Long-sleeved clothing and sunscreen are among the defences for cancer survivor Natalie Richardson when she goes outside now.J.P. Moczulski/The Globe and Mail
With Ontario's great outdoors as her playground, Natalie Richardson soaked up the warmth of the sun as a child, through her teen years and into adulthood, often wearing little more than a bathing suit and minimal sunscreen.
"I was always a sun baby – I grew up along the waters of Ontario and would go to Florida on vacation, and I usually would only use sunscreen if I would go to a tropical place. And I used tanning beds, too," says Richardson, whose medium-fair skin and Ukrainian background make her a prime candidate for sunburns.
Today at age 41 and living in Meaford, Ont., about 180 kilometres northwest of Toronto, you'd be hard-pressed to see Richardson's skin at all when she goes outdoors.
To Richardson and others who've endured melanoma – the most dangerous form of skin cancer – getting a "sun kissed" bronze glow equates with getting the kiss of death.
For many other Canadians – women in particular, according to research – there are also vanity reasons for not roasting in the ultraviolet (UV) rays, which can cause skin problems such as premature aging and hyperpigmentation, including brown age spots.
Richardson, for one, has a lot of living to do, so isn't about to become a hermit, instead choosing to practise safe sun year-round: wearing sunglasses, long-sleeved clothing and a wide-brimmed straw hat made of tightly woven materials, and slathering on generous amounts of high-SPF (sun protection factor) sunscreen well before she goes outdoors.
She isn't alone. Many women are getting the protection message, and not just amid the intensity of summer heat. Sun safety has become year-round.
"Prevention is the most important thing; you can enjoy the sun, but you have to do it safely," the single mother says in a phone interview after making a late breakfast for her children.
About 10 months after she was diagnosed at 37 with melanoma, Richardson began volunteering for the Save Your Skin Foundation, a non-profit advocacy organization founded by Vancouver melanoma survivor Kathleen Barnard. After starting out writing blogs to connect with other survivors, Richardson became a full-time project co-ordinator last fall.
She stresses there's no such thing as a "safe tan" or "just skin cancer," the most commonly diagnosed form of cancer in North America.
This year, 7,200 people in Canada will be told they have melanoma, and 1,250 will die from it, according to the Canadian Cancer Society. Non-melanoma skin cancers affect tens of thousands more. And although it's common for skin cancer to appear years later in life, the Canadian Skin Cancer Foundation says melanoma is the third most common form of cancer in women between 15 and 29, and the No. 1 cancer killer of women 25 to 30.
Research indicates the sun safety message is getting across to Canadians, experts say, but there's still too much complacency, especially among men, as women are more likely to take sun-protection measures such as using sunscreen.
"When we talk to Canadians, we find many don't think about it and don't know what to do in the first place," which is concerning, because "over 90 per cent of skin cancers are really down to your exposure to UV," Robert Nuttall, assistant director of health policy at the Canadian Cancer Society, says in an interview from his Toronto office.
Jennifer Beecker, a physician and Ottawa-based national chair of the Canadian Dermatology Association's sun awareness program, says awareness about the importance of sun protection has increased over the past two decades, and "generally, women are more vigilant for health and cosmetic reasons." However, the CDA's latest survey on sun behaviour and attitudes indicate people need to take sun safety more seriously, and still have misconceptions that could be putting them in danger.
The survey, conducted by Ipsos-Reid, asked 1,180 Canadians age 16 and over about sun exposure and protection. It found 46 per cent of respondents "strongly agreed" and 45 per cent "agreed" that it's essential to protect your skin against the sun. However:
– 51 per cent believe a good tan gives the impression of good health.
– 32 per cent feel having a good tan is important to them.
– 51 per cent believe some sun exposure without sunscreen is needed to meet vitamin D requirements (you don't).
– 69 per cent said they "really like" being in the sun despite the dangers.
With these mixed conclusions, experts are reiterating their advice. Besides using sun-protection products and clothing, Canadians are encouraged to:
– Organize activities outside peak UV hours, especially in the warm-weather months (11 a.m. and 3 p.m.).
– Stay in shady areas when possible.
– Check the daily UV index (a standard part of Environment Canada and weather reports), which forecasts the strength of the sun's UV radiation – from 1 to 2 on the low end of the scale, when wearing sunscreen and protective clothing and sunglasses aren't necessarily needed, to 3-plus when it's recommended you take precautions.
But the cancer society notes that UV rays can get through clouds, fog and haze, and can reflect off water, sand, concrete and snow – a big reason the use of sunscreen and other sun-protection products are recommended year-round.
Whenever possible, it's best to combine an SPF 30 or higher sunscreen that's broad spectrum (meaning it protects against both UVA and UVB rays) with sun-protective clothing.
Both Nuttall and Beecker say any tightly woven garment will help block out dangerous rays – they suggest putting the fabric up to the light, and if you can see light through it, it's not good protection against UV rays.
Manufacturers have also created active wear and other clothing using lightweight and breathable pretreated fabrics, which combine dyes, minerals or chemical treatments to give them a high ultraviolet protection factor. Clothing with a UPF of 50-plus, for instance, is said to block 98 per cent of the sun's burning rays.
MEC, a Vancouver-founded consumers' co-operative that sells outdoor recreational gear and clothing through its stores across Canada, is one of many companies selling UPF garments – everything from swimwear and swim shirts to arm sleeves and rash guards (fitted athletic shirts made of Spandex and nylon or polyester).
"We don't see a big difference between men and women when it comes to SPF or UPF products," says MEC apparel designer Sara Lanyon. "However, our assortment of rash guards for women is deeper because there is generally more choice in silhouette, colour and pattern, compared to men's in this category."
For Richardson, the range of protective products out there allows her to get more creative about planning her time outdoors. She has even had her car windows treated with an anti-UV tint.
"Now I'm looking at some beautiful ponchos that are sold in the United States that have SPF 50 fabric, and I hope they start selling them here," she says.