If you live in Florida, chances are that you or someone you know has had skin cancer. It's the most common cancer in the United States, particularly here in the Sunbelt.
For most cases — the less serious nonmelanoma cancers — treatment is a quick matter, achieved in the dermatologist's office. Which is why a lot of people might think it's no big deal.
Stan Kozma knows all about that attitude.
"People go, 'It's just skin cancer. Just cut it off. It's not real cancer,' '' the Tampa filmmaker said.
"It's not real until you have a 14-inch scar on your back," he said. "It's taking one life every hour."
Kozma's award-winning documentary on the real toll of skin cancer, More Than Skin Deep, airs on cable TV this weekend. It's an engaging film with an important message.
Kozma profiles several young women who battled the most serious form of skin cancer, melanoma, in their 20s and 30s and survived. An African-American woman who went to a string of doctors before finally convincing one that a lump on her bikini line was nothing to ignore shows that melanoma isn't a disease of just the fair-skinned. Keep the tissue box handy for a young mother's story of surviving a virulent melanoma diagnosed during her pregnancy.
The film is brutally frank, showing unforgettable pictures of what skin cancer can look like after its often painless arrival, sometimes in places that get no direct sun exposure.
'Topic found me'
Kozma has worked on movie sets, produced TV commercials and made documentaries for 30 years. His Tampa company, Z Film, has done work for Busch Gardens, Tampa's Hyde Park Village and the U.S. armed forces. His subjects have included art, music and Florida wildlife.
Skin cancer awareness wasn't on his agenda. "The topic found me," Kozma said. "It all started one evening in 1997."
Kristi Michael, Kozma's close friend, was coloring her hair. The solution stung when it touched a mole on the top of her ear, one that had been there since birth.
Over the next couple of weeks the mole seemed to change, so Michael, a freelance hair and makeup artist, went to a doctor, who told her not to worry.
She sought a second opinion, and was diagnosed with melanoma, the most serious type of skin cancer. After the mole was removed, a check of her lymph nodes was negative and Michael was given a clean bill of health.
But nine months later, the cancer was back and had spread to her lymphatic system; by 1999 it had invaded her brain. Numerous attempts at aggressive, experimental treatment failed and in 2001 Michael died. She was 35.
A dark-haired beauty, Michael relied on tanning beds for sun-kissed-looking skin. Like many young women, she thought the beds were a safe way to look good.
Upon her return to health, Kozma recalls, she talked with him about a skin cancer awareness campaign aimed at children, teenagers and their parents.
Instead, he completed the project in her memory in 2008. It has been screened at independent film festivals across the country, including this year's Gasparilla International Film Festival in Tampa.
Kozma stays informed about the latest developments in skin cancer research and treatment and updates the documentary as necessary. He produced a shorter version, 20 minutes, for use in high school classrooms. He gets many requests for the DVD from grandparents who want their grandkids to see it.
In the documentary, famed National Cancer Institute researcher and gene therapy pioneer Dr. Steven Rosenberg calls melanoma ". . . the most rapidly increasing cancer in the United States."
More than 68,000 new cases were diagnosed nationwide last year, according to the American Cancer Society; there were about 8,700 deaths.
For years scientists have known that overexposure to the sun, particularly blistering sunburns in childhood or the teen years, increases the risk of skin cancer later in life. But tanning beds may be even more dangerous. According to the World Health Organization, when the devices are used regularly before age 35, melanoma risk increases by 75 percent. In 2009, WHO classified tanning beds as "carcinogenic to humans."
It also offers a tour of how pop culture has contributed to this epidemic, starting with Coco Chanel kicking off the "tan is glam" attitude in the 1920s. Footage that manages to be both amusing and chilling captures the roots of the craze for indoor tanning. As a narrator extols the health virtues, a mother waves a handheld sunlamp over her infant, who is wearing nothing but eye goggles.
It also shows that many modern sun worshipers aren't much more knowledgeable.
One bikini-clad young woman interviewed at the beach explains that all through school students are taught about the dangers of smoking, alcohol and drugs, but no one ever tells young people about protecting their skin from the sun.
Irene Maher can be reached at firstname.lastname@example.org