularly will help detect any new or unusual spots that may be skin cancers. It is important to

check skin all over your body as skin cancer can develop in places not normally exposed to the sun. Look for

new spots or existing spots that have changed over weeks or months in size, shape or colour. A skin cancer

can also be a spot that bleeds easily, never heals properly or is always itchy.

What should you do if you think you have skin cancer?

If you think you have skin cancer you need to see your doctor as soon as possible. Over 95% of skin

cancers can be treated if detected early. A doctor will check whether you have skin cancer and will offer

treatments to remove the spot. Ignoring a suspicious spot could be dangerous as skin cancers can continue

to grow if left untreated. For more advice on skin protection or skin cancer see your doctor, call The Cancer

Council Helpline 13 11 20 or visit www.cancer.org.au/sunsmart.

Sun protection – what are the messages?

Whenever UV Index levels reach 3 and above sun protection is required. Protect yourself against sun

damage and skin cancer by using a combination of these five steps:

1. Slip on sun protective clothing

Clothing can be great for protecting you from the sun. Look for long sleeves, collars and

long pants or at least ¾ length pants or skirts. Choose loose fitting styles and materials that

have a close weave. Darker colours generally absorb more UV radiation than lighter shades.

2. Slop on 30+ broad spectrum sunscreen

Sunscreen can block up to 96% of UV radiation. However no sunscreen offers 00% UV

radiation protection. Sunscreen should always be used with other forms of protection

such as hats, sunglasses, clothing and shade. Sunscreen should not be used to increase

the time you spend in the sun. For the best protection, use sunscreen that is labelled

SPF 30+ broad spectrum and water resistant. Don’t forget to re-apply every two hours.

3. Slap on a SunSmart hat

A broad brimmed, bucket or legionnaire style hat provides the best protection for the

face, nose, neck and ears – common sites for skin cancers. Hats protect you from direct

UV radiation but not from reflected UV radiation. Caps and visors do not provide good

protection and are not recommended.

4. Seek full shade

Staying in full shade is one of the most effective ways to reduce sun exposure,

but remember that other skin protection measures (clothing, hats, sunglasses and

sunscreen) should also be used to avoid reflected UV radiation. UV radiation can reflect

from nearby surfaces and cause sunburn even if you are in the shade.

5. Slide on some sunglasses

Sunglasses are an effective measure to reduce eye damage from UV radiation. Choose

sunglasses that are a close fit, wraparound style, and meet the Australian Standard

(AS/NZS 067: 005) or have an eye protection factor (EPF) of 0. These numbers can be

found on the swing tag.

Remember to take extra care between 0 am and 3 pm when UV radiation is most intense.

Solariums

A solarium is a device that uses artificial UV radiation to tan human skin. Other names for a solarium are

sunbed, tanning unit, sunlamp, tanning bed or tanning booth. Solariums work by emitting concentrated

artificial UV rays. Solarium users either lie down on a UV bed, stand in front of a UV panel or angle a UV sun

lamp over their skin. The UV radiation prompts skin cells to make pigment or ‘melanin’, which makes the

skin look tanned.

Solariums emit levels of UV radiation up to five times as strong as the midday summer sun. Solariums emit

UVA and UVB radiation, which are known causes of skin cancer, including melanoma. UV radiation also plays

an important role in the development of cataracts and other eye conditions, and suppresses the immune

system. Solariums have been recognised as a known carcinogen since 000.

The Cancer Council Australia and the Australasian College of Dermatologists do not recommend the use of

UV radiation tanning devices due to the associated risks.

Tanning alternatives

If you insist on changing your skin colour, applying a fake tan is a safer alternative to using a solarium or the

sun. But remember even if you use fake tan, you still need to protect yourself from the sun.

Vitamin D

Exposure to the sun provides most of the body’s vitamin D, so we need some sun exposure to keep us

healthy. A balance is required to achieve enough sun exposure to maintain adequate vitamin D levels while

minimising the risk of skin cancer.

Most people with fair skin achieve sufficient vitamin D levels from the sun exposure they receive through

typical day-to-day outdoor activities, without needing to seek additional sun exposure.

If young people, or their parents, are concerned about vitamin D status they are encouraged to speak to

their doctor.

For more information refer to The Cancer Council Australia’s ‘Benefits and Risk of Sun Exposure’ position

statement, available at www.cancer.org.au.

. Standards Australia ‘AS/NZS 635: 00 Solariums for Cosmetic Purposes’ 00 .

. International Agency for Research on Cancer Working Group on artificial ultraviolet (UV) light and skin cancer. ‘The association of

sunbeds with cutaneous malignant melanoma and other skin cancers: A systematic review’. International Journal of Cancer, 0

( 006): 6- .

Dangers of sun

exposure

Worksheet A

What do you know about skin cancer?

Indicate whether you think the following statements are true or false by placing a tick in the

appropriate box.

. Skin cancer is the most common cancer in Australia. True False

. The wind can cause sunburn (ie. windburn). True False

3. In January, on a 0°C day your skin is just as likely to burn as on a 40°C day. True False

4. Some sun exposure is good for you. True False

5. It is estimated that one in two Australians will get skin cancer in their lifetime. True False

6. It is healthy to get a tan. True False

7. Melanoma is the most dangerous type of skin cancer. True False

8. Shade provides complete protection from ultraviolet (UV) radiation. True False

9. It is important to reduce exposure to the sun between 0 am and 3 pm. True False

0. Skin damage caused by the sun can be reversed. True False

. Research has shown that sun exposure in childhood and teenage years is

an important risk factor in developing skin cancer. True False

Worksheet A – answers

What do you know about skin cancer?

1. Skin cancer is the most common cancer in Australia.

True – Over 380,000 Australians are diagnosed with skin cancer every year and approximately 600 will

die as a result of skin cancer.

2. The wind can cause sunburn (ie. windburn).

False – There is no such thing as windburn. It is in fact sunburn from UV radiation. It may be cloudy

but UV radiation can still get through, or UV could be reflecting off sand, water or other light-coloured

surfaces. Have you ever been burnt on a windy night?

3. In January, on a 20°C day your skin is just as likely to burn as on a 40°C day.

True – A 0° January day is likely to have the same UV levels as a 40° January day. It is the UV

radiation, not the infrared radiation (which causes heat), that burns your skin. You cannot see or feel UV

radiation so it is important to use sun protection even on a cool day.

Further information on UV radiation can be found on the following websites:

•

Bureau of Meteorology – www.bom.gov.au/weather/uv

Australian Radiation Protection and Nuclear Safety Agency – www.arpansa.gov.au.

4. Some sun exposure is good for you.

True – Exposure to the sun provides most of the body’s vitamin D, so we need some sun exposure to

keep us healthy. Sensible skin protection should not put people at risk of vitamin D deficiency. Most

people with fair skin achieve adequate vitamin D levels through the sun exposure they receive during

typical day-to-day activities, so there is no need to deliberately expose yourself to the sun. , For more

information see The Cancer Council’s position statement on the benefits and risks of sun exposure

which can be found at www.cancer.org.au.

5. It is estimated that one in two Australians will get skin cancer in their lifetime.

True – Current statistics estimate that one in two Australians will be diagnosed with skin cancer in their

lifetime. 3

6. It is healthy to get a tan.

False – A suntan is a sign of skin damage. Skin damage caused by sun baking can lead to premature

ageing of the skin, wrinkles, loss of elasticity and thick, leathery skin. The longer your skin is exposed

to the sun, the greater your risk of developing skin cancer.

7. Melanoma is the most dangerous type of skin cancer.

True – Although melanoma accounts for less than 5% of all skin cancers, it is the most dangerous

and aggressive type of skin cancer and can spread to other parts of the body. A melanoma can grow

anywhere on the body – even on areas not exposed to the sun. Other common types of skin cancer

include basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). While skin cancer is dangerous,

early detection is vital as more than 90% of skin cancers can be cured if detected early.

