Melanoma incidence increased by 800% among young women between 1970 and 2009
It’s one of the trickiest sells in the health and beauty world: Ditch the tan in favor of a significantly safer skin tone. Here, we offer an earful of real-deal melanoma statistics—and some common-sense cautions that might just save your life.
BY Ruchel Louis Coetzee PHOTOGRAPH by Jill Greenberg
Hillary Fogelson’s dermatologist appointment began as they always would—with some lighthearted repartee and devil-may-care laughter. Her nurse had just congratulated her on her new marriage, and Fogelson was explaining how excited she was about the potential of becoming pregnant. “This was a couple of months after I had surgery to remove a cancerous growth,” she says, over a cup of tea at the Polo Lounge in Beverly Hills. “The nurse asked if I had spoken to the doctor about planning to become pregnant and I asked, ‘Why would I talk to him about this?’”
The rule of thumb at her dematologist’s hospital was to be hypercautious about the hormonal changes during pregnancy, which could potentially trigger new cancerous growths. She was shocked by the suggestion that she wait two years before becoming pregnant. “My hospital had seen many women who had a recurrence of melanoma that ended in their brain or in their lungs,” she says. “They didn’t want to lose the baby so they never sought advice. They ended up having the baby and then dying. At that moment, it felt like they were telling me I wouldn’t be able to safely have kids. That was devastating.”
Fogelson waited—but not before undertaking mindboggling amounts of Internet research, and talking to anyone who would listen. “I went crazy,” she reflects. “Which could be good and bad. It was not all great information.”
Melanoma screening is far less common than breast exams, pap smears, blood pressure checks, and cholesterol monitoring. Research and prevention are given significantly less attention in the media, and a mention of it at the water cooler is as foreign as a movie in Swahili at your local theater. “Most ofmy patients pay little attention to what’s on their skin,” says Jessica Wu, MD, a celebrated LA dermatologist and assistant professor of Dermatology at USC School of Medicine.
“Many of them feel like skin cancer is less important or less deadly than other things that can happen to them—when in fact melanoma can be very deadly.” According to data from the American Cancer Society, around 76,700 new melanomas will be diagnosed each year, and approximately 9,500 people are expected to die from them. Perhaps even more staggering: Melanoma incidences among young women increased by 800 percent between 1970 and 2009, another study found. Fogelson encountered these statistics during hours of research and decided to act.
After all, she had been diagnosed with melanoma before and defeated it three times. She even wrote a book, Pale Girl Speaks: A Year Uncovered (published by Seal Press), and became an activist for skin protection. “People are so comforted that they are not alone in how much anxiety they feel about getting melanoma again,” she says. “I think there is something particular about melanoma, because it feels like the environment—the outside—is the enemy. You can see it.”
With other cancers, you can’t look inside your body, she points out. What, then, is one of the major culprits behind this dramatic rise in melanoma cases? Global warming? The ozone layer? “Tanning beds,” insists Fogelson. “Tanning beds are pretty much exclusively UVA rays, which also give you melanoma. Some people use them multiple times a week, and a lot of apartment buildings that open up near college campuses have tanning beds in them.”
There are alarming statistics stating that tanning machines are twice as dangerous as the midday Mediterranean sun—perhaps up to six times more dangerous. Dr. Wu says. “Tanning beds will increase your melanoma risk—and the risk is even greater the younger you are,” Wu says. “One session of visiting a tanning bed increases your melanoma risk by twenty percent and if your first session was before you were thirty-five years old, that risk increases to ninety percent.”
Popular teen culture embraces the notion that a tanned body creates a healthier and slimmer look than pale skin. There is even a coined term that besets teenagers: tanorexia, a potentially life-threatening compulsion to tan on a frequent basis. Fogelson would love to see a ban on tanning bedsentirely. As that is not a realistic goal, she is now campaigning for a ban on tanning beds for those 18 years of age and under.
Meanwhile, many tanning bed companies are promoting their tanning beds as a safe way of getting UVA rays, rather than UVB rays. Dr. Wu cautions her patients that although there is a difference in the way UVA and UVB rays penetrate the skin, they still both come with a warning label. “UVB rays are shorter wave lengths and you think of UVB rays as the burning rays,” Wu explains. “UVA rays are longer wave lengths that penetrate deeper into the skin and they are more quickly related to aging—wrinkles and discoloration.
Both are related to skin cancer, but the UVB rays are burning and skin cancer while UVA rays are aging and skin cancer.” Dr. Wu points out that many patients believe they will get vitamin D from a tanning bed, when in fact most tanning beds use UVA-penetrating rays that have nothing to do with vitamin D.
“Not only are you not getting vitamin D because you have no UVB rays, you are getting a higher dose of UV rays than you would in the sun,” she says. She suggests that exposure to your arms and legs in the summer for 10 minutes a day will deliver sufficient vitamin D to your body, and that if you work in an office all day (or live in Finland) you can take a vitamin D supplement.
Fogelson goes even further in her campaign to bring down these alarming statistics. “With melanoma, you are asking people to change their habits—and that is a very tough thing to do,” she admits. “Getting a skin test once a year, and making sure it is a dermatologist with a trained eye, is absolutely key.” If you’re unsure how to check for growths, pay attention to moles with irregular shapes, discoloration, and those that change in size or border.
Any of those warning signs means it is time to seek a professional opinion. “Look where the sun doesn’t shine,” Wu adds. “I tell people, ‘You’ve got to get naked.’ I’ve found melanoma in the pubic area and on someone’s earlobe, so look at places you may not think of looking.”
Fogelson adds that it is never too late to start getting vigilant about this issue, and would like to see mothers begin early awareness with their children—introducing sunscreen creams and protective clothing to their newborns and infants. “My dream is to get to that place where you go to the beach and don’t see anyone uncovered,” she says, in all seriousness. The pale girl has spoken.
