Meeting the governor

Oregon Gov. Kitzhaber signs off on the Oregon tanning ban. I'm second from
the right. Image: Jeremy Rush / Knight Cancer Institute

I've gotten to cross quite a few items off the bucket list this spring. Here's a photo of me with Oregon Gov. John Kitzhaber (plus Dr. Brian Druker and a handful of Oregon legislators) at the House Bill 2896 signing ceremony last week. It was deeply gratifying to be involved in the passage of this important piece of legislation. I hope other states are taking note. Oregon was the third state in the nation to pass a bill limiting minors under age 18 from using indoor UV tanning beds. The law will go into effect January 2014.

Also, just posted today--Read about my experience with tanning and melanoma on the OHSU Knight Cancer Institute website.

Happy "Don't Fry Day"

On Monday, it was 60-some degrees. On Tuesday, I wore sandals to work, *thinking* that things would stay relatively the same, but by lunchtime, it was monsooning. By the time I left work, I was freezing, so I played the pity card and asked my boyfriend to come pick me up. This week sure doesn't feel like spring, but since I know summer is coming, I encourage you to observe national "Don't Fry Day."

The purpose of Don't Fry Day is simple: to remind folks to protect their skin when they're spending time outdoors. According to the American Cancer Society, one person dies from skin cancer every hour. Sunscreen, of course, is helping in preventing UV damage--but there's more to sun safety than just stocking up on SPF. The National Council on Skin Cancer Prevention provides the following tips:

• Do not purposefully try to burn or tan
• Seek shade when possible
• Wear sun-protective clothing (try Coolibar)
• Generously apply sunscreen
• Use extra caution near water, snow, and sand
• Get Vitamin D from a bottle, not a bed

Tanning salons in 2050

National Health Blog Post Month Day 21: Create a new technology related to health

Last week I attended a fascinating talk by TED speaker Juan Enriquez. He's a futurist--the opposite of a historian--who specializes in the future of biomedicine. One of the key points he made during his talk was that within the next year or so, genome sequencing is going to explode. This leaves us to wonder: What on earth are we going to do with all this genetic information?

To give you a little background in case you're not a science geek like me, researchers now how the power to look at all of a person's DNA collectively, which in some cases (like breast cancer for instance) can indicate whether an individual may be more susceptible to developing a certain disease. Since there seems to be a significant genetic component to melanoma (like breast cancer, it tends to run in families), perhaps genetic information could be used regulate indoor tanning usage.

Many scientists believe that in the not-too-distant future, we'll be able to walk into the doctor's office, hand them a jump drive containing our sequenced genome, and they'll be able to prescribe treatments based on our unique genetic makeup. Maybe the some data can be used for disease prevention, too.

Today's prompt asks me to create a new technology related to health. Well, here it goes: If you've been to a tanning salon at some point in the last five years or so, you may have noticed that many of them check customers in using a fingerprint scanner (my gym does this, too). What if, before you used a tanning bed, you had to scan your finger and if you're predisposed to cancer, the bed would automatically either limit or restrict you from using it? Similarly, the bed would know from a database what you natural, skin, and hair colors are, so it would time your sessions based on how long it takes for your skin to burn. The FDA currently makes recommendations on how long a person should tan based on these factors, but customers frequently exceed suggested exposure times and salons themselves don't enforce. This new technology would limit overexposure and better regulate indoor tanning.

Would this method be perfect? Of course not. Most derms will you that there's no such thing as a "healthy" tan. What this would do would limit burning (which increases melanoma risk) and restrict folks who are melanoma-prone from tanning.

Or maybe by 2050 tanning will have gone out of style. What do you think?

***

This post was inspired by the Day 21 prompt for National Health Blog Post Month.
View posts by other participants.

Melanoma and Mommyhood Pt. 2

A fair-haired kiddo wearing UV Skinz.
Image: ABC's and Garden Peas

While I look forward to having kids (someday), I also dread the inevitable: Mom, can I borrow the car? Mom, can I get my nose pierced? Mom, can I go spend the night at Rachel's house? And the one I fear the most: Mom, can I go tanning?

I dread having the "tan talk" just as much as some parents must dread the birds and the bees. Since I've had a melanoma, my offspring as more likely to develop one, too. Plus, one study I found suggested that children of women who've had skin cancer are just as likely to use tanning beds than those whose moms hadn't. Ack!