8. Shade provides complete protection from UV radiation.

False – Shade provides some protection, but UV radiation can also be reflected from nearby surfaces

such as concrete, sand and water. Using a combination of skin protection methods such as wearing

protective clothing, hats, sunglasses and sunscreen is still important in shade.

9. It is important to reduce exposure to the sun between 10 am and 3 pm.

True – Around 70% of the daily UV radiation from the sun is received between 0 am and 3 pm. The

sun is also most intense between these times making skin protection vital.

Worksheet 1A – answers cont

10. Skin damage caused by the sun can be reversed.

False – Sun damage is irreversible, it accumulates over time and increases the risk of skin cancer in

later life. Be SunSmart. Protect yourself against sun damage and skin cancer by limiting sun exposure

between 0 am and 3 pm and using a combination of these five steps:

1. Slip on skin protective clothing

Cover up as much of the skin as possible.

2. Slop on SPF 30+ sunscreen

Make sure it is broad spectrum and water resistant.

3. Slap on a hat

Wear a broad brimmed hat that covers your face, head, neck and ears.

4. Seek shade

Make use of trees or built shade structures – or bring your own!

5. Slide on some sunglasses

Close fitting wraparound styles offer the best protection.

11. Research has shown that sun exposure in childhood and teenage years is an important risk

factor in developing skin cancer.

True – Sun exposure in the first 5 years of life contributes significantly to skin cancer risk in

adulthood. 4 It is imperative that the skin be protected during childhood and adolescence to reduce the

risk of skin cancer in later life.

. The Cancer Council Australia, 007. Risks and Benefits of Sun Exposure: Position Statement. www.cancer.org.au/policy/

positionstatements/SunSmart/risksandbenefitsofsunexposure.htm

. Samenek A, Croager E, Gies P, Milne E, Prince R, McMichael A, Lucas R and Slevin T, 006, ‘Estimates of beneficial and harmful sun

exposure times during the year for major Australian population centres’. Medical Journal of Australia, vol. 84, no. 7, pp. 338–34 .

3. Armstrong B, 004, ‘How sun exposure causes skin cancer: an epidemiological perspective’, in Hill D, Elwood J and English D.

Prevention of Skin Cancer. Kluwer Academic Publishers, Dordrecht, The Netherlands, pp. 89– 6.

4. Institute of Health and Welfare and Australasian Association of Cancer Registries 003. Cancer in Australia 00 . National Cancer

Control Initiative 003. ‘The 00 national non-melanoma skin cancer survey’. A report by the NCCI Non-melanoma Skin Cancer

Working Group. Edited by MP Staples. NCCI Melbourne.

Worksheet B

60 Minutes – Sunburnt Country DVD questions

Answer the following questions while viewing the 60 Minutes – Sunburnt Country program on the

enclosed DVD.

. Why is tanning so popular in Australian society?

__________________________________________________________________________________________

. How many Australians will die of melanoma this year?

__________________________________________________________________________________________

Ben Foley – 16 years old

3. What is Ben Foley’s risk of getting another melanoma?

__________________________________________________________________________________________

Steven Nielson – 28 years old

4. (a) Where has Steven’s melanoma spread?

__________________________________________________________________________________________

(b) How did Steven spend his summer afternoons as a young person?

__________________________________________________________________________________________

Renee Marchment – 24 years old

5. What happened to a mole that she noticed on her leg?

__________________________________________________________________________________________

6. During the story Professor John Thompson examines young people’s skin. He makes a number of

comments during this segment.

(a) What did Professor Thompson find when examining the skin of these young people?

__________________________________________________________________________________________

(b) What do these findings mean for young people? What is the outcome?

__________________________________________________________________________________________

Worksheet B – answers

60 Minutes – Sunburnt Country DVD questions

1. Why is tanning so popular in Australian society?

In the 60 Minutes documentary Tara Brown (presenter) comments that it is seen as a “right of

passage” to spend long lazy days at the beach. Some Australians believe a tan is healthy. Research

conducted by The Cancer Council shows that 50% of Australians believe a suntanned person looks

healthy (53% of males; 47% of females) and 5% of Australians attempted to get a tan in the summer

of 003/04.

2. How many Australians will die of melanoma this year?

Approximately 000 Australians die of melanoma each year.

Ben Foley – 16 years old

3 What is Ben Foley’s risk of getting another melanoma?

Ben’s risk of getting another melanoma is four times greater now that he has already had a melanoma

removed.

Steven Nielson – 28 years old

4. (a) Where has Steven’s melanoma spread?

Steven’s melanoma spread to his spine, liver and lungs.

(b) How did Steven spend his summer afternoons as a young person?

Steven spent his summer afternoons outdoors in his backyard. He got burnt a lot and never

protected himself from the sun.

Renee Marchment – 24 years old

5. What happened to a mole that she noticed on her leg?

The mole on the back of Renee’s leg changed shape so she contacted her doctor and asked for it to be

checked.

6. During the story Professor John Thompson examines young people’s skin. He makes a number

of comments during this segment.

(a) What did Professor Thompson find when examining the skin of these young people?

Professor Thompson found the young people he examined had skin that had aged prematurely and

a number of suspect moles.

(b) What do these findings mean for young people? What is the outcome?

This is a sign that the skin has been damaged by the sun and there is a risk of developing skin

cancer. It is advised that skin protection is used to prevent further skin damage and if unusual

spots, moles or freckles are noticed that medical advice is sought early.

. Dobbinson S, Bowles K, Fairthorn A, Sambell N and Wakefield M, 005. Sun Protection and Sunburn Incidence of Australian

Adolescents: Summer 003–04. The Cancer Council Victoria, Melbourne.

. Australian Institute of Health and Welfare (AIHW), 005. Health system expenditures on cancer and other neoplasms in Australia,

000–0 . AIHW cat. no. HWE 9. Canberra.

Worksheet C

60 Minutes – Sunburnt Country DVD discussion/

extension questions

Discuss the following questions in small groups after viewing the 60 Minutes – Sunburnt Country

program on the enclosed DVD.

. What part of the DVD made an impact on you? Why?

__________________________________________________________________________________________

. What did you discover that you didn’t know before?

__________________________________________________________________________________________

3. Why do you think tanning is popular with teenagers, especially when most know the risks?

__________________________________________________________________________________________

4. Melanoma is the most common cancer affecting 5 to 44 year olds.

Does this surprise you? Why/why not?

__________________________________________________________________________________________

5. How did the melanoma diagnosis impact on each of the young people’s lives in the 60 Minutes story?

Consider physical, personal, emotional, social, family and financial factors.

__________________________________________________________________________________________

6. Dr Jonathon says “...wilfully lying around in the sun is different from enjoying activity out in the sun.”

Discuss what this statement means. How can people safely enjoy outdoor activities?

__________________________________________________________________________________________

Worksheet 1C – 60 Minutes – Sunburnt Country cont

7. Early detection is an important factor that increases survival rates of those who develop skin cancers.

What are some of the signs to be aware of to detect skin cancer?

__________________________________________________________________________________________

8. At what times is it important to use skin protection?

__________________________________________________________________________________________

9. (a) Overexposure to UV radiation in the first 5 years of life is an important factor in the development of

skin cancer later in life. With this in mind, think of creative ways to encourage students at your

school to be SunSmart.

__________________________________________________________________________________________

(b) How would you encourage your friends to adopt skin protection behaviours?

__________________________________________________________________________________________

Worksheet C – answers

60 Minutes – Sunburnt Country DVD discussion/

extension questions

Questions 1 to 5 and question 9 ask for students’ opinions and therefore detailed answers are not

provided in this discussion guide.

6. Dr Jonathon says “...wilfully lying around in the sun is different from enjoying activity out in the

sun.” Discuss what this statement means. How can people safely enjoy outdoor activities?

