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Jessica Lilley, M.D

Jessica Lilley, M.D

Some stories are so powerful they need to be retold.  This blog was written by Dr. Jessica Sparks Lilley, a pediatrician who learned the hard way that the risks of getting melanoma from using a tanning bed are real! Please do not use tanning beds.  Please do not allow your children to use tanning beds.  Help pass legislation to ban the use of tanning beds by minors.

“As a pediatrician, I have dedicated much of my life to improving the health of children—thirteen years of formal training after high school, to be exact.  I’ve worked thirty hour shifts every other day, delayed my dream of having children of my own, and moved across the country for the best learning opportunities.  Amid this 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 “ABCDs” of skin cancer—asymmetry, borders, color, diameter—and my mole was only a little larger than a pencil eraser with more heterogeneity than I remembered (meaning that it was a mix of brown and black rather than just all brown).  When I finally made an appointment with my internist (again, post-call—can’t be choosy when you work eighty hours a week), he brushed my concerns aside and refused to even look at it, instead writing out a referral to dermatology.  Six months later, the opportunity to see a dermatologist finally arose, and I found myself standing in the specialist’s office that February morning to find that the referral had never made it.  My medical training had kicked in and caused a bad feeling in my gut about the mole, so I called my internist’s office from the waiting room and even cried on the phone to get them to help me.  After much wailing and gnashing of teeth, the referral was processed and the physician’s assistant worked me into her schedule—the suspicious mole was off to pathology within fifteen minutes, and I received the call two days later that I was right to be worried—that mole represented an early-stage melanoma.

I was in my parents’ living room when I got the call.  I had traveled from Philadelphia to Mississippi for vacation.  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 (praise God!) 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 fifteen years old and trying to get a little “color” to look good in a dress I found to wear in a beauty pageant.  I bought eight visits, heard nothing of the risks (which were largely unknown at the time), never burned, and actually thought it was fun to have the fifteen minutes of quiet rest.  I had to beg my parents to let me go, and the owner of the tanning salon was quick to tell my mother that indoor tanning was much safer than tanning outside.  The strongest argument against the behavior in high school I heard was a bad urban legend about a girl who “fried her ovaries” by tanning.  You’d think that I would have been hesitant to step inside a device that looked like a coffin, had a dial like an oven, and was cleaned with only a dilute cleaning solution by other tanners.  Alas, I went about ten times a year after that for various reasons—prom, pageants, and even my wedding—despite being able to draw a picture of the pyrimadine dimers I was forming in my DNA as a result of UV radiation!  Strangely, I wore sunscreen and rarely went outside, especially as my training intensified.  The first time I thought seriously about never going back was after my first pathology lecture dealing with melanoma and the strong emphasis on UV radiation as a cause of skin cancer; I considered it again when a friend was caring for a patient with metastatic melanoma during our third year of medical school and lovingly warned me that I was putting my health in danger; but because I started tanning at a young age, the behavior seemed safe to me.  I rationalized tanning in every way imaginable.  After I graduated medical school, I vowed to never return lest I set a bad example as a physician.  My last tanning visit was April 24, 2007, about a week before my wedding…and two years before the cancer diagnosis that changed my life.

I am continuing 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.  We also understand now that any indoor tanning before the age of 35 increases the risk of melanoma, the deadliest form of skin cancer, by 75%!  I am appalled that I have friends who continue to go, reasoning that tanning “isn’t that bad” and is their “only vice” and “something they do for themselves.”  I’m infuriated that some idiot doctors perpetuate the myth that sun exposure is healthy and the lie that tanning beds are a good source of vitamin D.  That’s absolute hogwash.  I’m a fellow in pediatric endocrinology and know that 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.  Late-stage melanoma is almost always fatal.  Treatments like interferon have horrible side effects and don’t save everyone.  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 my demographic (25-29 year old women) is astounding, and it is unfortunately on the rise in association with more young women with a history of indoor tanning.  It’s humiliating to recount my story—I should have known better—but I hope to teach everyone who will listen three important take-home points:

1. Never, ever, ever, ever, ever, ever indoor (or outdoor) tan!  A tan is evidence of skin damage and potential DNA mutation that can lead to cancer.  There is no such thing as a safe tan!

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 someone who will.

3. Finally, take time to take care of your health.  We have all made an idol/status symbol out of “busyness” to the detriment of our well-being.  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 keep telling my story to anyone who will listen to defeat this often preventable cancer.”

Jessica Sparks Lilley, MD

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