Read my skin cancer story in U.S. News

Happy first day of summer! Before you head outside to get your tan on, read about my experience with melanoma in this article that was published in U.S. News earlier today.

Thank you so much to Donna Regen a.k.a. Melanoma Mama for sharing this article on my Facebook page! I did the interview months ago and I had almost forgotten about it. As always, I'm happy to be sharing my experience in hopes that it will prevent one more person from being diagnosed with this very deadly type of skin cancer.

Peace, love & sunscreen.

My trip to the Oregon House Health Care Committee

Me testifying at the Oregon House committee hearing. Photo: Jeremy Rush.

Let me begin with a spoiler: On Wednesday afternoon, Oregon House Bill 2896 passed unanimously through the Oregon House Committee on Health Care! That means we're one step closer to banning minors under 18 from using UV tanning beds in Oregon.

Now, let me rewind a bit. Earlier this week, I got to drive down to Salem and tell my story about tanning beds and skin cancer to the committee. I was one of three patients who testified (special shout out to my friend Mark Williams, who gave a fantastic testimony). Three experts also spoke in favor of the bill, including world-renowned cancer researcher Brian Druker.

Me and Brian Druker, M.D. Photo: Jeremy Rush.

Several friends have asked me if I was nervous at the hearing. Of course I was nervous! I'd never been to a hearing like this before and I had no idea how the representatives would react to my testimony. Plus, I've been following how similar bills have been proposed in other states. Learning about Chelsea's recent experience in Virginia was also a bit disheartening.

Fortunately, as I told my story about using tanning beds and my subsequent melanoma diagnosis, members of the committee seemed engaged and many nodded their heads when I shared how I begged my mom to let me go tanning in 10th grade. Some of the key concerns I expressed in my testimony are:

• That teenagers are unaware how serious skin cancer can be.
• Even if they know tanning is dangerous, they may engage in risky behavior because of influence by peers.
• A large number of high school students use indoor tanning beds, especially before prom and senior portraits. Even smart, high-achieving students are worried about their appearance.
• Tanning beds use is very poorly regulated. Most tanning salons I visited let me tan for the maximum time and did not take into consideration my naturally fair complexion or that I might burn.
• Parents are often unaware of the risks of indoor tanning, so they are unable to adequately protect their children. For example, many parents believe it's smart to get a "pre-vacation" tan or that you need to tan to produce enough vitamin D. Medical research suggests that neither of these myths are true.
• Melanoma rates in young tanning bed users are skyrocketing.

I also gave a detailed description of my melanoma diagnosis, treatment, and the anxiety I deal with knowing I may develop a second melanoma.

Talking with one of the committee members after the hearing. Photo: Jeremy Rush.

Of course, we had to hear from the opposition, which included both a local tanning industry representative and a national lobbyist who flew in from Colorado. It was frustrating to hear them speak, especially when they said things that contradicted what I had said just minutes earlier. Their arguments were predictable: that tanning beds don't actually cause melanoma, that parents should be able to monitor their own children, and that the tanning bed industry strives to encourage "smart" and healthy tanning behavior. Interestingly, the lobbyist's testimony was very argumentative. At one point, everyone in the room held their breath while he sparred back and forth with the committee chair, refusing to directly answer his question about the safety of UV tanning equipment. Ultimately, his testimony persuaded one of the more conservative committee members to vote in support of the bill.

The bill is now headed to the full Oregon House for a vote, so it's not over yet! But I do feel very lucky, not just to be alive to share my story, but also to have been chosen to speak on behalf of so many other people impacted by melanoma in our state. This is all a tremendous learning experience for me, and I hope it becomes another vehicle to raise awareness about melanoma--not just in Oregon--but across the U.S.

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.
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Five-year tanniversary

National Health Blog Post Month Day 20: A health moment you regret

A health moment I regret? This one's easy. I wish I hadn't used tanning beds in high school and college. Not only did I end up with melanoma just one year after I quit tanning indoors, but my skin has lasting, visible signs of UV damage. Sexy, right?

