Melanoma Awareness From a High Schooler’s Perspective: Where We Are and Where We Need To Be

Not many teenagers know that melanoma is the number one new cancer diagnosed in young adults ages 25-29. It is also difficult to believe that as with many mistakes made at a young age, neglecting sun safety during childhood and adolescence can harm you later in life.

Most of my peers would never dream of lighting a cigarette, yet few would think twice about laying out unprotected at the pool or beach.  Luckily, people are beginning to understand the dangers of indoor tanning, appropriately likening tanning beds to coffins. In previous years, girls would go to tanning beds before school dances. They now settle for a safer (but orange) alternative: spray-tans. Skin cancer awareness has increased, sadly due to the rise in its prevalence, but there is still a ways to go. Most people I know have yet to realize that unprotected sun exposure is just as deadly as a tanning bed.

They're called artificial sun for a reason

They’re called artificial sun for a reason

My paler friends are the most vigilant about sunscreen use. Not one of them wants to get sunburned, so they’re sure to use (and re-apply!) broad-spectrum, high-SPF sunscreen to protect themselves. They do this to escape short-term effects of the sun, but rarely think about the sun’s capability for long-term damage. They are correct in practice, but lack part of the motive for their protective actions. Maybe this is why the occasional girl will still come home from spring break bright red.  They don’t know the danger and how one blistering sunburn in childhood or adolescence doubles their risk for melanoma.

Many of my friends have olive-toned skin, like I do, that tans easily and rarely burns. It is hard for people with this skin type to think twice about going to the beach and getting a dark tan.  Ironically, we are quick to criticize our fair-skinned friends when they get badly sunburned, but the truth is everyone is at risk for melanoma, the most dangerous form of skin cancer.

Tanning is a sign of our body’s response to damage caused by harmful UV rays. Without sunscreen, UV rays from the sun penetrate the skin and damage DNA. Cells called melanocytes can begin to grow uncontrollably because of change in their genetic makeup, and melanoma (skin cancer of melanocytes) develops. Many people do not see skin cancer as a big deal. It is often thought of as a spot that can be removed and forgotten. However, this is not the case with melanoma, which makes up only 4% of skin cancer cases but 80% of skin cancer deaths. Melanoma spreads extremely rapidly and if not caught and treated early on, will spread to the lymph nodes and vital organs. Stage 0 or 1 melanoma has a 90% cure rate, while Stage 4 melanoma patients have a median life expectancy of less than a year. If more people knew these facts, the melanoma death rate could decrease significantly.

What does the future hold for melanoma awareness? Teenagers have already progressed to the point where most of us avoid tanning beds. The next step is to be better at protecting ourselves from the sun, even though it means giving up tanning in favor of sunscreen, healthy skin, and a melanoma-free life. If we can be truly and completely aware of the sun’s hazards, we can motivate ourselves and others to eradicate this aggressive but completely preventable disease.

About the Author

abouttheauthorI’m Isabella Todaro, a rising junior at Georgetown Visitation in Washington, D.C. I have spent this past week as a volunteer at MRA and learned a lot in the process. My cousin has been working here for two years, so I was already interested in the organization before I decided to volunteer. The experience has been great, as I have learned information that otherwise might have remained unfamiliar to me. Like many people, I used to think that getting sunburned, but not getting a tan, puts people at risk for melanoma. Now I know that both of these dangerous behaviors are risky. After learning this and so much more at MRA, I intend to practice sun safety and let others know why they should, too.


Kids Have No Place in Tanning Beds

Tanning Bed Coffin Crop

It has been said that tanning beds are shaped like coffins for a reason.  The ultraviolet (UV) light emitted by tanning beds is a known carcinogenic—the World Health Organization (WHO) recently named both UVA and UVB rays as such, along with cancer-causing agents like cigarettes and asbestos.  But, despite the wealth of health information about the dangers of tanning beds, many Americans continue to invest money and time, and risk their future health, with regular visits to the tanning salon.

We live in a nation where informed, consenting adults have long been free to make choices that could end up being detrimental to their health.  But, that freedom of choice assumes that there is quality information presented about the benefits and risks of different behaviors.  The health claims circulated by purveyors of tanning beds make it difficult for even adults to wade through the deluge of misinformation surrounding the dangers of indoor tanning.  This misinformation is a problem right off the bat for the concept of “informed” adults.  But when we talk about what is happening with children and indoor tanning, there should be even more concern.