When Dr Jonathon talks about “wilfully lying around in the sun”, he is referring to people who lay in

the sun for extended periods of time with the purpose of developing a tan. He is also referring to those

people who spend time outdoors without any form of sun protection, such as using shade or wearing

protective clothing, hats, sunglasses and sunscreen.

People can use a combination of strategies to safely participate in outdoor activity. Be SunSmart.

Protect yourself against sun damage and skin cancer by limiting sun exposure between 0 am and

3 pm and using a combination of these five steps:

1. Slip on skin protective clothing

Cover up as much of the skin as possible.

2. Slop on SPF 30+ sunscreen

Make sure it is broad spectrum and water resistant.

3. Slap on a hat

Wear a broad brimmed hat that covers your face, head, neck and ears.

4. Seek shade

Make use of trees or built shade structures – or bring your own!

5. Slide on some sunglasses

Close fitting wraparound styles offer the best protection.

7. Early detection is an important factor that increases survival rates of those who develop skin

cancers. What are some of the signs to be aware of to detect skin cancer?

Some signs to be aware of are:

• a skin spot that is different from other spots around it

• a mole or freckle that has changed size, shape or colour

• a suspicious spot that is new or has changed over weeks or months in size, shape or colour

•

an inflamed sore that has not healed within three weeks.

8. At what times is it particularly important to use skin protection?

Time of day: The most important factor affecting UV radiation is the sun’s height in the sky. UV radiation

is highest when the sun is directly overhead and the path of the radiation through the atmosphere is

shortest. When the sun is lower in the sky, the path of the radiation through the atmosphere is much

longer and more of the radiation is absorbed or reflected back into space.

UV radiation is most intense between 0 am and 3 pm because this is when the sun is more directly

overhead and the distance sunlight has to travel through the atmosphere (and be filtered by it) is

shortest. Around 70% of the total daily UV radiation from the sun on a mid-summer day is received

between 0 am and 3 pm.

Time of year (season): UV radiation is more intense during summer than winter. During summer the

southern hemisphere is closer to the sun than the northern hemisphere.

As you move closer to the equator UV radiation increases because the path of the radiation from the

sun becomes shorter. Therefore in the north of Australia UV radiation levels are high all year round.

Worksheet D

Ben’s story – newspaper article

Article from: Sunday Telegraph, Sunday 28/05/2006, p 11

Just 8, and a victim of melanoma’s cruel odds

Ben’s courage a lasting legacy

By Sarah Blake

The red hair and alabaster

skin shared by the four Foley

children drew attention all their

lives, but for one of them, the

striking combination took a fatal

toll.

Ben Foley was just 18 when

he died last week of melanoma.

And his death comes at

a time when cancer experts

are concerned Australians are

continuing to ignore clear and

unequivocal evidence that the

sun here is a killer.

“We have the highest rate

of skin cancer deaths in the

world, but you still see parents

letting their children play in the

sun at the beach. It’s really just

criminal”, said Professor John

Thompson, the director of the

Sydney Melanoma Unit at Royal

Prince Alfred Hospital.

Ben Foley, a popular,

athletic teenager who managed

to complete his HSC last year

during months of gruelling

treatment, had no doubt what

caused the disease that would end

his life.

“I spent too much time in the

sun without sunscreen”, he told

60 Minutes when the current

affairs program interviewed him

last year.

Showing the courage that

his mother, Sue, said was innate

and inspiring, he then took the

television crew to Cronulla to

warn other teenagers about how

dangerous it was to get a suntan.

“Seeing him over the past

year, how strong he was, it

showed me that he was an

extraordinary person”, Mrs Foley

said last week at her Bexley

home.

“He wanted to help other

people understand about skin

cancer, about how it wasn’t

something that only happened to

older people.”

“He never felt embarrassed

about showing the scars on his

back from his operations, even

though they were terrible”.

Ben’s sister, Erin, said she

had never really accepted that her

baby brother was going to die.

“He just seemed so strong.

He never complained about

anything: you never would have

known that he was suffering”,

she said.

“I didn’t think he would die.

Young boys don’t get skin cancer

and die – it just doesn’t happen”.

Professor Thompson said it

was rare for someone Ben’s age

to die from melanoma.

“The vast majority of people

we treat are older, but we have

teenagers and even children with

melanoma”, he said.

He said Ben’s skin type made

him more susceptible to the

disease.

“People with fair complexions

are at much higher risk”,

Professor Thompson said. “If you

have a single Celtic ancestor, you

are at significantly higher risk,

and 75 per cent of the Australian

population is of Celtic ancestry

– that’s why we have the highest

incidence in the world”.

Skin cancer accounts for

about 81 per cent of all new

cancers in Australia each

year, with more than 374,000

Australians diagnosed with nonmelanoma

skin cancer.

And more than 8,800

Australians are diagnosed with

melanoma, with nearly 1000 of

these dying, according to the

Australian Cancer Council.

Survival rates have risen

significantly since the early

1980’s as a result of skin cancers

being detected earlier and

improved treatment methods.

However, the Council advises

people to stay out of direct sun

between 10 am and 3 pm when

UV levels are at their highest,

wear water-resistant sunscreen, a

hat and sunglasses.

Note: Overexposure to the

sun as a child and teenager

is an important factor in the

development of skin cancer later

in life – The Cancer Council.

Worksheet D

Ben’s story – questions

This is the story about Ben Foley – one of the young people interviewed in the 60 Minutes – Sunburnt

Country documentary. Ben’s death is especially sad, as we consider such a young loss of life. His courage

was notable, as he became an advocate for skin protection before his death.

Read the article about Ben Foley and answer the following questions.

. How old was Ben Foley when he died of melanoma?

__________________________________________________________________________________________

. What comments does Professor John Thompson make about the rates of skin cancer in Australia?

__________________________________________________________________________________________

3. What did Ben Foley say caused his skin cancer?

__________________________________________________________________________________________

4. What did Ben Foley want people to understand before he died?

__________________________________________________________________________________________

5. What are other ways that Ben’s message can be shared?

__________________________________________________________________________________________

6. Everyone is at risk of developing skin cancer, even those with darker complexions. How can you lower

your risk of developing skin cancer?

__________________________________________________________________________________________

Worksheet 1D – Ben’s story cont

7. (a) What percentage of all new cancers diagnosed in Australia are skin cancers?

__________________________________________________________________________________________

(b) How many Australians are diagnosed with non-melanoma skin cancers each year?

__________________________________________________________________________________________

year?

__________________________________________________________________________________________

8. Why have survival rates improved since the early 980’s?

__________________________________________________________________________________________

9. (a) What does the article say people should do to protect themselves from the sun?

__________________________________________________________________________________________

(b) What are the other protection strategies apart from these?

__________________________________________________________________________________________

sun? (eg. during leisure time, sports sessions, at school)

__________________________________________________________________________________________

Worksheet D – answers

Ben’s story

1. How old was Ben Foley when he died of melanoma?

Eighteen years old.

2. What comments does Professor John Thompson make about the rate of skin cancer in Australia?

Australia has the highest rates of skin cancer in the world.

3. What did Ben Foley say caused his skin cancer?

Ben said he spent too much time in the sun with no sunscreen.

4. What did Ben Foley want people to understand before he died?

Ben wanted people to understand more about skin cancer – about how it wasn’t something that only

happened to older people. He wanted to warn young people about the dangers of getting a suntan.

5. What are other ways that Ben’s message can be shared?

Ben’s family and friends can share Ben’s story and warn others of the risks of not protecting yourself

out in the sun. All students who see this story can adopt better skin protection strategies and warn

their friends about the dangers.

6. How can you lower your risk of developing skin cancer?

Minimise your time outdoors between 0 am and 3 pm (when UV radiation is most intense) and follow

these five simple steps:

1. Slip on skin protective clothing

Cover up as much of the skin as possible.

2. Slop on SPF 30+ sunscreen

Make sure it is broad spectrum and water resistant.

3. Slap on a hat

Wear a broad brimmed hat that covers your face, head, neck and ears.