Yesterday, one of my best friends from college forwarded me a promotional email that was sent to her old ".edu" address this week. Here's the email she forwarded me:

This is what she said: "I'm pretty positive I unsubscribed to these emails 2 months after graduating college and haven't received anything since then, then BOOM, what's in my inbox? Also, it makes me feel really old that this place is 5 yrs old because I remember what a hit it was when the "nice" tanning place came to south Bethlehem. We used to plan our days around when we would tan, sickos!"

Seeing this in my inbox gave me the kind of feeling my friend Chelsea had recently when she found her old tanning goggles. It brought back so many memories--both good and bad. My friends and I really would plan our days like the guys on Jersey Shore who GTL'ed. We knew it probably wasn't good for us, but it was fun. It was always a social activity.

On one hand, it's hard to believe that I graduated from college almost five years ago, but on the other, it feels like a lifetime has passed since then. I'm not just taking about skin care, either. Of course, that's part of it, but I've become more conscious of my health overall and I'm learning to listen to my body more. As much as I do regret using tanning beds as a teenager, I think that dealing with melanoma has empowered me to make healthier decisions in all aspects of my life that I may never have not made otherwise. I do, however, regret that I'll never be able to get rid of some of these sun spots...

***

This post was inspired by the Day 20 prompt for National Health Blog Post Month.
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They're everywhere!

National Health Blog Post Month Day 16: Use a picture to inspire a post

 

I had no idea what I was going to write for this prompt until I woke up this morning and checked my email. I don't know about you, but I'm subscribed to just about every "daily deal" listserv out there. Every once in a while--more often than I'd like--I'll get a coupon in my inbox for indoor tanning. Ick!

I also get coupons for free tanning sessions in the mail and on the back of my receipts from the grocery store. I know we see hundreds of advertisements per week for everything ranging from luxury vehicles to diaper cream. Much of the time, the ads we see are for products we'll never even buy, so we're able to tune them out. But when I see an ad for a tanning salon, I can't tune it out.

What's even more disheartening is when I see that "500 users have already purchased this deal." Maybe they bought the spray tan? One can hope, I suppose.

On a lighter note, a huge group is gathering in North Carolina this weekend for an AIM at Melanoma fundraiser. I'm sad I won't be there, but I'm super excited to see pictures and hear stories when everyone gets back. If you're local (a.k.a. PDX), stay tuned for more information on the 2nd Annual Portland Melanoma Walk. I'm organizing it this spring and will be announcing the date/time soon! Shoot me an email if you live in the Portland area and would like to volunteer or get involved.

***

This post was inspired by the Day 16 prompt for National Health Blog Post Month.
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Sookie Stackhouse and other vices

National Health Blog Post Month Day 13: What’s your favorite book and how can you tie it to your health or life? 

 

Anna Paquin as Sookie Stackhouse

Since HBO's True Blood is dead and gone until next summer, I decided to check out the books from whence the TV show came. The first book, I thought, was awful. The second one? Not impressed. The third one? Eh, not bad. Now, I'm on book ten and I'm certifiably obsessed.  I love reading about my favorite characters (namely, Eric Northman)--but with all kinds of crazy plot twists we haven't seen on TV. Spoiler alert: Sookie (protagonist, telepath, object of everyone's affection) dates a "weretiger" in book seven. Weird, I know.

Much as I love the books, I'm genuinely surprised by how much Sookie talks about tanning beds throughout the series. Of all things! Naturally, I'm more sensitive than the average person when it comes to tanning talk, but really, Sookie? Really?!

Here are some examples. Let at me put my college lit major to use:

• "I took a deep breath, turned to the mirror, and slapped on some makeup. My tan wasn't great this far into the cold season; but I still had a nice glow, thanks to the tanning bed at Bon Temps Video Rental." - Club Dead (Sookie Stackhouse/True Blood, Book 3)
• "His companion's face might have been sculpted from marble. Had the woman never heard of a tanning bed?" - Dead as a Doornail (Sookie Stackhouse/True Blood, Book 5)
• "I enjoyed lying in the sun in a little bikini, timing myself carefully so I didn't burn. I loved the smell of coconut oil. I took pleasure in shaving my legs and removing most of my other body hair so I'd look smooth as a baby's bottom. And I don't want to hear any lectures about how bad tanning is for you. That's my vice. Everybody gets one." - Dead as a Doornail (Sookie Stackhouse/True Blood, Book 5)
• "Every year I thought of all the reasons I shouldn't lie out in the sun. Every year I added up my virtues: I didn't drink, I didn't smoke, and I very seldom had sex, though I was willing to change that. But I loved my sun, and it was bright in the sky today. Sooner or later I'd pay for it, but it remained my weakness. I wondered if maybe my fairy blood would give me a pass on the possibility of skin cancer. Nope: my aunt Linda had died of cancer, and she'd had more fairy blood than I had. Well... dammit." -Dead and Gone (Sookie Stackhouse/True Blood, Book 9)

