Sometimes, when people ask about my scar, I jokingly tell them I got shot. In reality, the plastic surgeon who helped perform my surgery had used a new stitching technique, so instead of the standard long, horizontal gash, I was left with a smaller, minnow-shaped blemish a couple of inches above my right breast that could well have been made by a stray bullet instead of cancer – malignant melanoma, to be specific.
When I explain to whoever has asked that the scar is actually from malignant melanoma and not a firearm, they still react with shock. "What? But you're so young for that! And you're never in the sun!"
I, too, used to think that melanoma was something that only happened to fifty-something sun addicts and tanning bed fiends, not someone a few years out of college who had never even seen the inside of a tanning salon. So when I first noticed that a mole on my chest was changing, I didn't really pay attention to it.
I didn't know that an increasing number of young women are being diagnosed with skin cancer every year. According to a recent study by Mayo Clinic researchers, the incidence of melanoma increased eightfold among young women between 1970 and 2009. Moreover, the Melanoma Research Foundation (MRF) reports that melanoma is the most common form of cancer for 25-29 year olds, and is the leading cause of cancer death in women between the ages of 25 and 30.
"I've seen more young women developing melanoma in my own clinic," Dr. David Peng, Chair of the Department of Dermatology at the University of Southern California's Keck School of Medicine told Bustle. "There is definitely an increase."
One reason behind these sobering statistics? An ongoing obsession with tanning, both indoor and outdoor. "The biggest attributable rise in the past decade is indoor tanning," Dr. June K. Robinson, Research Professor of Dermatology at Northwestern University's Feinberg School of Medicine, tells Bustle. "But people who indoor tan also outdoor tan, it's just that they couldn't tan all year round before."
Although most young women are drawn to tanning to embody the "healthy" look long-associated with tan skin, cultural beauty standards aren't the only thing driving them to seek ultraviolet light. Tanning is actually physically addictive, releasing feel-good endorphins that promote a sense of well-being, according to the MRF.
My own relationship with the sun was more of a fling than a long-term love affair. I was born on the East Coast, but spent most of my adolescence and young adulthood in California. I had suffered a few intense sunburns as a kid, but no worse than many of my playmates. And although I spent a couple of high school summers basking at the beach or in the backyard in a vain attempt to transform my complexion from a Victorian-era pallor to a surfer-girl bronze, by senior year I had given up and swapped my tanning oil for sunblock. Tanning was time consuming, and plus, anti-tanning campaigns had begun to appeal to my teenage vanity, if not my fear of mortality. I didn’t want to prematurely age my skin.
By the time I was at college in Santa Barbara, SPF 30 was a part of my daily routine. While my classmates spent hours baking by the shore, I hid under an umbrella or a hat. Some of my acquaintances teased me. I thought I was being careful. What I didn’t know was that it was too late and the damage had already been done.
"The delay from the time you have had the ultraviolet light exposure until the development of melanoma is about 10 years," says Dr. Robinson. She adds: "For teens, it's hard for them to grasp the idea that what they do now could have consequences later."
Moreover, the Skin Cancer Foundation reports that just one blistering sunburn in childhood or adolescence more than doubles your chances of developing melanoma later in life. I recall the painful welts on my leg after a long day on Assateague Island one summer, and the cluster of bubbles on my nose following an afternoon swimming in the Gulf of Mexico when I had refused to reapply sunblock. By the time I was 18, I had experienced at least three bad burns.
I had always had the mole, but after college it began to change. It's visible in old pictures: A dark oval to the right of my bikini strap, as if a small beetle had landed there without me having noticed it. In one photo I am lounging on the beach on the island of Santorini and you can clearly see it. I remember that day well. It was sometime in mid-September. I had slathered on the sunblock as usual, and was enjoying the sensation of the late-afternoon rays on my skin, completely obvious to the spot on my chest. I was diagnosed with Stage I Level II melanoma seven months after that picture was taken.
At first, I didn't believe it. "But I haven't tanned since I was 16, and I wear sunblock every day," I kept telling my dermatologist, as if those facts could somehow commute what I thought to be a death sentence. What I didn't know was that up until recently, many sunscreens were only designed to block UVB light — the kind that causes burns. According to Dr. Peng, UVA light (the kind that makes us tan) can also cause cancer, and that up until 2014, the SPF number on a bottle of sunblock only indicated protection from UVB rays. "Historically, all previous SPF ratings only applied to UVB, and offered zero protection against UVA," says Dr. Peng. "There was no regulation for the marketing and branding of sunscreens."
However, even broad spectrum sunscreen, the kind that blocks both types of rays, may not be sufficient protection against skin cancer. A recent study conducted by the University of Manchester suggests that a more effective way to prevent melanoma is the use of sunblock combined with other methods of protection: avoiding the sun between certain hours and wearing protective clothing. More troubling still is the recent news that UV damage can continue for hours after sun exposure.
The doctor who diagnosed me also told me that although my fair skin and light eyes were classic melanoma risk factors, he was seeing more cases among patients with darker complexions. Other physicians also agree that dark skin shouldn't be an excuse to skip the sunblock. "What we are finding is that melanoma is increasing in all skin types," says Dr. Peng. "There is no racial or ethnic background that is free of risk."
Treatment was aggressive and swift. There was a surgery to remove a sizable swath of skin, a bit of weight loss and a lot of sleep. A few months later I was given the all-clear. I looked forward to moving on and putting the experience behind me. But cancer has a way of marking you emotionally as well as physically. The slightest change in an existing mole can result in a panic-stricken visit to a dermatologist's office. Knowing that as a survivor my risk of new melanomas has all but quadrupled means I don't even come near the beach until late in the afternoon. I hope my newfound vigilance is able to prevent a reoccurrence, but if I've learned one thing it's that you can never be too careful.
Nearly 10,000 Americans will die from melanoma this year. When I look at my scar, I am reminded that I was lucky. I may not have literally taken a bullet, but I did dodge one. I hope you never have to.
Images: Getty Images, Erin Zaleski, Marco Mazzone/Flickr