You've heard of people treated for lung cancer who continue to smoke, right? It turns out this baffling phenomenon happens among those dealing with other types of cancer too: A new study shows that some people treated for melanoma—the most serious type of skin cancer—do not use sunscreen to reduce their risk of recurrence. Even more shocking, some melanoma survivors in the study used tanning beds.
The research raises head-scratching questions about why some people not only don't heed medical advice, but take huge risks with their health. "We know there are some great protections to reduce the risk of skin cancer recurrence," says the lead author of the study, Dr. Aness Chagpar, an associate professor of surgery at Yale University School of Medicine. Those include using sunscreen religiously, staying out of the sun during peak hours of sunlight, and avoiding other sources of damaging ultraviolet (UV) light, like tanning beds.
"We thought melanoma survivors would do much better than the general population in terms of taking care of their skin. In general, we found that to be the case. But some of the numbers we found were still shocking," says Chagpar. She and her colleagues looked at data from a survey of more than 27,000 people, part of the National Health Interview Survey. Of those surveyed, 171 people had a history of melanoma. Melanoma is a dangerous form of skin cancer that typically starts from a mole. Exposure to UV light is a known risk factor for the disease. If caught early, the cure rate for melanoma is very high; but if the disease is diagnosed at an advanced stage, the five-year survival rate drops to less than 50 percent.
Melanoma is the most common form of cancer for adults ages 25 to 29, and the second-most common cancer in people ages 15 to 29. What’s even scarier is that the rate of melanoma in people under 30 is increasing faster than any other demographic group—up 50 percent in young women since 1980, according to the Melanoma Research Foundation. People who have been diagnosed with this type of skin cancer have a nine-fold higher risk of having a recurrence of the disease. So taking precautions after a diagnosis is especially important for survivors of the disease.
Overall, people with melanoma were more likely than people who had never had the disease to take action to protect their skin. But the survey still showed that 27 percent of the melanoma survivors said they never wore sunscreen when outdoors on a sunny day, and just over 15 percent said they rarely or never stayed in the shade. Most unbelievable were the two percent of survivors who said they still used tanning beds. "That was really shocking to me," Chagpar says of these numbers. "Using a tanning bed is a practice we know increases the risk of skin cancer. So why would a melanoma survivor do this? I was flabbergasted."
Even when the researchers controlled for other factors that may influence behavior, such as age, insurance status, and race and ethnicity, melanoma survivors "were no less likely to use tanning beds than the general population. That was absolutely amazing," she says. But it's hard to explain why. It could be that some people don't understand they need to take precautions to protect their skin. "Could physicians do a much better job of educating patients to make sure they know how high the risk is of a second melanoma?" asks Chagpar. It's also possible they believe they've beaten the disease for good. "Some people may think, I got through melanoma. This couldn't possibly happen to me again, right?" she surmises.
It's also likely that tanning is a hard habit for some people to break. Previous research has suggested that people can become "addicted" to tanning (think of last year’s so-called "Tan Mom," Patricia Krencil, who was accused of taking her young daughter with her to a tanning salon in New Jersey).
Cancer survivors, she notes, have much to live for. "We have great, targeted therapies," says Chagpar. "People are living longer and doing better with all kinds of cancers. It would be truly tragic for melanoma survivors to say 'I had this; it will happen again. What can I do? Give up.' "
Doctors should make the effort to ensure survivors know they can fight the disease and should give their patients specific instructions about lowering their risk of recurrence, she says. But, she adds, "Part of the solution is for patients to really embrace the idea that they can beat cancer, but they have to be proactive about their own health."
Do you worry about melanoma and other types of skin cancer? What precautions do you take to protect yourself?
Related Stories on TakePart:
Shari Roan is an award-winning health writer based in Southern California. She is the author of three books on health and science subjects.