One thing I find particularly interesting is that over the course of the series, Sookie's tone evolves. It goes from "I use tanning beds and everyone else should, too" to "stop giving me a hard time for tanning" to "I hope I don't get skin cancer from tanning so much." I suppose, from a literary standpoint, Sookie's bronze skin makes her a good foil to her paler than pale vampire suitors. But when something like suntanning makes its way into popular chick lit, it's indicative that tanning has become ubiquitous in American culture.

A few of my favorite vices that Sookie might try as a tanning substitute:

• Pinterest
• Weekly manicures
• ABC's Revenge
• Cheese
• Vanilla lattes
• Cheesy vampire novels :)

***

This post was inspired by the Day 13 prompt for National Health Blog Post Month.
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A melanoma survivor walks into a tanning salon

National Health Blog Post Month Day 12: Call BS on Something 

 

Starting on #12! What a fantastic idea.

Walking into a tanning salon after being diagnosed with melanoma feels a bit like being a hippie-liberal at a tea party convention. This was about a year and a half ago. I was there because even after my run-in with skin cancer, I was still a little self-conscious about wearing a bikini in public. I was also curious to try spray tanning, which temporarily darkens the skin using a chemical called DHA instead of UV radiation.

I hadn’t been to this tanning salon before, so the gentleman at the front desk asked me to fill out a new member questionnaire. Every salon’s questionnaire is a bit different, but they all ask about your natural hair and eye color, as well as if you tan easily, so that if you ever decide to UV tan, operators can recommend an appropriate UV dosage.

“Have you ever tried UV tanning before?” he asked. “You could do what we call a tanning cocktail. Lay in a UV bed for a few minutes, open your pores up, and then head on in for your spray tan.”

“Yes, and no thank you.”

Meanwhile, a woman who was just nine days away from her wedding had come in for her first ever indoor tanning experience. She’d received a full tour of the facilities from a friendly female employee and was deciding which package to buy. Sensing a bit of hesitancy in the bride-to-be, the man at the front desk walked over to the waiting area and grabbed a newspaper that was sitting on the table.

“This here is gold,” he said, pointing to the cover story. “Researchers at Oregon Health & Science University right here in Portland say that we need more vitamin D. In a climate like Portland where it rains eight months of the year, the only way you’re going to get enough vitamin D is by using an indoor tanning bed. Plus, tanning beds have improved so much in the past few years. They won’t fry your skin and burn you like they used to. Our beds are so high tech. They use 98% UVA rays—hardly any of the burning rays at all. So we don’t even have to worry about the c-word anymore.”

As he finished his sentence, I felt like I’d been punched in the gut. Research by doctors at the university where I worked was being manipulated to sell tanning beds to innocent consumers. And him blatantly saying that tanning beds won’t cause cancer? Do you think he would have been offended had I pulled up my shirt and showed them the scar on my chest? I didn’t want to start a scene, nor start a fight that I knew I wasn’t going to win, so I kept my mouth shut.

Despite this salon operator’s promises that today’s tanning beds won’t cause the “c-word,” in the scientific community, UV radiation is well known to be the primary cause of most skin cancers. Even the Indoor Tanning Association, a lobbying organization for the indoor tanning industry, admits that their products can lead to skin cancer, stating clearly on their website: “You do not need to become tan for your skin to make Vitamin D. Exposure to ultraviolet radiation may increase the likelihood of developing skin cancer and can cause serious eye injury [1].”