After Cher forwarded me that email about tanning during pregnancy, I decided to ask her a few questions about being both a mommy and a melanoma survivor. Here's what she had to say:

You were diagnosed with melanoma as a young adult--now you're a parent. How has that experience impacted the way you think about sun safety and your family?
I was still pretty casual about my sun protection for the first six years post diagnosis. Young and dumb! But, I slowly started being more realistic and actually using the sunscreen I bought. As I look at my choices as a kid and young adult, I realize those choices left many scars on my body. Physical scars that everyone can see. Mostly biopsy scars, but also my melanoma scar. Looking at these scars, I realize that I don't want my kids to have scars like these on their bodies, marring their perfect skin, so we developed a ritual before we go out that I help my daughter put on sunscreen and she helps me put my sunscreen on. Makes it a fun time and now she asks for sunscreen before we leave the house!

How do you protect your family from the sun?
Our primary protection is, at minimum, SPF30. And it gets applied several times a day, especially when playing in or near the water. I also make sure we are covered up well with shirts and shorts before leaving the house. Now that my daughter is closing in on 3, she does better with sunglasses and will request them to help her from the sun. (And by this I mean she doesn't continually take them off and see just how far they bend until they break!) I laugh because she always tells me the sun is too bright without her sunglasses! I also like to seek out shade to sit in while outside. I know that this is not great sun protection, but it helps me not feel quite so overwhelmed by the heat/sun.

You're also expecting another baby. Are there any special precautions you take being pregnant and having a history of skin cancer? 
No special precautions. Unless you count the times I check my freckles and moles myself compared to not being pregnant. Since the hormones in my system can increase the chances of changes, I have paid closer attention to my freckles and moles to make sure and catch anything that may be changing. I just learned as well, from my new dermatologist, that they prefer to have women not get pregnant within the first 3 years after a melanoma diagnosis as the treatments and testing they may do can be harmful to a fetus.

How do you think you'll protect your children from sunburns and from using tanning beds even as they become teens and young adults?
I hope to use my own experience as a kid/teen that refused sunscreen, even with my family history of skin cancer, as a basis. I'm sure that vinegar baths as a threat are not going to work! I hope that I can remember what I thought during my "rebellious" and "immortal, nothing like that will happen to me" phase that I can use as proof that we are not immortal and this does happen to young people. One of my thoughts was always, "I'll think about that when I'm old!" Well, old turned out to be 23. Or, not so old… So, hopefully I can relay the "use sunscreen" talk in a way that doesn't sound like the mom forcing their kid to do things their way. My greatest wish is that tanning bed businesses go out of commission long before I have to have this talk. I doubt that will happen… I'm not really sure what to say about tanning beds overall especially since I was never into tanning salons and didn't have friends that were either. I won't be turning a blind eye to them, but will need to find the battle that will work for me if that comes up.

Other parents out there--feel free to chime in. I'd love to hear about your experiences.

The man tan

Jake Gibb, Olympic beach volleyball player is
a melanoma and testicular cancer survivor.

When I was in college, still an avid tanning bed user, my girlfriends and I used to giggle every time we saw a guy at a tanning salon. Call me old fashioned, but I've always preferred my men to be more rugged and outdoorsy. If a guy is more high maintenance than me (think waxed chest and designer denim)--I'll pass.

Come to find out, many of my guy friends have been to a tanning salon. And many of the ones who haven't are notorious for shunning sunscreen when they spend time outdoors. While I spend most of my time educating young women about the dangers of UV radiation, I wanted to take a moment to remind you: guys get skin cancer, too. Men are actually more likely to be diagnosed with melanoma than women.

To quote a U.S. News article from a few years back:

"Why men? 'Part of it is because men tend to get more [ultraviolet] exposure because of their jobs, part of it is that they use sunscreen less, and part of it is later detection,' says Barbara Gilchrest, chair of the dermatology department at Boston University. Many of her male melanoma patients, she says, come in only after being nagged by family members. Forty-seven percent of men report they never use sunscreen, one survey found. That's part of the reason, no doubt, that researchers at the Centers for Disease Control and Prevention say men have higher rates of sunburn."

I hate, hate, HATE to stereotype, but so many guys I know are (a) too cool to wear sunscreen or (b) totally invincible and don't need to go see a dermatologist--or so they think. Even if you do stay out of the sun, be careful that you don't fall into the latter category. Make skin checks part of your regular routine, especially as you age. I imagine that checking your back in the mirror every so often is less of a pain than an annual colonoscopy. There are undoubtedly people in this world who care about you, so please take care of yourself.

Steve Hock, father of these two, passed
away from melanoma on July 16, 2012.
Men: You are not immune.

