The Hole Story:
Human Studies of Skin Cancer ctd
If it is proved statistically that there is a link between the incidence of UV light and moles and melanoma, a major project of public education will have to be undertaken. Education is what will make a difference. McCarthy says "Mothers, for instance, will have to be persuaded that their children are not doing well out of doors when they are not appropriately clothed or protected. They will have to be convinced that it is not altogether good for their children to be outside all the time getting a lot of sun and getting lovely brown skins; that in fact it may be making them unhealthy with a higher risk of mortality. They will have to be persuaded that even from a cosmetic point of view the sun is giving their children a lot more moles." It is these sorts of changes in attitude that may significantly influence the level of melanoma in the community.
Currently the incidence of melanoma is still continuing to rise despite all that has been done to date in getting people to use sunscreens and change their clothing habits. "The current educational programmes don't seem to have made an appreciable difference to date," McCarthy points out. "It appears that the message has only been picked up by people over the age of 25 or 30. That's when they begin to think their skin looks a bit bad and they decide; who wants to get sunburned anyway. But for many people that may be closing the door after the horse has already bolted. Once you get to the age of 25 the bulk of the damage has been done. There is no doubt now that sunlight is a general cause of skin cancer. That has become very clear. But the publicity to get people to lower sunlight exposure has only been marginally successful to date because kids are not getting the message."
"We're often treating kids in their teens who have had melanoma diagnosed. But there's not much point for these children to take a lot of trouble with their skin in the future, now that the damage has been done," says McCarthy. "Of course one can always protect against further problems but had they been protected much more at a younger age, they might not have been in to visit us."
"This research should give us the kind of information that makes public education programmes much stronger. It is no good just telling people what they should or shouldn't do, they must be shown the evidence. Having the actual evidence will make people respond more. People usually tend to be relatively rational. If they can be shown that it is going to make a difference, and this is proved to them, then they will take notice."
McCarthy points out that it is not only children and their parents who are slow to learn about the dangers of UV light, governments also need to be persuaded of the urgent need to prevent CFCs (chlorofluorocarbons) from being released. CFCs are chemicals that cause ozone depletion and therefore an increased incidence of UV light. "There has been a recent report on the world-wide output of CFCs for 1989 and it is a sad but unfortunate part of that report that the amount of CFCs reaching the atmosphere for 1989 was twice that of 1988. This is despite the Montreal protocol (an international agreement to reduce CFC production and usage) and despite world-wide efforts to control CFCs. The good side of the report was where it said that if it had not been for the Montreal Protocol and the world-wide interest, 1989 releases would have been around 5 times that of 1988. At least it was not as high as it could have been. But it means we are not saving the ozone layer, we are just slowing down the rate of destruction." The government is more likely to act and spend money on the problem if the data is available which proves that UV light causes skin cancer.
McCarthy believes that as a scientist who is very knowledgeable in this area, he has a responsibility to tell what he knows to the public and speak to public meetings. He feels that because he has the status and prestige of a University professor and is also working in a cancer unit, he is a good role model. When he makes statements people listen because he has had first hand experience.
"If you send out someone who just stands up and says, I read it in a book, it doesn't work so well. I can show them some relatively nasty pictures (not the nastiest ones we could show them) and say 'hey you kids are doing this to yourselves and it is about time you stopped'. Because I am who I am, they tend to respond more than to someone who doesn't have the background of being both an academic and a practising surgeon."
These attitudes put the Melanoma Unit, and Bill McCarthy in particular, in the frontline of public education programmes. They have regular invitations to speak. Sometimes they respond to invitations to spend the afternoon with an entire school talking about this particular topic. He never refuses an invitation to speak, if he can possibly make it. If he can't go himself he sends one of his team. Very few invitations get knocked back even if it means driving out to Canberra or some rural area to give a single lecture. One of his team went down to Young recently to talk to a group of people down there. The whole trip took him a day and a half just to give a one hour lecture. But they all thought this was a worth while contribution.
Bill McCarthy's personal feeling is that the more academics can get involved in doing good for the community, the better it is for both the community and for the academics.