When the skin is exposed to UV radiation from the sun or from an artificial light source, it triggers a molecular reaction within skin cells, specifically between the keratinocyte cells in the top layer and the melanocyte cells in the bottom layer. UV rays cause the pigment-containing melanocytes at the bottom layer of the epidermis to travel upwards, where the pigment creates a protective cover for the top layer cells [2]. According to a report by the American Academy of Dermatology, the molecular mechanism that is responsible for creating a tan appearance is the exact same mechanism that leads to skin cancer [3].

Although the Indoor Tanning Association has acknowledged that exposure to UV rays may increase a person’s risk for developing skin cancers like basal and sqaumous cell carcinoma, they are adamant that there is no correlation between melanoma (the most deadly type of skin cancer) and UV exposure from tanning beds.

In contrast, the World Health Organization, a global authority on health research, has found not one or two, but 19 studies that linked sunbed use with an increased risk for melanoma. The same group also came to the conclusion that using tanning beds before the age of 30 increases a person’s risk of developing melanoma by 75% [4]. An American’s risk of developing melanoma has increased 2000% over the past 75 years [2], signifying that a change in human behavior over the last century is likely responsible for this increase. And what has changed that dramatically in the last 75 years? The use of tanning beds.

Admittedly, we have more epidemiological evidence than biological evidence that tanning beds increase a person's risk for developing melanoma. But why risk it? Tanning salon owners are more concerned about making a profit than taking care of your health.

Next time you try to tell me tanning beds don't cause cancer, I will call bullshit.

***

This post was inspired by the Day 12 prompt for National Health Blog Post Month.
View posts by other participants.

[1]The Indoor Tanning Association. http://www.theita.com/. Accessed June 5, 2011. 
[2] Tran TT, Schulman J, Fisher DE. “UV and pigmentation: molecular mechanisms and social controversies.” Pigment Cell Melanoma Res. 2008 Oct;21(5):509-16.  
[3] Lim HW, James WD, Rigel DS, Maloney ME, Spencer JM, Bhushan R. “Adverse effects of ultraviolet radiation from the use of indoor tanning equipment: time to ban the tan.” J Am Acad Dermatol. 2011 May;64(5):893-902. 
[4] “The association of use of sunbeds with cutaneous malignant melanoma and other skin cancers: A systematic review.” Int J Cancer. 2007 Mar 1;120(5):1116-22.

The skin cancer paradox

Image: Skin Cancer Prevention

A statistic that continues to perplex me: 86% of tanning bed users acknowledge that tanning causes cancer, and yet they do it anyway.

A reality that continues to perplex me: The number of people I'm friends with who continue to tan even though they know I've had melanoma (it's surprisingly high).

I realize that not all cases of melanoma are caused by UV radiation--natural or artificial--but some of them are. Yesterday, my dad sent me an article from CNBC.com that reiterates what I'm always saying about tanning and skin cancer: "Despite piles of research on the skin cancer risks of sun exposure and tanning beds, dermatologists and cancer groups struggle to persuade people to protect their skin from ultraviolet rays."

We know what we're doing is bad, and yet we do it anyway. It's like some sort of skin cancer paradox, isn't it?

If you're unfamiliar with recent findings, statistics, and legislation on melanoma, the CNBC article gives a great overview. I've read many of the studies it references in their entirety. I also love the suggestion from the University of North Carolina dermatologist at the end of the article: "Changing public opinion may be more effective than legislating change [for young people]. Effective campaigns to prevent skin cancer may need to emphasize that skin is most beautiful and healthy in it's natural, untanned, state."

P.S. Best of luck to my girl Chelsea Price who is speaking at the uber-fancy Skin Cancer Foundation Gala this evening. Besides hobnobbing with the rich and the famous, Chelsea will be sharing her experience of what it's like being a Stage III melanoma survivor in her mid-twenties. I hope that people pay attention because Chelsea isn't an anomaly. Melanoma isn't just an old person's disease anymore, and by limiting our exposure to harmful UV rays, we may be able to reduce the numbers of young people diagnosed with this crappy, crappy disease.

Why did we ever use tanning beds in high school?

I  love it when my friends sent me notes like this!

My friend Debbie sent me this text the other day. She just had to have her fourth mole removed. As a teenager, neither of us though we'd regret tanning until we were older. Who would have thought that "older" meant "in our 20s?"