Does this look like a cancer patient to you?

May is Melanoma Awareness Month. Please help spread the word by sharing this post with your friends and family. 

Earlier this week, my friend Rachael, the brains behind the Glenna Kohl Fund for Hope's social media outreach, posted this picture on Facebook of Glenna on her graduation day. If you're part of the melanoma club, you may already be familiar with Glenna's story (if not, you can read up on Cosmo). Long story short: this photo was taken mere months before Glenna found out she had stage III melanoma. She died four years later at age 26.

The other day, I was out having a drink with a friend of mine when I mentioned the Portland Melanoma Walk.

"Oh yeah, you had melanoma, right? Well, if your going to get cancer, at least it's just skin cancer, right?"

I love my friend. She is a very intelligent young woman, but in this instance she was all wrong. This is an uphill battle that many of us early-stage melanoma survivors face. Superficially, it may look like we just had to have a funky mole removed, and then things were golden again. But let me remind you that I had the very same type of cancer Glenna had, and she died. This vibrant, beautiful, fun-loving girl died because of skin cancer.

Sometimes I look back at pictures of myself over the holidays in 2009. I had just had my mole biopsied, and was completely unaware that there was anything malignant growing on my body. Unless you looked at my skin cells under a microscope, you would have had no idea that there was anything wrong with me. You can look healthy and happy but still be at risk for developing a deadly disease. Just look at Glenna on her graduation day. Does she look like your stereotypical "cancer patient"? Maybe that's part of the reason why melanoma is so dangerous. It's sneaky and ruthless.

So, two takeaway messages for this lovely Thursday evening:

1. Don't ever underestimate the dangers of skin cancer. Just last week, at the melanoma walk, I met friends and family members of three more individuals who lost their lives to melanoma.
2. No one knows your body like you do (OK, except for maybe your significant other). So check yourself out in the mirror. (Just don't take creepy pictures of yourself and post them on Facebook.) Notice if anything changes or looks suspicious. If so, go talk to your derm. It's likely nothing, but you'll thank me if it's not.

Free skin cancer screenings at Portland Melanoma Walk, May 12

May is Melanoma Awareness Month. Please help spread the word by sharing this post with your friends and family.

If you live in the Portland area and haven't yet signed up for the AIM at Melanoma 5k on Saturday, May 12, the walk's organizers have recently added free skin cancer screenings by the Portland Dermatology Clinic to the event. Save yourself a trip to the dermatologist, then stay and walk for a good cause.

A few reasons why you need a skin check:

• Melanoma is the most common form of cancer for young adults 25-29 years old and the second most common form of cancer for young people 15-29.
• The survival rate for patients whose melanoma is detected early is about 99 percent. The survival rate falls to 15 percent for those with advanced disease.
• The number of women under age 40 diagnosed with basal cell carcinoma has more than doubled in the last 30 years; the incidence of squamous cell carcinoma among women under age 40 has increased almost 700 percent.
• If you've used a tanning bed, you're 74 percent more likely to develop melanoma than those who haven't.

For more information, visit the AIM at Melanoma Portland website. Can't make it? Consider sponsoring me for the walk.

Portland's first AIM at Melanoma walk, May 12

As many of you know, I had surgery to remove an early-stage melanoma in 2010. Since then, I've become an advocate for skin cancer prevention and early detection. I've made quite a few friends along the way--many of whom have participated in melanoma walks and other large fundraisers all over the country. The whole time, I've thought to myself, Wouldn't it be cool if there was a melanoma walk in Portland, Oregon? Well, guess what? This year, there is! It's happening Saturday, May 12, 2012.

Needless to say, I'm thrilled that little 'ole Portland is getting its own melanoma walk, so I've been emailing with walk's organizer. Since it's the first year, there's still a lot of work that needs to be done. If you live in Oregon or Southwest Washington, please join us on May 12 and share the event with your friends and family (the U of O duck will be there, so bring the kids, too!) Unlike other 5k races I've been doing lately, there's no fee to sign up, although you're more than welcome to make a donation. Not local? Consider sponsoring me! Even $10--the cost of one session in a tanning bed--would do wonders.

Some thoughts on "curing cancer"

Image: www.e-magineart.com.

Cancer researchers everywhere dubbed 2011 as the year for melanoma. Two new drugs,  ipilimumab and vemurafenib, were approved by the FDA to treat advanced stages of the disease, making them the first new melanoma drugs in 13 years (that's a long time in cancer land). Just this week, MSNBC published an article called, "New melanoma drug - a turning point against cancer?" Of course, this is great news. Melanoma has been, for a long time, one of the most elusive cancers to scientists.

