Sometimes, when she drives past a tanning salon, Carson Smith is tempted to stop.
She doesn’t, though. She keeps moving forward and doesn’t look back.
Studies show UV light can be addictive to people who tan often. The light increases the release of opioid-like endorphins, chemicals that relieve pain and produce feelings of wellbeing, according to a 2006 study published in the Journal of the American Academy of Dermatology.
Smith, junior in history, readily admits she was a frequent tanner — she said she used the beds nearly every day for three years.
On days she didn’t go to the salon, Smith was in the sun.
Smith is from Mobile, a scenic city near Alabama’s coast. Like many other Alabamians, her childhood was spent on the beach.
“In Mobile, our four seasons are summer, more summer, blazing hot summer, then fall,” Smith said.
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She feels at-ease in a bathing suit and sunglasses, with salt in her hair and sand between her toes.
To her, the sun was comfortable. It was home.
Of course, Smith knew about skin cancer. She was always told it was easily treatable, something only people much older than her needed to worry about.
“I used to say, ‘If I die, at least I’ll die tan,’” Smith said.
In October of last year, Smith noticed a mole on the back of her leg. It was growing darker, but she didn’t worry too much — she has Irish blood and is no stranger to freckles. Cancer just wasn’t on her radar at 19 years old.
One day, during her sophomore year at Auburn, Smith noticed a “get checked for skin cancer today” sign at her doctor’s office.
On a whim, she asked her doctor to take a look at the unusual mole.
The doctor’s face told Smith everything she needed to know.
“The light drained from her eyes as soon as she saw it,” Smith said. “In that moment, I could tell she just knew.”
Still, Smith couldn’t believe it was cancer.She went to the tanning bed the next Monday.
On Tuesday, she got the call. Melanoma.
By Wednesday, she was on the way to Mobile’s Mitchell Cancer Center to prepare for emergency surgery.
Doctors use several factors to determine the severity of a melanoma. One of those factors is depth.
Smith’s cancer was 4 millimeters beneath her skin. A few more millimeters, and the melanoma would’ve become deadly.
“If I had waited another 6 months, it could’ve very well spread to all of my organs,” Smith said.
During the procedure, the surgeon found another melanoma on her stomach.
She woke up with two new scars – two reminders etched into her skin forever.
Smith spent the year after her diagnosis telling her skin cancer story to one of the most at-risk groups: white teenage girls and college-aged women.
A recent study surveyed more than 600 women who were enrolled at an American university.
The study, published by Kemig Yang in the Journal of Dermatological Science, showed that women know they are placing themselves at risk of skin cancer and premature skin aging, but most continue to tan indoors anyway.
While 99.4 percent of the women surveyed agreed that tanning can cause skin problems such as skin cancer and premature aging, 69.1 percent said they still like to tan.
Almost 84 percent of the women said they believe a tan makes them “more attractive.”
Melanoma accounts for less than one percent of skin cancer cases, but the vast majority of skin cancer deaths, according to the Skin Cancer Foundation, and individuals who have used tanning beds 10 or more times in their lives have a 34 percent increased risk of developing melanoma compared to those who have never used tanning beds.
A 2006 study by the International Agency for Research on Cancer Working Group showed that people who first use a tanning bed before age 35 increase their risk for melanoma by a staggering 75 percent.
UV tanning devices were reclassified by the FDA from Class I (low risk), to Class II (moderate risk) devices in 2014, but the tanning industry is still a contentious issue in the U.S. – especially now that President Trump is promising to repeal the Affordable Care Act. A full repeal would eliminate the 10 percent tax that was part of former President Obama’s original health care reform bill.
“Millions of people [tan] every day and the vast, vast majority do not get melanoma,” said John Overstreet, executive director of the Indoor Tanning Association, which represents companies covering all aspects of the tanning business, including salons, lotion makers and bed manufacturers.
“Anytime a young person gets any type of sickness, it’s very sad,” Overstreet said to The Plainsman. “I certainly understand why this young woman [Smith] is angry and upset. But melanoma is a very complicated disease and there are lots and lots of risk factors. Sun burning is one of those factors. There is no research that shows a relationship between non-burning exposure and melanoma. The biggest risk factor is heredity.”
Overstreet believes there are benefits to indoor tanning, including vitamin D production.
“There are volumes of research on the role vitamin D plays in overall good health,” Overstreet said. “Just Google vitamin D and health, and see for yourself.”
A little more than one year after Smith’s original diagnosis, her doctor called. The cancer was back.
She endured another surgery a few days before Christmas.
Smith has gone under the knife 20 times since the first irregular mole appeared on the back of her leg, and she anticipates future surgeries – recurrences are common in melanoma survivors.
She visits her oncologist — ironically named Dr. Tan — regularly to catch new moles as soon as they appear.
“This is something I’ll deal with for the rest of my life,” Smith said.
Smith said she’s disheartened that, even after witnessing her battles with skin cancer, many of her friends still tan indoors and in the sun.
She won’t stop fighting, though, and is determined to use her experience to teach others.
“We shouldn't be afraid of the sun, but we have to learn the proper precautions to protect ourselves,” Smith said. “If I would have taken precautions or been educated I might not be in this situation I am now.”
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