4. Seek shade

Make use of trees or built shade structures – or bring your own!

5. Slide on some sunglasses

Close fitting wraparound styles offer the best protection.

7. (a) What percentage of all new cancers diagnosed in Australia are skin cancers?

8 %.

(b) How many Australians are diagnosed with non-melanoma skin cancers each year?

Approximately 380,000.

melanoma each year?

According to the article, more than 8800 are diagnosed with melanoma and 000 people die.

(More recent statistics show more than 9500 are diagnosed with melanoma and 00 people die).

8. Why have survival rates improved since the early 1980s?

Survival rates have risen due to skin cancers being detected at an earlier stage and improved treatment

methods.

9. (a) What does the article say people should do to protect themselves from the sun?

Stay out of the direct sun between 0 am and 3 pm when UV radiation levels are highest, wear

water resistant sunscreen, a hat and sunglasses.

(b) What are the other protection strategies apart from these?

Wear sun protective clothing and seek shade.

. Australian Institute of Health and Welfare and Australasian Association of Cancer Registries, Cancer in Australia: an overview,

2006. Canberra, 007.

Worksheet E

Myth or fact – group activity

Work in groups and indicate whether you think the following statements are a myth or a fact by

placing a tick in the appropriate box.

. UV radiation is present in the sun’s rays throughout the year.

Myth Fact

. Reddening of the skin on a cool, cloudy day is windburn not sunburn.

Myth Fact

3. Skin cancer is preventable.

Myth Fact

4. I am going to be outside all day today but as long as I use sunscreen properly I won’t burn.

Myth Fact

5. More expensive sunglasses provide better protection from the sun’s UV radiation.

Myth Fact

6. A suntan is healthy.

Myth Fact

7. Sunscreen protects me so I can sunbathe much longer.

Myth Fact

8. Baseball caps and visors do not provide adequate protection from the sun.

Myth Fact

Worksheet E – answers

Myth or fact – group activity

1. UV radiation is present in the sun’s rays throughout the year

Fact – UV radiation is present in the sun’s rays throughout the year in varying amounts, peaking in the

summer months. UV radiation levels are high all year round in the northern half of Australia.

2. Reddening of the skin on a cool, cloudy day is windburn not sunburn

Myth – There is no such thing as ‘windburn’, it is actually sunburn. The wind can dry your skin but it cannot

burn you. It is the UV radiation in sunshine that causes our skin to burn. UV radiation cannot be felt on the skin

(or seen by the eye). So even on a cool or cloudy day, UV radiation can be high enough to cause sunburn.

3. Skin cancer is preventable

Fact – Most skin cancers are caused by overexposure to UV radiation and so are largely preventable.

You can reduce your risk of developing skin cancer by protecting yourself from the sun. Be SunSmart.

Protect yourself against sun damage and skin cancer by limiting sun exposure between 0 am and

3 pm and using a combination of these five steps:

1. Slip on skin protective clothing

Cover up as much of the skin as possible.

2. Slop on SPF 30+ sunscreen

Make sure it is broad spectrum and water resistant.

3. Slap on a hat

Wear a broad brimmed hat that covers your face, head, neck and ears.

4. Seek shade

Make use of trees or built shade structures – or bring your own!

5. Slide on some sunglasses

Close fitting wraparound styles offer the best protection.

4. I’m going to be outside all day today but as long as I use sunscreen I won’t burn

Myth – No matter how high the SPF (sun protection factor) is, sunscreen cannot completely shield you

from the sun. Sunscreen does not provide 00% protection. This is why sunscreen should not be used

as the sole form of protection against UV radiation, but rather used in combination with wearing a shirt,

hat, sunglasses and using shade.

5. More expensive sunglasses provide better protection from the sun’s UV radiation

Myth – Spending more on sunglasses does not necessarily mean that you are purchasing a better

quality product. Regardless of price all sunglasses sold in Australia must meet the Australian Standard

AS/NZ 067: 003. Check the swing tag before purchasing sunglasses and choose sunglasses with

an eye protection factor (EPF) of 0. Choose large, wraparound, close fitting sunglasses to reduce UV

radiation that passes around the edge of the glasses to reach the eyes.

6. A suntan is healthy

Myth – A tan results from your body trying to defend itself against damage from UV radiation. A tan

does not provide effective protection from the sun and is a sign of skin damage. Tanning without

burning may cause DNA and skin damage leading to premature ageing and potentially, skin cancer.

7. Sunscreen protects me so I can sunbathe much longer

Myth – The protection sunscreen provides depends critically on the correct application. Sunscreen does not

provide 00% protection and should not be used to increase the amount of time you spend in the sun.

8. Baseball caps and visors do not provide adequate protection from the sun

Fact – Baseball caps and visors are not recommended as they leave the ears and back of neck

exposed. These are common skin cancer sites.

. Raab WP 990, ‘Photodamaged skin: a medical or a cosmetic concern?’ Journal of International Medical Research, 8. Supplement 3: c – 7c.

Worksheet F

Skin protection interview activity

Interview a parent, grandparent or friend about their attitudes towards tanning and skin protection

now, and when they were younger to determine whether their attitudes have changed since they

were young.

Interview a male and female about their attitudes towards tanning and skin protection to determine

whether their attitudes are different and if so, how they differ.

Questions to include in your interviews:

. Did you seek a tan when you were young? Why/why not?

. Were you aware of the risks of tanning as a teenager? If so, did this change your behaviour?

3. Do you think a tan is healthy? Why/why not?

4. Do you protect yourself from the sun now? Why/why not?

5. Why do you think young people desire a tan?

6. Have you ever used a solarium or tanning bed? Are you aware of the risks?

Compile a report/summary detailing the attitudes your interviewees held towards tanning and skin

protection.

Worksheet G

Young people and skin cancer – newspaper article

Article from: The West Australian, Monday 20/11/2006, p 10

Marked man: Peter Wallis, 18, shows the scar from where his potentially deadly melanoma

was removed. Picture: Sharon Smith.

DEBBIE GUEST

Youth no barrier to skin cancer

Skin cancer is no longer a

condition which plagues only

older generations with children

as young as 14 diagnosed with

melanoma and people in their

early 20s killed by it.

Four men between 20 and

24 died from melanoma in WA

two years ago, a fate 18-year-old

Peter Wallis came all too close to.

He now faces a lifetime of skin

checks and being vigilant about

the dangers of the sun.

The University of WA law and

economics student mentioned a

mole on his leg to his GP in July

and was quickly referred to a

dermatologist who removed it.

The mole was a 2.4mm

thick intermediate melanoma,

big enough to enter Mr Wallis’

bloodstream. He needed more

surgery to remove extra skin and

tests confirmed the cancer had

not spread.

Mr Wallis swam a lot when he

was younger and did not bother

with sunscreen because it was for

short periods each day.

“I didn’t really think of it

being damaging,” he said. “I

didn’t think a melanoma or any

sort of skin cancer was ever

going to happen to me.”

He now has an increased risk

and needs regular skin checks.

The rise in young people

getting skin cancer prompted

the WA Cancer Council to focus

on youth as part of this week’s

National Skin Cancer Action

Week. Graphic advertisements

will show a melanoma being

removed from a young woman.

Perth dermatologist Allan

Donnelly said people of all ages

had to monitor moles to see if

they grew, changed colour or

developed an irregular border.

He said young people were

shocked when told they had a

melanoma.

Worksheet G

Young people and skin cancer questions

Read the article “Youth no barrier to skin cancer” which appeared in The West Australian newspaper

and answer the following questions.

. How many men between 0 and 4 years of age died from melanoma in WA in 004?

__________________________________________________________________________________________

. How old was Peter when he was diagnosed with skin cancer?