A newly-released study from the Journal of the American Medical Association (JAMA) found that nearly 30% of white, non-Hispanic high-school aged girls have used tanning beds over the past year.  The AAD estimates that 2.3 million teens use tanning beds each year in the U.S.  Visiting the tanning salon before big events like prom has become a teenage rite-of-passage, akin to getting a driver’s license.  There are mothers who go tanning with their teenage daughters as a way of family bonding.  Of all the things parents need to worry about when it comes to the health and safety of their kids, too often the dangers of indoor tanning don’t rise to the top of the list.

So what are the facts?  Prolonged exposure to UV light, whether from the sun outdoors or tanning beds indoors, increases a person’s chances of developing all types of skin cancer, including deadly melanoma.  But the concentration and frequency of UV light exposure that indoor tanners face raises their odds of developing these skin cancers, especially if they start indoor tanning at a young age.  One of the most startling facts is that a teenage girl who goes indoor tanning increases her lifetime risk of developing melanoma by 75%.  Did you feel the earth just shutter a little bit?  That was the collective result of millions of teenage girls shrugging.   After all, they have a lifetime to worry about things like “lifetime risk.”  Only they don’t.

Melanoma is increasing at an alarming rate in the U.S.  An estimated 77,000 Americans will be diagnosed with the cancer next year and it will take the lives of 9,500. This disease is also affecting young people with a vengeance: It is now the second most common form of cancer among young people 15-29 years old.  Young people focusing on being tan today are raising their risk of dying from melanoma in the not-so-distant future.

melanona us graph

Fast Stats: An interactive tool for access to SEER cancer statistics. Surveillance Research Program, National Cancer Institute. (Accessed on 8-29-2013)

Researchers have even noted that indoor tanning seems to have an addictive quality, with frequent  indoor tanners reporting improvements in mood and happiness due to tanning sessions.   Teenagers’ brains are still changing as they move to adulthood, and an unfortunate side-effect of this ongoing development is that teens are at high risk for developing addictions.  One study found that 21% of teens aged 14-17 experienced difficulty when they tried to stop indoor tanning.

We should be doing more to prevent children from exposure to the needless dangers and risks of indoor tanning, including skin damage from preventable UV radiation.  It has taken a generation to learn the lessons from cigarettes; will we move more quickly now with the indoor tanning devices?

Kids Crossing Sign

The FDA is currently in the process of reclassifying these devices to place additional restrictions on indoor tanning. While this is an important first step, the FDA should consider instituting further regulations to completely restrict minors from the use of tanning beds.  A nationwide ban on indoor tanning for minors would be the most effective way to achieve this aim.  At least eleven countries and six U.S. states have already passed similar legislation to keep minors safe from the dangers of indoor tanning.

Ideally, we would live in a society where “beautiful skin” was defined as healthy skin, changing our social norms so adults and teens alike would have no desire to fry their skin in pursuit of some sort of ideal.  The phrases “healthy glow,” “base tan,” and “sun kissed” wouldn’t even make it into the lexicon.  Until that day comes, we must take the steps we can to safeguard our children against this known cause of cancer and delay their access to indoor tanning devices until they are responsible and mature enough to understand the lifetime risks associated with entering a tanning bed.

If you have strong feelings about the issue of UV exposure and skin cancer and melanoma, we urge you to take action and comment on the note issued by the Surgeon General’s office looking for information on how to reduce UV exposure and skin cancers in the U.S.  Comments are due by September 4th and are encouraged from individuals, organizations, and industry.

A Teenager’s View: Keeping Sun Fun and Avoiding Melanoma

By Langley Grace Wallace

Over the past 40 years, melanoma has increased 800% in young women and 400% in young men. Recently, melanoma has become the most common cancer among 25-29 year olds, and even teenagers are developing this deadly skin cancer.

As a teenager who spends a lot of time in the sun, these statistics shocked me. I began researching melanoma online, and found that I was a perfect target. If you have pale skin, freckles, blue eyes, and red or blonde hair (all of which apply to me), you are more likely to get melanoma than someone without these physical traits.

The author, practicing sun-safety at age five.