But (yes, there is always a but)--as news of a new melanoma drugs becomes more mainstream, I fear that the public will develop misconceptions that tanning is safe again. Although most news articles clearly state that we're still far from a cure, people seem to have great faith in the powers of science to "cure cancer" before it can hurt them. For example, when I was in college, I remember asking a fellow tanner if she ever worried about the potential side effects from UV radiation.

"We're all going to get cancer anyway," she said. "And besides, by the time I'm 80, they'll probably have a cure for cancer anyway."

"You don't worry about getting wrinkles either?"

"Um, hello. Botox?"

Years later, this conversation has stuck with me because it epitomizes the way we rationalize our use of tanning beds: "Yes, tanning can cause cancer, but it won't happen to me." Or, "Yes, tanning causes cancer, but it won't happen until I'm older." It was around the time I had this conversation that my grandfather was diagnosed with skin cancer. Years of playing golf and vacationing in warm climates wrecked havoc on his face and scalp. To this day, he's had more lesions removed than I can count on both fingers and toes. Hearing about my grandpa's run-in with skin cancer scared me, but it didn't scare me completely out of the sun. My grandpa was old. Things like that happened to old people.

From that point on, every time I laid down in that acrylic bed and pulled down the clam-shell lid, I was able to make peace with the fact that someday I too would probably be diagnosed with skin cancer. That is, if I hadn't already died from a heart attack, stroke, or breast cancer. If something was going to kill me, I thought, I might as well look beautiful and have fun while I'm young.

I never thought I would be diagnosed with melanoma less than 10 years after I started tanning. And I'm not the only one. My friends over at the Glenna Kohl Fund for Hope sent me a great article today from Providence College's The Cowl about a former teenage "tanorexic" turned melanoma prevention advocate (like me!) When I read about Megan Rothschild, I felt like I was reading about myself. In the article, Megan is quoted saying:

"In my mind, I thought 'I'm not going to get melanoma. I'm not going to get skin cancer.' People told me that I looked dark and maybe I should go get my skin checked out, but my mentality was if I was going to get cancer it would be when I was 70. At that time, I felt invincible."

I think she hits the nail right on the head there, going on to say: "There's still this conception that [melanoma] is an 'easy' cancer. It used to be most common among older men because of their habitual golfing, but it's actually becoming a young woman's cancer now."

So let's celebrate the fact that every day we're inching closer to a time when advanced-stage melanoma will no longer be a death sentence. Let's just also keep in mind that regardless of what breakthroughs come out of the labs, we shouldn't delude ourselves into thinking that suntanning is safe.

My own "Dear 16-year-old me"

There's a good chance you're one of the 5.4 million people who has viewed the David Cornfield Melanoma Fund's "Dear 16-year-old Me" video on YouTube. If you haven't watched it yet, you should. Every time I see this video, it makes me a little teary eyed, and trust me, I'm not the type of girl to get a little teary eyed. Like the survivors in the video, I have a scar too, and of course I have pangs or regret about tanning (indoors and out) as a teenager and young adult.

A month or so ago, a friend of mine introduced me to a woman who's compiling an anthology of short stories about prom. I jumped at the opportunity to share my story about tanning before prom. Prom was, after all, the breaking point at which my mom finally caved and let me use tanning beds for the first time. While I have no doubt that prom has changed since 2002, I'm sure that tanning is still part of the pre-prom ritual for many.

The million dollar question: How on earth do I tell a 16 year old to not use a tanning bed without sounding like my mother? Touching as this video is, especially now that I've had a run-in with skin cancer, would the 16-year-old Katie have paid attention to the things they say in the video? More importantly: would it have even impacted my behavior? Regretfully, the skeptic inside me says no. On the flip side, these days there are initiatives like the Melanoma Foundation of New England's "No Tanning Pledge Contest" (thank you for sharing Rachael!) By promising not to tan before prom, high school students from Connecticut, Maine, Massachusetts, etc. can wish cash and an assortment of other prizes. Again, would this sort of a campaign have appealed to me when I was 16? It's hard to say.

I suppose all I can do is share my story and cross my fingers that it will resonate with someone. Would I have tanned if I knew I was going to develop melanoma at age 23? Probably not. In the meantime, let's hope that more states continue to follow California's lead and pass legislation to prevent tanning for minors. If you have any suggestions on how you'd speak to a 16-year-old about tanning, I'd love to hear it. Leave a comment below.