Thursday, July 5, 2001

Recovering skin cancer patient Raymond Longo
now applies sunscreen, wears a long-sleeve shirt
and dons a hat before going into the sunlight.

Sun worshippers
play with fire

One man's story is a
warning for cancer

Group aims to reverse trend

By Helen Altonn

Ray Longo was a "sun worshipper my whole life" who never paid attention to warnings about the sun and skin cancer.

"Being in the sun was always important to me," said the 50-year-old avid body builder, former lifeguard and hula dancer.

That changed six years ago, he said, when he was referred by his internist, Robert L. Schiff, to dermatologist Jenifer Fong. "If it wasn't for her, I wouldn't be here today."

Fong is president of the Hawaii Dermatological Society, and Longo is an example of what happens when people do not heed warnings about overexposure to the sun's ultraviolet radiation.

Depletion of the earth's protective ozone layer because of pollutants began to level off in 1999, the Mauna Loa Observatory has reported.

Skin cancer forced Longo to change
his lifestyle.

With decreased ozone levels, the risk for skin cancer has increased for all people and especially for those living close to the equator like Hawaii residents, the Dermatological Society warns. "We are seeing more and more people with skin cancer," Fong said, "partly because it is more prevalent, and also people are learning more about it."

Since islanders are "in the sun all the time," she said, they should wear sunscreen and protective clothing. If possible, they should stay out of the sun between 10 a.m. and 4 p.m., she said. "They have to do all those things; they can't just do sunscreen." Her four children, two boys and two girls, 11, 9, 6 and 3, "absolutely" wear sun protection factor-35 every day, she said.

"It's still hard to get them to do that, so I show them pictures of people before and after," she said. One is of a woman in her 60s with wrinkly, weathered skin who looks at least 100 years old, she said. The other is of a 100-year-old monk with baby-soft skin, "like a baby's bottom," who was never in the sun, she said.

Longo, who works in the planning and engineering department at the Pearl Harbor Naval Shipyard, is a victim of the long-term effects of the sun.

He said he was a lifeguard on weekends and a nightclub bouncer in Waikiki when he was in college. A part-Hawaiian with fair skin, he said, "My buddies told me, 'You've got to get a suntan.'"

"Hanging around with Hawaiian guys, I wanted to be dark." He mixed oil and iodine to increase tanning. "Anything I could to maximize as much sun as I could get. It becomes almost like an addiction." He became a bodybuilder in the early 1980s, working as a personal trainer part time at the old Nautilus Hawaii.

He competed in several small local bodybuilding contests, and "a good tan was absolutely necessary," he said.

He said he was not aware that he had any problems until a couple of sores on his arms and hand would not go away.

He went to a dermatologist in town, he said. "I asked him about a dark spot on my shoulder. He said, 'That's nothing,' so I wasn't worried at all."

He said the dermatologist told him he had something like a fungus that could be cured with medicated shampoo.

His family doctor prescribed some creams. When they did not help, he referred Longo to Fong in Straub's Pali Momi Clinic.

Fong said she saw Longo the first time in September 1995 and again the following month.

She removed five basal cell carcinomas, the most common type of skin cancer tumors, and the black spot on his shoulder. It was melanoma, the most serious form of skin cancer. "We got the melanoma at the low-risk stage, so the chance for survival is excellent, 95 percent," Fong said.

He also had extensive sun damage, with multiple precancerous actinic keratoses, scaly skin growths from sun exposure, all over his face, chest and arms.

Longo said he was still going in the sun until he knew he had melanoma. "Even then I was skeptical about stopping."

Now, he said: "I don't go to the beach anymore. I don't swim in a pool like I used to, not, at least, for hours at a time." If he takes his children, ages 14 and 12, swimming, he said he wears a shirt, and he never goes outside without SPF-30 sunscreen.

He wears a hat and a long-sleeved shirt when golfing. "I had no idea I was damaging myself all those years. Meeting Dr. Jenny and being treated by her, I started reading up on skin cancer. I educated myself a lot.

"People I know, I'll speak to them, my friends, my children and family members: 'You should wear sunscreen at an early age.'"

Safety with sun means
protection from rays

By Helen Altonn

A Healthy Baby Exposition will be held 8:30 a.m. to 4 p.m. Saturday at Ward Warehouse as part of an effort by the Hawaii Skin Cancer Coalition to reverse a rising trend in skin cancer.

"We will give away plenty of sunblock and sun protection, T-shirts, information and hats for children," said Dr. Jenifer Fong, president of the Hawaii Dermatological Society. Coalition members and medical students will be present to answer questions, she said.

The coalition is made up of representatives of the University of Hawaii Cancer Research Center, the Cancer Information Service, American Cancer Society, State Department of Health, health service organizations and businesses.

An estimated 100 Hawaii residents annually are diagnosed with malignant melanoma, one of the fastest-growing types of cancer in the United States, the coalition said.

Most skin cancer cases in Hawaii involve Caucasians, but no race is immune, the coalition said. A study of melanoma patients by the Cancer Research Center showed Hawaiians and part-Hawaiians were the second-largest group diagnosed.

The Skin Cancer Coalition and member organizations mounted an education effort last year, "SunSafe for Kids," to begin teaching sun safety and cancer awareness in grades K-3.

Among facts they are emphasizing: Sunscreen should be worn daily with an SPF (sun protection factor) of at least 15, regardless of skin type, according to the American Academy of Dermatology.

Sunscreens should not be used as the only sun protection, but as "a backup to primary means of sun protection, such as shirts, hats and sun avoidance."

Studies have confirmed that repeated sunburns substantially increase the risk for life-threatening melanoma, it said.

"This is especially true for childhood sunburns because there is more time and opportunity for subsequent sun damage to lead to fully malignant melanoma."

For more information or free publications on the signs and symptoms of skin cancer, call the Cancer Information Service of Hawaii toll free at 1-800-4 CANCER, or the American Cancer Society, 1-800-ACS-2345.

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