__________________________________________________________________________________________

3. What was Peter’s behaviour like when he was out in the sun as a teenager?

__________________________________________________________________________________________

4. What kind of attitude did Peter have toward melanoma and skin cancer?

__________________________________________________________________________________________

5. What was Peter’s reaction when he was told he had melanoma?

__________________________________________________________________________________________

6. Luckily the cancer in Peter’s leg did not spread, but he now has an increased risk of more skin cancer

developing. What can we all do to reduce our risk of developing skin cancer?

__________________________________________________________________________________________

7. Perth Dermatologist Allan Donnelly says people of all ages should monitor their moles.

What should they look for?

__________________________________________________________________________________________

The facts on skin cancer

• Australia and New Zealand have the highest incidence of skin cancer in the world.

• Malignant melanoma is the most common cancer in males and females aged 5 – 44 years.

•

Sun damage before the age of 8 is the most significant cause of melanoma.

Worksheet G – answers

Young people and skin cancer

1. How many men between 20 and 24 years of age died from melanoma in WA in 2004?

Four men aged 0 to 4 years died from melanoma in 004.

2. How old was Peter when he was diagnosed with skin cancer?

Eighteen.

3. What was Peter’s behaviour like when he was out in the sun as a teenager?

Peter swam a lot as a teenager and often did not bother applying sunscreen.

4. What kind of attitude did Peter have toward melanoma and skin cancer?

Peter did not think his behaviour was damaging and thought he would not get skin cancer.

5. What was Peter’s reaction when he was told he had melanoma?

Peter was very surprised and shocked. He thought he would never get skin cancer.

6. Luckily the cancer in Peter’s leg did not spread, but he now has an increased risk of more skin

cancer developing. What can we all do to reduce our risk of developing skin cancer?

Minimise your time outdoors between 0 am and 3 pm (when UV radiation is most intense), and follow

these five simple steps:

1. Slip on skin protective clothing

Cover up as much of the skin as possible.

2. Slop on SPF 30+ sunscreen

Make sure it is broad spectrum and water resistant.

3. Slap on a hat

Wear a broad brimmed hat that covers your face, head, neck and ears.

4. Seek shade

Make use of trees or built shade structures – or bring your own!

5. Slide on some sunglasses

Close fitting wraparound styles offer the best protection.

7. Perth dermatologist Allan Donnelly says people of all ages should monitor their moles. What

should they look for?

People should be aware of changes to the size, shape (irregular borders) and colour of a mole or

freckle. If you find a suspicious spot see your doctor. In most cases skin cancer can be treated if

detected early.

Worksheet H

Reduce your risk – group activity

Discuss in groups, behaviours you could change to reduce your risk of developing skin cancer.

. List at least four changes you would make to your day-to-day activities at school to reduce your risk of

sunburn and skin damage.

__________________________________________________________________________________________

. List at least four changes you would make to your day-to-day activities on the weekend to reduce your

risk of sunburn and skin damage.

__________________________________________________________________________________________

3. Look at your responses. How do they compare to the five SunSmart messages?

__________________________________________________________________________________________

4. How could you improve your personal behaviour?

__________________________________________________________________________________________

Worksheet I

Dangers of sun exposure – group and extension

activities

The following activities may be completed as extension or class activities.

. Debate the statement “A healthy tan makes you look good and feel good”. Divide the room into “for”

and “against” the topic. Students take turns from each side of the room to argue and rebut each side’s

statements. Debate points raised for each side could be scribed on to the board for students to record.

. Using copies from the background information of this resource allocate a topic to groups of students,

eg. Sun protection – what are the messages? Groups read and summarise their allocated topic, mapping

the main points on butcher’s paper or in their books. Each group reports their topic to the class.

3. Role-plays

Students form pairs/groups and role-play one of the following scenarios. In each role-play, one student

will need to convince the other to make sensible SunSmart choices. After each role-play discuss the

situation and invite students to make further suggestions.

Pool party: You are planning a pool party for the weekend with all your friends. How could you make it

fun and SunSmart?

Beach: You and a few friends are planning to go to the beach. None of your friends have thought about

being SunSmart. How could you help to ensure that you and your friends are protected from the sun?

Sport: One of your friends rings at 8:30 am and wants to play tennis on the local courts at lunchtime.

How could you make this activity SunSmart?

Student choice: Students to create their own role-play scenario.

4. Research a job that involves a lot of outdoor activity eg. a farmer, council worker, surf lifesaver. List the

sun protection methods they use and note any improvements they could develop. Report examples to

the class.

5. Design advertisements to promote SunSmart behaviour eg. information on UV Alert, sun protection

methods, checking for skin cancer. Use various media such as posters, radio or television. and present

them to the class.

Dangers of solarium use

Worksheet A

Solariums – How much do you really know?

Consider the following statements and respond True or False for each.

. Tanning on a sunbed is safer than tanning in the sun. ________

. Exposure to UV radiation is the only way of providing the body with vitamin D. ________

3. Solariums use artificial UVA and UVB radiation. ________

4. Solariums significantly increase the risk of melanoma and squamous cell carcinoma among users, in

particular those exposed to sunbeds before the age of 35. ________

5. Australia and New Zealand have the highest rates of skin cancer in the world. ________

6. Solariums emit UV radiation up to five times stronger than midday sun. ________

7. People who burn and never tan in the sun will be able to achieve a tan in a solarium. ________

8. Some cosmetics and prescription drugs can increase a person’s sensitivity to UVA radiation and if a

solarium is used under these conditions, it may cause a severe sunburn. ________

9. The more your skin is exposed to UV radiation, the greater your risk of skin cancer. ________

0. The most common users of solariums are older men and women. ________

. No solarium can guarantee a “safe tan”. ________

. Obtaining a solarium tan will help protect you from the harmful UV rays during outdoor activity or a

holiday in the sun. ________

My score /

Worksheet A – answers

Solariums – How much do you really know?

. False Tanning on a sunbed is not safer than tanning in the sun.

A tan is a sign that the skin is attempting to protect itself against UV damage. It is not a sign of good

health and a sunbed is potentially as dangerous, if not more dangerous than the sun due to the

stronger UV levels emitted.

. False Exposure to UV radiation is not the only way of providing the body with vitamin D.

Vitamin D is important for strong healthy bones and we do need some sun exposure to produce it in

our bodies. However normal daily activity is enough for most people to produce vitamin D without

excessive sun exposure. Small amounts of vitamin D are also obtained from eggs, milk, margarine, oily

fish, liver and cheese.

3. True Solariums use artificial UVA and UVB radiation.

Solarium ultraviolet light is divided into two wavelength bands. Short wave ultraviolet rays called UVB

can burn the outer layer of skin. Long wave ultraviolet rays called UVA penetrate more deeply and can

weaken the skin’s inner connective tissue and cause immune system damage.

4. True Solariums significantly increase risks of melanoma and skin cancer among users, in particular

those exposed to sunbeds before the age of 35.

A recent international review (IARC 006) of studies on sunbed use found a 75% increased risk of

melanoma and squamous cell carcinoma among users, especially those whose sunbed UV exposure

occurs before the age of 35.

5. True Australia and New Zealand have the highest rates of skin cancer in the world.

Australia and New Zealand have the highest rates of skin cancer in the world. At least one in every two

Australians will be diagnosed with skin cancer in their lifetime and more than 600 will die each year.

6. True Solariums emit UV radiation up to five times stronger than the summer midday sun.

Solariums use powerful tubes that can emit UV radiation up to five times stronger than midday sun eg. the

maximum UV Index in Australia can reach around 7, but the maximum UV Index in a solarium can be 60.

7. False People who burn and never tan in the sun will not be able to achieve a tan in a solarium.

Fair skinned people produce much less melanin than those with darker skin – no amount of sun baking

will result in a tan, just sunburn and skin damage. Fair skinned people who burn and never tan in the

sun will not tan in a solarium either.

8. True Some cosmetics and prescription drugs can increase a person’s sensitivity to UVA radiation and if

a solarium is used under these conditions, it may cause a severe sunburn.