When Debbie and I met up for happy hour over the weekend, she let me snap a picture of her stitches. Ouch! Fortunately, all of Debbie's moles have been either benign or precancerous, so the procedure to remove them is less invasive than with a melanoma. Still, removing even a benign spot can be uncomfortable, and it can leave a pretty nasty scar. Plus, what would you rather spend your hard-earned cash on: a new pair of Frye boots or a biopsy because you spent too much time in the sun? I'll take the boots, please.

Stitches from my friend's most recent skin biopsy. It's
about one-third the size of my melanoma scar.

Everything causes cancer

When are we going to start seeing these as one and the same?

Over the weekend, I spent a few hours catching up on my magazine reading. I'm one of those people who swaps airline miles for magazines subscriptions, so there's a lot of junk for me to sift through (guilty pleasure, whoops!)

Every month, it's the same: eat blueberries, they protect against cancer. Drink wine, it's good for your heart. Drink coffee, the caffeine is good for you! Then two months--if not two weeks later--it's the opposite. Don't drink alcohol, it's bad for you! Caffeine is bad for you. Smoothies are bad for you and so is Diet Coke (OK, I already knew about that one, but still.) Admittedly, science is a moving target. Our knowledge base is constantly evolving, and it's only fair for the media to share the latest research with the public. But with so much conflicting health information out there, how do we know what to do?

For example, doctors tell us we need vitamin D for bone health and to support our immune systems. On the other hand, one of the easiest ways for our bodies to synthesize vitamin D is to sit outside in the sun. Well, guess what? Sun causes skin cancer. It's a real "damned if you, damned if you don't." So what do we do? Because UV radiation has been proven to be carcinogenic in numerous studies, the American Academy of Dermatology recommends adjusting your diet or taking supplements instead of getting vitamin D from sunlight. The key here is that UV has been proven to be dangerous. Vitamin D from the sun versus from a supplement is still up for debate. Just one or two publications don't mean something is a fact. It can take years to establish compelling evidence that something is truly beneficial or harmful (and even then, sometimes we don't know for sure.) Based on a large number of studies over a long period of time, there is a clear link between UV radiation and skin cancer.

This all leads me to an article I read recently about teenagers rationalizing risky behavior like tanning bed use. More than half of the teens questioned in a study by Memorial Sloan-Kettering Cancer Center said that they tanned because "everything causes cancer." To many, using a tanning bed seemed to hold about as much risk as walking across the street or eating a burger (cholesterol, hello!) Sure, tanning has been in the news a lot lately, but what makes using a tanning bed seem any more dangerous than the hundreds of other warnings we receive on a weekly basis? I fear that if every time I read one of my magazines that all the dos and don'ts are diluting warnings against behavior that is truly dangerous. The importance of taking care of our skin and avoiding tanning beds needs to rise to the level at which we educate our children about smoking, doing drugs, and driving without a seat belt.

I also found it interesting that 32% of teenagers said: "If tanning bed use was so bad for you, the government would ban tanning beds." Kids: have you taken a look at our government lately? Take health matters into your own hands, and don't trust the government to do it for you.

Picking a new bad habit

This skincare set from by Philosophy was a
lifesaver. Literally.

I decided to stop using tanning beds in the summer of 2008, shortly after my college graduation--about a year and a half before I was diagnosed with melanoma. This sudden change coincided with my transformation from blonde to brunette, and a new, chin-length bob that I felt made me look more "professional." I still spent a fair amount of time in the sun, but I was starting to realize that tanning beds were a habit I couldn't afford to maintain (for both health and financial reasons). Paradoxically, when I decided to quit tanning cold turkey, I remember obsessing over how uneven my skin tone looked. As soon as my tan began to fade, the freckles on my arms and face became more noticeable. There were freckles, now, on my legs and chest that didn't exist before I started using tanning beds. It seemed the only way I could hide these new freckles and keep my skin looking flawless was to continue tanning, but every 12 minutes in that bed, I knew how much worse I was making things for myself in the long run. How could I break the cycle?

