July 21, 2011
As a pediatrician, I have dedicated much of my life to improve the health of children. Amid my grueling schedule, during my second year of residency I noticed in a bleary-eyed post-call shower that a mole on my chest had changed a little. I recounted the ABCD’s of skin cancer: my mole was only a little larger than a pencil eraser with more heterogeneity than I remembered. When I made an appointment with my internist, he brushed my concerns aside and refused to even look at it. Six months later, the opportunity to see a dermatologist finally arose, but my internist’s referral had never arrived. I had a bad feeling in my gut about the mole, so I called my internist and even cried to get them to help me. The physician’s assistant finally worked me into her schedule. The suspicious mole was off to pathology within minutes, and I received the call two days later that I was right to be worried—the mole represented an early-stage melanoma.
I will never forget the way my mother cried when she overheard me asking questions about whether sentinel node mapping would need to be part of the diagnostic work-up. I only required a wider excision, which was done that very week and showed no signs of metastasis. As I sat in doctors’ waiting rooms and even as I was walking back to the operating room, I mulled over the same regrets—why did I ever step foot into a tanning salon?
The first time I went to a tanning bed, I was 15 years old and trying to get a little “color.” I heard nothing of the risks, never burned, and actually thought it was fun to have the 15 minutes of quiet rest. I had to beg my parents to let me go tanning, and the owner of the salon was quick to tell my mother that indoor tanning was much safer than tanning outside. You’d think that I would have been hesitant to step inside a device that looked like a coffin and had a dial like an oven! Alas, I went tanning about 10 times a year after that for various reasons—prom, pageants, my wedding—despite being able to draw a picture of the pyrimidine dimers I was forming in my DNA as a result of UV radiation. Because I started tanning at a young age, the behavior seemed safe to me. After I graduated medical school, I vowed to never return lest I set a bad example as a physician.
I continue to devote my life to the health of children now as an advocate to ban tanning in minors, just as we regulate other known carcinogens like tobacco. We know that younger DNA is more vulnerable to dangerous mutations and that teens don’t yet have the cognitive skills to judge long-term ramifications of their actions. I am appalled that I have friends who continue to go tanning, reasoning that tanning is their “only vice” and “something they do for themselves.” I’m infuriated that some doctors perpetuate the myth that sun exposure is healthy and the lie that tanning beds are a good source of vitamin D. Much better sources of vitamin D are available without the side effect of deadly cancer!
I shudder to think of what would have happened to me if I hadn’t detected my melanoma early. I no longer feel safe in my own skin and feel that the quality of my life has been impacted by the fear that my cancer will recur. The fact that melanoma is the most common form of cancer death in 25-29 year old women is astounding, and it is unfortunately on the rise in young women with a history of indoor tanning. It’s humiliating to recount my story—I should have known better—but everyone who reads this learns three important take-home points:
1. There is no such thing as a safe tan! A tan is evidence of skin damage and potential DNA mutation that can lead to cancer.
2. If you are worried about something with your health, there may be a reason. Talk to your physician, and if he or she doesn’t listen, find one who will.
3. Take time to take care of your health. If you don’t take care of yourself, no one else will.
As part of my crusade, at least one later-stage melanoma has been diagnosed and countless friends and acquaintances have stopped tanning. I will continue to tell my story to defeat this preventable cancer.
Editor’s Note: Guest Blogger Jessica Sparks Lilley, M.D. is a Clinical Fellow specializing in pediatric endocrinology and a skin cancer prevention advocate.