A number of cosmetics and prescription drugs, including some antibiotics, drugs for high blood

pressure, antidepressants, some medicines for skin conditions, drugs that suppress the immune

system (as used after organ transplants) and non-steroidal anti-inflammatory drugs, can increase a

person’s sensitivity to UVA radiation. Use of a solarium under these conditions may result in severe

sunburn; it can also cause an itchy and painful rash followed by blotchy darker patches on the skin and

damage to the eyes.

9. True The more your skin is exposed to UV radiation, the greater your risk of skin cancer.

UV radiation increases the risk of skin cancer and causes premature ageing of the skin, which may be

evident as wrinkling, loss of elasticity, sagging, yellowish discolouration and brown patches.

0. False The most common users of solariums are not older men and women.

70% of the people using a solarium are women aged between 8 and 35.

Worksheet 2A – Solariums – How much do you really know? cont

. True No solarium can guarantee a “safe tan”.

Solarium use increases the risk of skin cancer and causes skin ageing. Due to the high levels of UV

exposure, a user’s safety cannot be guaranteed.

. False Obtaining a solarium tan will not help protect you from the harmful UV rays during outdoor

activity or a holiday in the sun.

Any solarium use exposes the skin to UV radiation, which can cause skin damage and skin cancer.

Building a base tan before a summer holiday does not protect the skin from further damage to sun

exposure.

Worksheet B

7.30 Report DVD questions

Answer the following questions while viewing 7.30 Report stories “Dangers of a deadly tan” (21 August

2007) and “Melanoma victim to change the shape of public health” (30 August 2007) on the enclosed DVD.

The segment focuses largely on young Melbourne woman, Clare Oliver, who was diagnosed with melanoma

at the age of . She went public with her story to raise awareness about the dangers of solariums because

she attributed her melanoma largely to her previous solarium use. Clare died, aged 6, on 3 September

007, however, her determination to ensure the industry became regulated will have a lasting legacy.

Some useful prior information: Solariums use artificial UVA and UVB radiation; both are known to be

directly responsible for causing skin cancer and prematurely ageing skin. A recent international review

(IARC 006) of studies on sunbed use found significantly increased risks of melanoma and squamous cell

carcinoma among users, in particular those exposed to sunbeds before the age of 35.

Dangers of a deadly tan

. Why did Associate Professor Grant McArthur, from the Peter McCallum Hospital, state that “solariums

are dangerous”?

__________________________________________________________________________________________

. What are some strategies used by solarium operators to attract clients?

__________________________________________________________________________________________

3. Clare’s melanoma diagnosis was made when she was years old – two years after her solarium use.

Did she have any knowledge of the risks she was taking at the time?

__________________________________________________________________________________________

4. Why was Clare keen to get a tan?

__________________________________________________________________________________________

5. What is the major concern about the operation of the solarium industry according to Craig Sinclair from

The Cancer Council?

__________________________________________________________________________________________

6. When described as ‘brave’, Clare denied this. What were her reasons for going public and sharing her

story?

__________________________________________________________________________________________

Melanoma victim to change the shape of public health

7. What has been pledged by governments as a result of the wave of publicity from Clare’s situation?

__________________________________________________________________________________________

8. What action did the Health Minister at the time, Tony Abbott, take?

__________________________________________________________________________________________

Worksheet 2B – 7.30 Report cont

Discussion/extension questions:

. What is your reaction to Clare’s early statement, “I don’t think using solariums and having a golden tan

is worth it”?

. Melanoma is the most common cancer for the 5–44 year old age group. Research and produce an

information brochure on the importance of regular skin checks and early detection in attempting to

reduce the impact of skin cancer.

You could include information about different skin types, risk factors for developing skin cancer, steps

on how to check your skin and what to do if something suspicious is detected.

3. Analyse and discuss why it is so difficult to get the message about safe sun behaviours across to

young people.

•

Consider your own and your peers’ behaviour and attitudes and identify the issues or barriers that

exist.

Work in small groups to produce a ‘skin protection’ campaign aimed specifically at young people.

This could take the form of a pamphlet, poster, radio jingle, new catchy slogan, short radio script, or

a TV advertisement. Depending on the medium you choose, it could be displayed around school or

in the school newsletter; or performed at assembly. Ensure your message is clear and proactive!

7:30 Report – Dangers of a deadly tan. Transcript, video and extended interviews available at:

www.abc.net.au/7.30/content/2007/s2011387.htm

7.30 Report – Melanoma victim to change the shape of public health. Transcript, video and extended

interviews available at:

http://www.abc.net.au/7.30/content/2007/s2019818.htm

Worksheet B – answers

7.30 Report DVD questions

Answer the following questions while viewing 7.30 Report stories on the DVD “Dangers of a deadly

tan” (21 August 2007) and “Melanoma victim to change the shape of public health” (30 August 2007).

The segment focuses largely on young Melbourne woman, Clare Oliver, who was diagnosed with melanoma

at the age of . She went public with her story to raise awareness about the dangers of solariums because

she attributed her melanoma largely to her previous solarium use. Clare died, aged 6, on 3 September,

007, however, her determination to ensure the industry became regulated will have a lasting legacy.

Some useful prior information: Solariums use artificial UVA and UVB radiation; both are known to be

directly responsible for causing skin cancer and prematurely ageing skin. A recent international review

(IARC 006) of studies on sunbed use found significantly increased risks of melanoma and squamous cell

carcinoma among users, in particular those exposed to sunbeds before the age of 35.

‘Dangers of a deadly tan’ segment

1. Why did Associate Professor Grant McArthur, from the Peter McCallum Hospital, state that

“solariums are dangerous”?

Solariums emit levels of UV radiation that are up to five times higher than midday summer sun; there

is a clear link to increasing rates of skin cancer; the solarium industry is rapidly growing eg. there was a

500% increase in listed solariums in the Melbourne yellow pages over the last ten years.

2. What are some strategies used by solarium operators to attract clients?

Package deals; many new operators opening; unlimited sessions offered; competitive business ready

to give good deals.

3. Clare’s melanoma diagnosis was made when she was 22 years old – two years after her

solarium use. Did she have any knowledge of the risks she was taking at the time?

Clare was unaware of any risks and followed the advice from the solarium operator to visit every

second day for the best results.

4. Why was Clare keen to get a tan?

Part of the Aussie culture is to have a ‘golden tan’. Clare believed view that brown symbolised health

and being a ‘beautiful girl’.

5. What is the major concern about the operation of the solarium industry according to

Craig Sinclair from The Cancer Council?

There are a number of concerns, these include: no compliance; self regulation means businesses can

do as they please. ie. young people using equipment without guidance; inappropriate skin types using

solariums; businesses operating unsupervised eg. laundromats, gymnasiums, etc.

6. When described as ‘brave’, Clare denied this. What were her reasons for going public and

sharing her story?

Clare wanted her story told to help others and wanted others to know the risks involved.

‘Melanoma victim to change the shape of public health’ segment

7. What has been pledged by governments as a result of the wave of publicity from Clare’s

situation?

Some governments have introduced or are considering the introduction of legislation to regulate the

solarium industry.

8. What action did the Health Minister at the time, Tony Abbott, take?

Mr Abbott wrote to state health ministers asking them to consider a formal mandatory system of

regulation of solariums rather than a voluntary code.

Worksheet C

Solariums – killer tans – newspaper article

Article from: The West Australian, Friday 27/10/2006, p 13

Perth mum

‘fried’

after 20

minutes in

Solarium

CATHY O’LEARY

MEDICAL EDITOR

Two months after 34-year-old

Agnieszka Arto visited a Perth

solarium to brown up for a party, she

is still wincing in pain from having

her skin “fried” in only 20 minutes

under the lamp.

The mother of one spent several

days feeling delirious and living on

painkillers after suffering severe

burns to her legs, arms and torso from

a single solarium session in August.