Enter Sephora. In 2008, there was a Philosophy skincare kit I'd been dying to try. Face wash, ultra luxe moisturizer, exfoliant--it was a beauty addict's dream come true. The only problem was that it retailed at about $100. Normally, there's no way I'd be able to rationalize spending 100 bucks on skincare, but when I thought about it, wasn't I doing so already? A month-long unlimited tanning package in my preferred choice of bed cost me around $40 a month. Single tanning sessions ranged from 5 to 15 bucks a piece depending on where I went and what level bed I used. Then, I had to factor in the tanning bed lotion. Although I was unconvinced that it made much of a different, the women who worked in tanning salons were as ruthless as used car salesmen. They could sell me a bottle of $30 moisturizer that I swore was probably generic brand lotion with coconut scent added, packaged in a shimmery pink bottle. If I were to cut tanning beds out of the equation, that opened up at least $150 in my budget every three months. I could more than afford to spend $100 on a skincare kit that would last me at least the same amount of time. So I bought it.

Last month, I was relaxing after a hard day's work with my stack of fashion glossies. Right there, staring me in the face, was an article in Marie Claire called, "Smart Girls Bad Habits." Story of my life. I decided to read on. The teaser of the article: "Stop drunk-texting your ex, snacking late-night, and skipping the gym! New research into how the brain works may help you get into the positive groove--once and for all." OK, now I was really hooked. What was this new research and how could I incorporate it into my life?!

According to the article, based on research in a new book called, The Power of Habit: Why We Do What We Do in Life and Business, our brains are hardwired to stick to our habits. Even the strong-willed find it impossible to break bad habits (um, hello failed New Years resolutions?) until they replace their old habit with a new one. The answer to unparalleled bliss: Replace all of your bad habits (e.g. tanning, smoking, drinking) with better ones (e.g. running, volunteering, eating salad). Sounds a little unrealistic at first, but this is exactly what I did when I quit using tanning beds. It was rough at first, not having the bronze glow I was accustomed to, but after four years of diligently using high-quality skin care treatments, my skin looks clearer, smoother and brighter now than it did when I was 18. Just the other day, a friend of mine asked me, "How do you get your skin to glow like that? You look so well rested." Retinol, my friends. Retinol.

I've come to terms with the fact that when I'm having a bad day, nothing will make me feel better than a hydrating face mask or a Biore pore strip. I will never not care about how I look or what other people think of how I look, I just channel my money and energy into finding the best sunscreens and cleansers, not the strongest bed or newest tanning potion. If you're trying to cut back on tanning or stay out of the sun, it could be worth making a trip to your local department store (or sephora.com). You could also try yoga, or a subscription to wine-of-the-month club.

Well, duh: Young women tan despite health risks

I don't want to call out any one sorority,
so I'm leaving this purposefully vague :)

All this week my Facebook feed has been blowing up with links to a new study that was presented at the American Academy of Dermatology annual meeting. Key points of the study:

- Two thirds of sorority members at a Midwestern university used tanning beds.
- 93% intentionally tanned outdoors.
- 40% had no plans on using sunscreen.
- To give perspective, 81% of young women in the U.S. (not just sorority chicks) tan outdoors and 32% have used tanning beds in the past year.

While these numbers are sobering, I can't help but to think: well, duh. I love Rich from Hotel Melanoma's reaction to the study, which he titled "The Folly of Youth":

"My initial reaction to this story was to get uppity, shake my head, and dismiss these young women as vain and vapid airheads. But then I remembered some of the high-risk behaviors I engaged in as a college student in the early 70’s, knowing they were risky but thinking I was bulletproof. I once read that the male brain doesn’t reach maturity until we reach the age of 25 or so, and until then we aren’t fully capable of rationally evaluating the potential risks and consequences of our actions. If I’m representative of my species and gender, I don’t doubt this one bit."

