St. Louis- When Kelly Quick started school at the University of Missouri-Columbia, she had more to worry about than the average college freshman. Like all of her peers, she faced the inevitable pressures of making new friends, studying for classes and beginning life in a different place. Unlike most of them, Kelly, a former tanning salon employee, had just been diagnosed with malignant melanoma, the deadliest type of skin cancer.
Her doctor, Scott Fosko, M.D., director of the Multidisciplinary Melanoma Group at Saint Louis University, said Kelly, 19, may be part of a disturbing trend. He said he is seeing more cases of skin cancer in young people than ever before.
"I don't think people realize how common this is," Fosko said. "There does seem to be a big shift in age."
Department records indicate the number of people in their 30s, 20s and younger who have sought treatment at SLU for skin cancer has increased dramatically during the past seven years.
Fosko said this could indicate a larger trend, though there also may be other explanations for the finding. The numbers might be increasing because young skin cancer patients often are referred by their physicians to university hospitals such as SLU, or because the overall number of Americans diagnosed with skin cancer, young and old, is increasing rapidly, he said.
"The overall incidence is going way up," Fosko said. "Five years ago, there was a one-in-100 lifetime chance of developing melanoma. Now it's about one in 50. During the next five years, you're going to see and hear a lot more about it."
That's the bad news.
The good news is many incidents of skin cancer can be prevented. The best prevention methods are staying out of the sun during the middle of the day, wearing sunscreen and covering up with long-sleeve shirts or other protective clothing, Fosko said.
Most skin cancer also is easy to treat if it is detected early enough, he said.
Early detection methods include watching freckles and moles to see if they change size, color or shape-often the first indications of skin cancer. For adults, he recommends a yearly screening by a dermatologist.
Kelly was lucky. When she showed her mother, a primary care physician, a freckle she had developed just above her stomach, her mother knew enough to keep an eye on it.
The family lives in Fenton. Just a few days before Kelly was set to move to Columbia for college, her mother noticed the freckle had changed colors and felt unusually hard. She made sure Kelly had the freckle removed and sent to a laboratory for testing. A couple of weeks later, after she had settled into her dorm room, Kelly received disturbing news: The freckle had tested positive for malignant melanoma.
"I cried," she said. "Part of me was upset because I'm really self-conscious about my skin color, and I knew I couldn't tan anymore. And what if it spread?"
During her junior and senior year at high school, she had worked at a tanning salon.
"Of course I tanned a lot," she said. "And I have really fair skin. I thought tanning beds are great for fair-skinned people, because you don't burn."
Kelly said that when she was a young girl other kids made fun of her because of her complexion, calling her an "albino," or comparing her to the all-white protagonist in the movie "Powder."
She began going to tanning salons her freshman year of high school, usually just to develop a "base tan" before going on a vacation. But when she began working at a salon, she started tanning about three times per week.
After the diagnosis, she immediately turned to Saint Louis University to see if the melanoma had metastasized. Luckily, it hadn't.
"It was a very thin melanoma," meaning all of the cancerous cells were near the surface, Fosko said. "It's a very good prognosis."
Fosko believes the time Kelly spent in tanning beds could have led to her developing the melanoma. He said a common misperception is that tanning beds are safe because they primarily use Ultraviolet A light, and not the more sunburn-inducing Ultraviolet B.
Fosko said studies have shown light from the beds does cause cancer, though it is more likely to cause basal cell carcinoma, the most common kind of skin cancer, than malignant melanoma. Basal cell carcinoma, though still dangerous, generally grows more slowly and predictably than malignant melanoma.
It also is a misperception that only fair-skinned people contract skin cancer, Fosko said. While fair skinned people are at increased risk, even dark-complected people can develop the disease.
Since the diagnosis, Kelly has taken Fosko's recommendations, keeping out of the sun during the middle of the day, wearing sunscreen, and staying out of the tanning beds. She said while she enjoyed working at the tanning salon, she wishes now the salon's owner would have given her and other patrons better warning about the risks involved.
"I think they should definitely have something very legible, in plain terms, saying that you may develop skin cancer from prolonged use of tanning beds. I've never seen a sign like that in any tanning salon," she said.
Still, she doesn't know if such a warning would kept her out of the tanning beds when she was younger.
"I don't know if it would have stopped me," Kelly said. "A lot of people smoke, even though it says on the pack you may develop lung cancer."