The author, practicing sun-safety at age five. Photo by Julie Langley Campos

I’ve always been encouraged to practice sun-safe habits to lower my risk of sun damage and developing melanoma. My aunt, Dr. Melissa Langley, is a Nashville dermatologist and skin expert. She began educating me and my parents about the sun and skin practically from the moment I was born! From a very young age, I wore sun-protective clothing, hats, and LOTS of sunscreen any time I was outdoors.

In the last year, every patient Dr. Langley diagnosed with melanoma was a woman age 18-24, a disturbing trend as this deadly form of skin cancer becomes increasingly common among young people. “More young adults will be diagnosed with melanoma – as long as they think they are too young to get skin cancer and then wait too long to get their skin checked,” Dr. Langley says.

Teenagers and young adults not only believe that they are too young to develop melanoma; they also think that it is a near-harmless kind of cancer. What they do not understand is that melanoma can actually spread to the lymph nodes and other organs, and can eventually kill you if it is not caught in the early stages. “My patients don’t think about getting cancer, and they especially don’t think about dying from it,” says Dr. Langley.

Many of my friends will spend their summer days lying out in the sun at the beach or by the pool. They know that tanning isn’t good for them, but they don’t understand the damage it does to their skin (and how that damage increases their risk of developing melanoma). Dr. Langley stresses that tanning (outdoor or indoor) is “ignorant.”  The browning of the skin as a result of ultraviolet radiation is the skin’s response to injury: the skin produces more melanin to protect itself. When you tan, you are permanently injuring your skin.

Because it’s so apparent that tanning is extremely harmful to the skin, I asked Dr. Langley how she gets her patients to stop tanning, “I give them the facts: tanning leads to melanoma, which is very aggressive and deadly.” She revealed that her most effective strategy is a comparison of tanning to smoking. “I ask my patients if they would ever smoke two packs of cigarettes a day. I usually get the same response from everyone, ‘No! That is so bad for your lungs.’ I tell them, ‘Tanning has the same effect on your skin as smoking has on your lungs.’ They often realize how damaging tanning is and stop.”Beach and sun

Unfortunately, tanning isn’t the only problem: one blistering sunburn as a child or adolescent doubles your risk for developing melanoma. Teenagers and young adults are especially negligent about sun protection. The Centers for Disease Control and Prevention estimated that only one-third of American youths use effective sun protection and less than half of all teenagers use sunscreen. I have observed that even the ones who are mindful enough to use sunscreen most likely don’t use a high enough SPF, or don’t reapply sunscreen regularly. Ultimately, protecting yourself from the sun is just as important as skipping the tanning appointment.

How can we prevent young adults from developing melanoma? Dr. Langley says, “The best way to prevent melanoma is to educate people about it. I believe that education about the sun’s damaging rays and skin cancer should start from birth.” (Dr. Langley also advises monthly self-skin examinations, in order to check for new or changing moles).

Maybe I’m living proof that this approach works. I took it upon myself to start educating people about the sun and skin. When I’m at the pool with my friends or playing sports outside, I’m always the person that nags everyone about how important it is to apply –and then reapply– sunscreen. I think that it is vital for more teenagers and young adults to get involved in educating their peers about the sun and skin cancer. Teenagers are much more willing to take advice from friends than from a doctor.flipflops

Melanoma prevention is not just about telling your friends to wear sunscreen; it’s about making a larger impact. Teenagers can share their thoughts and strategies through social media (whether it is Facebook, Twitter, Instagram, or a blog) and use these channels to educate people about skin cancer. Because a lot of melanoma prevention is about changing habits, perhaps the change needs to start with young people instead of older people? We are young – which gives us the time to make smart decisions about tanning and activities in the sun before we damage our skin too much. Being young might be what could help us to make a difference in the fight against melanoma!

About the Author

I’m Langley Grace Wallace, 14, a rising freshman at Sidwell Friends School in Washington DC. My interest in skin cancer began a few years ago. I started playing tennis competitively, and spent most of my summer days outside in the hot sun. With a fair complexion, I realized that I had to be extremely careful – or I would get sunburned quickly. That led me to wonder about my risk for developing skin cancer, especially melanoma. This past spring, while researching the new immunotherapy approach to treating melanoma, I came across the Melanoma Research Alliance.  I was immediately intrigued by its efforts to find a cure. As soon as the school year ended, I came to MRA’s office to learn more about the organization and its work.