Whether you're male or female, Rich is right. If you're still in your teens and possibly early twenties, you can probably blame your prefrontal cortex for some of your impulsive behavior. A book I finished recently about the prefrontal cortex and decision making says:

"Brain areas that are relatively recent biological inventions--such as the frontal lobes--don't finish growing until the teenage years are over. This developmental process holds the key to understanding the behavior of adolescents, who are much more likely than adults to engage in risky, impulsive behavior. More than 50 percent of U.S. high school students have experimented with illicit drugs. Half of all reported cases of sexually transmitted diseases occur in teenagers. Car accidents are the leading cause of death for those under the age of twenty-one. These bleak statistics are symptoms of minds that can't restrain themselves." -Jonah Lehrer in How We Decide

We've all done stupid shit. When I was pledging my sorority, I did particularly stupid shit. Truth be told: if one of my sorority sisters had asked me to jump off a bridge--I would have (especially if they prepped me with a shot of SoCo and lime and told me I'd have a date for winter formal waiting for me at the bottom). College is a really tricky period of time in life. You're not a kid anymore, but you're definitely not an adult, and you're far from living in reality. For me, this was exacerbated by the fact that I want to a small, private East coast school that was heavily Greek. Everyone knew everyone else and we were all up in each others' business. Sorority girls aren't necessarily "vain and vapid airheads." Quite the opposite, actually. Some of the smartest, most intelligent women I know have been Greek, but there's a tremendous amount of peer pressure that goes on inside a sorority. Consequently, you have premeds graduating magna cum laude with eating disorders, binge drinking problems, and a propensity to line up for the tanning salon before heading to Cabo for spring break.

I think the only real way we'll be able to decrease the number of tanning bed users will be to change our perception of what's attractive. Simply knowing that tanning is dangerous will not stop sorority girls--or anyone--from sunbathing. It actually took about a year or so after I had my run-in with melanoma that I started to realize, maybe pale really is prettier after all. Friends still poke fun at me sometimes, telling me that maybe I should go outside and get some vitamin D. Six months or so after my surgery, I remember being at the lake with a group of friends, literally fuming with jealousy that they all got to lay there, soaking in the sun, returning home with tan lines and flushed cheeks. Right in front of me. Even having known me, seen my scar, and heard me complain to death about how evil the tanning salon industry is, a number of friends and acquaintances still tan. They know what can happen to them, and yet they still do it. So, really, I want to just ask everyone, what is it about the fake 'n bake that's really all that attractive? Because as long as ya'll love the Jersey Shore look, we're going to continue to see a rise in melanoma in young people.

Image: Papermag

Unluck of the Irish

On St. Patty's day, everyone loves to be Irish. Drinking beer before noon, decorating your body with temporary shamrock tattoos (amongst other things)... what's not to love about being Irish on March 17? If only I felt the same way about my partial Irish heritage the other 364 days of the year. My mom's dad was a full-blooded Irishman. When I was a kid, I remember coming home from school, sitting with him in my grandparent's living room, telling him about what I learned at school that day. He always sat reclined in his favorite armchair. I still remember him that way: sitting in his armchair, his legs poking out from underneath a wool blanket--legs that were white to the point of translucence.

If I had to guess, I'd say my grandpa's skin tone would have been classified as Fitzpatrick Type I. The Fitzpatrick Skin Type scale is a system used by dermatologists--and by tanning salons--to determine how your skin will react to sun UV radiation. Very fair skin is classified as Type I and on the other end of the spectrum, very dark skin is classified as Type VI. Many of us Irish folk, with fair skin, light eyes, and light hair, are classified as Type I or Type II, which means we're more susceptible to sunburns. Lucky us, we're also lighter more likely to develop skin cancer.

The tanning bed industry claims that they will not sell UV tanning sessions to patrons with Fitzpatrick Type I skin. Tanning bed users with Type II or III skin, according to Tanningtruth.com, should only tan up to three times per week, starting with three-minute sessions. I can tell you from experience, tanning salon operators in Oregon, New York, Pennsylvania, and New Jersey have not limited me to three times weekly, three-minute tanning bed sessions, even though my skin tone is naturally Type II. According to a study conducted by several congressional representatives which was published just last month, 51% of tanning salons denied that indoor tanning would increase a fair-skinned teenagers risk for cancer (based on a survey of 300 salons nationwide by congressional interns). Quite the opposite, actually. Four out of five salons surveyed said that tanning would actually be beneficial to a teenage girl with fair skin. Some went as far as to say that using a tanning bed would prevent cancer. Why such a discrepancy between the science, FDA regulations, claims by tanning industry lobbyists, and salon owners and operators?