“I thought I was going to die,”

she said. “I’m still in pain now when

I touch my skin and I’m paranoid

about light and the sun, my message

to others about using a solarium is,

don’t do it.”

Ms Arto said that when she

complained to the salon the day

after she was burnt, she was brushed

off by the operator and told to put

moisturiser on her skin.

The Cancer Council WA said

Ms Arto’s case was proof that selfregulation

in the solarium industry

did not work and the State needed to

implement tighter controls to protect

the public.

Council director of education

and research Terry Slevin said there

were no laws governing the industry,

only an Australian standard code

of practice which did not have to

Burnt alive: Agnieszka Arto has developed a fear of light and the sun and is still in

pain more than two months after her solarium ordeal.

Picture: Lee Griffith

be enforced. He warned that with

summer looming, many people,

particularly women aged 18-30, were

tempted to “get up a bit of colour” by

using a solarium.

“A lot of people believe it’s safe

but that’s not true, and if you don’t

believe the Cancer Council then

you should pay attention to what the

World Health Organisation says,” he

said. “The industry is taking people’s

money to expose them to artificial

light which can increase their risk of

skin cancer.”

Mr Slevin said there had been a

31 per cent increase in the number of

solarium salons in Perth in the past

five years.

Health Minister Jim McGinty said

the Health Department would work

with the Cancer Council and other

experts to ensure people tanning

themselves in solariums were not

putting themselves in danger of

developing skin cancer.

Worksheet C

Solariums – killer tans – questions

Read the article “Perth mum ‘fried’ after 20 minutes in Solarium” which appeared in The West

Australian newspaper and answer the following questions.

. Ms Agnieszka Arto suffered severe burns after a solarium session. Which parts of her body were

damaged?

__________________________________________________________________________________________

. How long did Agnieszka spend in the solarium to receive such severe burns?

__________________________________________________________________________________________

3. How long after using the solarium was Agnieszka still suffering from burns?

__________________________________________________________________________________________

4. What did the solarium operator advise Agnieszka do to treat her burns?

__________________________________________________________________________________________

5. Can exposure to the artificial light of solariums increase your risk of skin cancer?

__________________________________________________________________________________________

6. Are there any laws in place to govern the solarium industry?

__________________________________________________________________________________________

7. How has Agnieszka’s attitude to solariums changed as a result of her experience?

__________________________________________________________________________________________

8. What do you think about the use of solariums? Should solariums be banned?

__________________________________________________________________________________________

Worksheet C – answers

Solariums – killer tans

Question 8 asks for students’ opinions and therefore a detailed answer is not provided in this discussion

guide.

1. Ms Agnieszka Arto suffered severe burns after a solarium session. Which parts of her body were

damaged?

Ms Arto suffered burns to her legs, arms and torso.

2. How long did Agnieszka spend in the solarium to receive such severe burns?

Agnieszka spent 0 minutes in the solarium.

3. How long after using the solarium was Agnieszka still suffering from burns?

Agnieszka was still in pain and was fearful of exposing her skin to sunlight two months after using the

solarium.

4. What did the solarium operator advise Agnieszka do to treat her burns?

The solarium operator told Ms Arto to put moisturiser on her skin.

5. Can exposure to the artificial light of solariums increase your risk of skin cancer?

Solariums can emit levels of ultraviolet (UV) radiation up to five times as strong as the midday summer

sun. UV radiation plays an important role in the development of cataracts and other eye conditions and

suppresses the immune system. Recent findings from a review conducted by the International Agency

for Research on Cancer show a 75% increase in risk for melanoma for people who first used solariums

in their teens or twenties. Solariums have been recognised as a known carcinogen since 000.

6. Are there any laws in place to govern the solarium industry?

Some states, such as Victoria, are moving towards introducing regulation of solariums. Currently, there

are no laws to govern the solarium industry in Australia, only a voluntary code of practice developed

by Standards Australia. “AS/NZS 635: 00 Solariums for cosmetic purposes” was developed in 983

and updated in 00 . The standard sets out guidelines for the installation, maintenance and operation

of solariums and seeks to increase safety for users. Current research shows that compliance with this

voluntary standard is low.

7. How has Agnieszka’s attitude to solariums changed as a result of her experience?

Agnieszka will not use a solarium again and she warns others to avoid using them. Even two months

after her burning experience with a solarium, Agnieszka still felt pain on her skin when in sunlight.

Solariums can cause:

•

burning, irritation, swelling, blistering and pain

premature ageing of the skin (wrinkles, blotches, sagging, thickening of the skin)

eye damage (such as cataracts and eye cancers) and

skin cancer.

. Standards Australia ‘AS/NZS 635: 00 Solariums for Cosmetic Purposes’ 00 .

. International Agency for Research on Cancer Working Group on artificial ultraviolet (UV) light and skin cancer 006. The association

of sunbeds with cutaneous malignant melanoma and other skin cancers: A systematic review. International Journal of Cancer, 0

( 006): 6– .

Worksheet D

Solariums – killer tans group activity

Watch the Channel Ten News item “Solariums”.

Discuss the following questions in groups.

. What were your thoughts while watching this news item?

. Why do you think people want to use solariums?

3. What were the reasons Agnieszka used a solarium?

4. What are some of the risks associated with solarium use outlined in the news report?

5. Can you think of any other risks associated with using solariums?

6. A number of photographs were used to highlight Agnieszka’s burns.

What was your reaction? Why?

7. Do you think solarium operators have a duty to warn people about the dangers of using solariums?

Why or why not?

8. What action could people take to ensure that the solarium industry is strictly regulated?

Worksheet D - answers

Solariums – killer tans group activity

Question 1, 2, 6 and 8 ask for students’ opinions and therefore a detailed answer is not provided in this

discussion guide.

3. What were the reasons Agnieszka used a solarium?

Agnieszka wanted a quick tan so she could brown up for a party. Agnieszka thought that getting a tan

from using a solarium was a safer way to tan than baking in the sun.

4. What are some of the risks associated with solarium use outlined in the news report?

• painful burns

• exposure to artificial forms of ultraviolet radiation

• increased risk of developing skin cancer.

5. Can you think of any other risks associated with using solariums?

Solariums can cause:

• burning, irritation, swelling, blistering and pain

• premature ageing of the skin (wrinkles, blotches, sagging, thickening of the skin)

• eye damage (such as cataracts and eye cancers)

• skin cancer.

Solariums have been recognised as a known carcinogen since 000.

7. Do you think solarium operators have a duty to warn people about the dangers of using

solariums? Why or why not?

Many people mistakenly believe that solariums are a safe way to tan. Over 90,000 Australians were

exposed to ultraviolet (UV) radiation due to solarium use in 003. Solariums can emit levels of UV

radiation up to five times as strong as the midday summer sun. 3 Solariums can cause:

•

burning, irritation, swelling, blistering and pain

premature ageing of the skin (wrinkles, blotches, sagging, thickening of the skin)

eye damage (such as cataracts and eye cancers)

skin cancer.

. International Agency for Research on Cancer Working Group on artificial ultraviolet (UV) light and skin cancer 006. The association

of sunbeds with cutaneous malignant melanoma and other skin cancers: A systematic review. International Journal of Cancer, 0

( 006): 6– .

. Dobbinson S, Bowles K, Fairthorn A, Sambell N and Wakefield M, 005. Sun Protection and Sunburn Incidence of Australian

Adolescents: Summer 003–04. The Cancer Council Victoria, Melbourne.

3. Standards Australia ‘AS/NZS 635: 00 Solariums for Cosmetic Purposes’ 00 .

Worksheet E

Solarium advertising group activity

In groups of four analyse the advertisements below and then answer the questions. Report your

findings back to the class when you have completed the group activity. Some of the questions below

may generate an opportunity for further discussion and debate.

Prior to beginning this activity discuss the information about solariums (page 6) with your students.

Advertisement one

The solarium assists in the treatment of psoriasis, acne, arthritis, eczema, dermatitis and bone deficiency.

It is now proven that UV rays can be good for your health. However, one of the biggest disadvantages of

tanning in the natural sunlight is that it emits a relatively high proportion of UVB rays which unfortunately

cause rapid sunburn. Using our solarium, UVB is low (0.8%) and UVA (tanning rays) are high, which

produces a natural healthy tan all year round. Also available is our exclusive range of bronzing tanning

products, designed for use in the solarium.

Advertisement two

Whether it’s your special day or someone close to you, why not look your best by having a beautiful tan

to match the perfect outfit? Here at (X) you can trust your skin with our trained and certified staff and feel

comfortable in knowing you will receive nothing but the best. After completing our skin type analysis, a

tanning program will be designed specifically for your individual needs, plus a comprehensive information

pack is provided. Choose from our wide range of tanning accelerants and skin care to not only enhance

your tan but to ensure that your skin is completely looked after. (X) has a wide range of sunbeds to cater for

everyone’s tanning needs, including the standup solariums.

Advertisement three

(Y) ensures your safety and comfort by adhering to the standards of Smart Tan International. The Golden

Rule of Smart Tanning is simple: Don’t EVER sunburn. This professional indoor tanning facility is dedicated

to helping you avoid sunburn whether you’re tanning here or outdoors under the sun. On your first visit to

the studio you will have your skin type analysed to determine what type of tanning program is optimal for

you.

Advertisement four

The capsules work from within to stimulate the skin’s natural production of melanin, the protective pigment

responsible for skin colour. (Z) prepares your skin for the sun, reduces sun sensitivity and redness, helps

protect against sun-induced ageing, and boosts and optimises your tan. With continued use after sun

exposure, you can maintain a healthy and golden glow.

Answer the following questions in relation to your advertisement:

. What is the main message of your advertisement?

__________________________________________________________________________________________

. What emotions or attitudes are the advertisers appealing to? What is drawing the reader in?

__________________________________________________________________________________________

3. Does it make you feel that using this product would be safe?

__________________________________________________________________________________________

Worksheet 2E – Solarium advertising group activity cont

4. Does the information in this advertisement correspond with the background information you have

heard about solariums and skin protection?

__________________________________________________________________________________________

5. Would you consider this to be false advertising?

__________________________________________________________________________________________

6. What role do governments have in ensuring that people using solariums are safe? Give reasons.

__________________________________________________________________________________________

Worksheet F

Solariums – group/extension activities

The following activities may be completed as extension or class activities.

Students could also work in groups to prepare and present an activity of their choice to the class.

. Debate the topic “It is an individual’s right to make their own decision to use a solarium for tanning

purposes”.

. Prepare an article for the school newsletter / local newspaper commenting on solarium use and current

research. Use the appropriate language genre, formatting, research, headlines, quotes, interviews and

photos to ensure you engage the interest of the target audience.

3. Research one of the following topics or another area of interest:

• solarium legislation and compliance among solarium operators

• skin protection attitudes and behaviours of young people

• mortality and incidence rates for skin cancers in relation to age, place of residence, sex etc.

4. Prepare a presentation for the annual ‘National Conference on Solarium Use’ to inform others about the

dangers of solariums. Use a variety of delivery styles, such as quotes, powerpoint slides and graphic

illustrations. Include the following in your presentation:

• A general introduction to the topic.

• What are solariums and how do they work?

• What are the effects on the human body – both short and long-term?

• Case studies and real stories/examples.

• What action needs to be taken to ensure the public is informed and aware of any health risks?

•

Summary and conclusions regarding solarium use.

5. Collect three to five advertisements, flyers, or newspaper articles that promote the use of solariums.

Using your knowledge about solariums produce a poster that dispels any myths associated with these

advertisements. Explain and display your poster to the class.

Worksheet G

Solarium regulation – newspaper article

Article from: The Sun-Herald, 26 August 2007, p 24.

Solarium scare

Cancer claim prompts push for regulation

by MICHELLE SINGER

THE tanning industry has

welcomed the Federal Government’s

decision to push for stronger rules

around solarium use.

Health Minister Tony Abbott

has asked State and Territory

governments to consider uniform

national rules for tanning salon

operators.

The Australian Solarium

Association, which represents about

50 members nationally, said the

regulations are overdue.

A call for tighter rules comes

after 26-year-old Clare Oliver spoke

publicly last week about her belief

that excessive solarium use led to her

developing a deadly melanoma.

Ms Oliver, from Melbourne,

is dying from skin cancer and has

dedicated her last days to warning the

public about the dangers of tanning.

The Victorian Government has

already toughened regulations for

solarium operators, who will be fined

for breaching the legislation.

On Friday, Mr Abbott said most

states had no regulation at all.

Ms Oliver, who turned 26

yesterday, was a regular solarium

user before being diagnosed with

melanoma four years ago. Cancer

has now spread to other parts of her

body.

Solarium association spokesman

Patrick Holly said its members had

their own operating standards.

They say that children under

15 are not permitted and clients

are advised to avoid exposure to

ultraviolet rays within 48 hours of a

session.

Mr Holly said Cancer Council

research in 2005 found that fewer

than 60 per cent of operators

complied with those standards.

“We’ve been asking for

regulations for about a year now,” Mr

Holly said.

“In 2005 we tried to self-regulate

the industry, especially in NSW, and

we made guidelines for solarium

operators available. We are still part

of a working group, along with the

Cancer Council and Health NSW,

and we are looking at ways to

legislate solarium operators.”

Melanoma is the most common

form of cancer among 15 to 30 year

olds.

Cancer Council Australia chief

executive Ian Olver confirmed the

industry’s voluntary safety code was

not working.

He said the proliferation of

solariums without reasonable safety

controls was a serious public health

issue.

“In a nation that has for many

years had the world’s highest skin

cancer incidence and mortality

rates, it is unacceptable that we

significantly increase our risk of a

potentially deadly disease through

artificial means in an unregulated

environment,” he said.

Mr Holly said a level of federal

regulation was needed to allow

businesses that did not adhere to the

guidelines to be punished.

“It’s a very emotive issue, there’s

a young girl dying from melanoma.

She has the right to question why and

how,” he said.

“The emotive issue at the

moment is whether solarium use

is the only cancer causing problem

and will the incidence of melanoma

decrease from the regulation of the

industry?”

Worksheet G

Solarium regulation questions

Refer to the article and discuss the following questions in groups. Dot point your ideas.

. What is the view of the following people in relation to solarium regulation?

(a) Federal Government Health Minister – Tony Abbott

__________________________________________________________________________________________

(b) Solarium association spokesman – Patrick Holly

__________________________________________________________________________________________

. Do you think there should be stricter uniform national rules for solarium operators? Present your

group’s views to the class.

__________________________________________________________________________________________

3. Research task: Find out about the current legislation and regulations regarding solarium use in your

state. List any new developments that have been instigated.

Worksheet G – answers

Solarium regulation

Refer to the article and discuss the following questions in groups. Dot point your ideas.

. What is the view of the following people in relation to solarium regulation?

(a) Federal Government Health Minister – Tony Abbott

• Stronger rules needed around solarium use.

• State and territory governments should consider uniform national rules for solarium operators.

(b) Solarium association spokesman – Patrick Holly

• Solarium regulations are overdue and needed.

• The solarium association has tried to self regulate the industry and have looked at ways to legislate

solarium operators.

• Federal Government regulation was needed to allow businesses that did not adhere to the

guidelines to be punished.

• The solarium industry’s voluntary safety code is not working – research in 005 found that fewer

than 60 per cent of the operators complied with those standards.

•

Solarium operation without reasonable safety controls is a serious public health issue – there is an

increased risk of skin cancer in an unregulated environment.

Questions 2 and 3 ask for student’s opinions therefore specific answers have not been provided.

For further information visit www.cancer.org.au or call The Cancer Council Helpline 13 11 20 (local call cost

anywhere in Australia).

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