Whether you're Irish or just pretending to be for the weekend, I hope you have a safe and happy St. Patrick's Day. If indeed you do have a bit o' Irish blood in you, be sure to keep slapping on the SPF, keep up with regular skin checks, and stay out of tanning salons. Call it "unluck" of the Irish, but us fair-skinned folks have a higher risk of developing melanoma and other skin cancers.

Shame on you, Groupon

 

Sometimes Groupon's daily deals are a little off the wall (e.g. Justin Bieber singing toothbrush, discount Lasik, etc.), but I still love them. That said, it REALLY annoys me when they advertise UV tanning.

Newsflash: There's a growing body of research indicating that frequent UV exposure can evoke addictive-like behavior. So, theoretically, offering an unlimited tanning package for one month isn't all that different than selling half-priced cartons of cigarettes. Would you ever see that on Groupon? I think not. How long will it take before selling tanning packages on Groupon becomes taboo, too?

Guilt trip

A blonder, tanner version of myself.

Last weekend, I went out to dinner with a good friend of mine who beat testicular cancer shortly before I had my run-in with melanoma. At dinner, I felt disgustingly selfish when we were exchanging cancer stories. How could my stage I melanoma compare to my friend losing his hair during intense rounds of chemotherapy? I feel the same way when I read about young women like Chelsea Price, a fellow blogger and stage III melanoma survivor. She has more scars than I can count and is participating in a clinical trial for a new melanoma drug. It's like I'm swimming in the kiddie pool while these guys are diving in the deep end. Not that I want to be in the deep end by any means, but I worry that people will look at me and think: yes, melanoma is just a skin cancer that you can cut out and be done with.


Not so much. In addition to the three-inch chunk of flesh I had removed (and the $3,000 it cost me after insurance), there's been an overwhelming feeling of guilt that's haunted me every day since my diagnosis. Recently, I mentioned that I was writing a short story for teenagers about why tanning beds are evil. As I wrote, I asked a few friends to take a look at my drafts. They all had wonderful, insightful feedback that was able to incorporate into my final draft, but one comment in particular stuck out to me. In my essay, I wrote that I had been "lucky" to catch my melanoma before it progressed past stage I. It's something numerous doctors have told me and that I've told myself over and over. But what if I hadn't been so lucky? What makes me so different than all these other 20-somethings who didn't catch their cancer early? These were some of the questions I was grappling with in the days and months following my diagnosis. It actually wasn't until this week, sitting down and writing this short essay and reaching out to my friends for feedback, that I realized the impact of these feelings. My friend Liz said to me:

"Something that wasn't in the piece was the depth to your emotions when you were first diagnosed. I remember that you literally fell of the face of the earth, you didn't go out as much, you weren't as social, and it was difficult to even have a conversation with you over text messages, even. I feel like you were really scared that you could die. I know those emotions may be a little heavy in the short piece that you wrote, but saying that you 'were lucky' could give some teenagers who think they are invincible the impression that it's super easy to be cured of skin cancer and to move on with your life."

Liz's comment immediately made me rethink my strategy. Yes, of course I was lucky that I caught my cancer early. That doesn't mean that melanoma doesn't SUCK. Having a doctor tell me that I had melanoma shook me to my core. I never thought that tanning in my teens could have killed me in my 20s. But it can, and it does. Melanoma has become the most frequently diagnosed cancer for young adults aged 25 to 29, second only to breast cancer for women aged 15 to 29. Tanning bed use can increase a person's risk for developing melanoma by 75%, and yet indoor tanning is still a $5 billion per year industry, up from $1 billion in 1992.


Just for the record, when I talk about my melanoma, I'm not looking for a pity party. A prevention party maybe (ha!) but definitely not a pity party. Since I started doing some research and sharing my experiences with anyone who will listen, I've discovered a wonderful network of people whose lives have also been impacted by skin cancer. I've also had my fair share of run-ins with people who listen to my story and still choose to tan. Giving up UV tanning and living the "pretty in pale" lifestyle is easier said than done. Trust me. I get it. But if my story resonates with just one person and they change their behavior because of me, then somehow it seems like all this guilt will have been worth it.

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.