Dr. Mary Finnegan – Omaha World Herald – Tanning Concerns Heat Up

5/13/2010
Published Feb 11, 2010
Omaha World Herald
by Bob Glissman

For 15 years, from about April through September, Vicki Ondracek would head to the tanning salon two or three days a week.

“You want to look better,” Ondracek said.

But that was before she was treated for malignant melanoma, the most serious type of skin cancer, which accounts for about 8,600 deaths each year in the U.S.

The 55-year-old Omahan doesn’t know for sure what caused her cancer – the ultraviolet light from tanning beds, the UV from natural sunlight, a combination of the two.

But she has joined a growing chorus of critics who say the use of tanning beds is too risky.

“I feel like it would be a death sentance for me to get back in a tanning bed,” Ondracek said.

Congress and two federal agencies are shining a hot light on the tanning industry:

Late last month, two U.S. House members introduced a bill called the Tanning Bed Cancer Control Act, which asks that the U.S. Food and Drug Administration consider tougher federal regulations of tanning beds, with the goal of limiting both the amount of UV rays emitted by the devices and the time consumers may be exposed to the rays.

“Tanning beds are the cigarettes of our time: cancer-causing and poorly regulated,” said one of the bill’s co-sponsors, Rep. Carolyn Maloney, D-N.Y.

The same day the legislation was introduced, the Federal Trade Commission charged the Indoor Tanning Association, which represents thousands of tanning centers and tanning-equipment suppliers, with making false health and safety claims about indoor tanning.  In a settlement with the FTC, the association is prohibited from continuing to make the misrepresentaitons (including the idea that indoor tanning is approved by the government), from misrepresenting any tests or studies and from providing deceptive ads to members.

The tanning group’s Web site now includes this statement on its home page: “Exposure to ultraviolet radiation may increase the likelihood of developing skin cancer and can cause serious eye injury.”

In March, FDA advisers will hold a public hearing to consider amending tanning-equipment labeling requirements to strengthen warnings about skin cancer and eye damage and make the warnings easier to read and understand.

Last summer, a working group of the International Agency for Research on Cancer, part of the World Health Organizaiton, published a report classifying UV-emitting tanning devices as carcinogenic to humans.  The group’s analysis of more than 20 studies showed that the risk of melanoma increased by 75 percent when the use of tanning devices starts before age 30.

The American Academy of Dermatology says evidence from several studies has shown that exposure to UV radiation from indoor-tanning devices is associated with an increased risk of melanoma and non-melanoma skin cancer such as squamous cell carcinoma and basal cell carcinoma.

The American Cancer society and the U.S. Centers for Disease Control and Prevention also recommend that people avoid tanning beds.

But indoor tanning remains extremely popular with millions of people.  The Indoor Tanning Association says the nation’s 25,000 indoor-tanning businesses serve 30 million people and have a total economic impact of $5 billion.  The American Academy of Dermatology estimates that about 70 percent of tanning salon patrons are girls and women, primarily those ages 16 to 20.

Tracie Cunningham, executive vice president of Nebraska-based Ashley Lynn’s tanning salons, said moderation in tanning is the kiy: “We tell that to all of our clients.’

The anti-ultraviolet light idea, she said, is “absolutely the wrong message.  It’s irresponsible to tell (people) to avoid it altogether,” noting that skin exposure to UV light induces the production of vitamin D, a necessary nutrient.

She acknowledges, though, that people don’t need to develop a tan to produce vitamin D.

Cunningham said people with Type 1 skin, the fairest skin type, aren’t allowed to use tanning beds at her business and are encouraged to instead use spray-on tans. People with other skin types are given charts offering guidelines on how often they can tan and for how long.  Tanners also are advised wo wear eye protection while tanning, she said, and are warned to never burn.

Dermatologists, in general, don’t like indoor – or outdoor – tanning.

“If you get tan, there is some risk of all forms of skin cancer” said Dr. Chris Huerter, head of the division of dermatology at Creighton University Medical School. “The premise that there is a safe tan is a false one.  If you’re developing a tan, you’re doing damage.  It’s as simple as that.”

People who tan “develop facial lines and other signs of aging at a much faster rate,” said Dr. Mary Finnegan, Ondracek’s dermatologist, who serves as vice president of the Nebraska Dermatology Society.  Tanners, she said, have “more lines and wrinkles, more sunspots.”  Tanning also decreases elasticity, she said, and tanners’ skin sags and droops more than those who don’t tan.

“You can really tell the people who have tanned a lot versus those who haven’t,” Finnegan said. “Just the quality of the skin is different.”

Ondracek said she wouldn’t have been checked for skin cancer had her then-11-year-old daughter, Katie, not had a dark mole on her back.  In June 2005, a couple days before the family left on vacation, Ondracek accompanied her daughter to Finengan’s office.  To put Katie at ease, Finnegan examined Ondracek first.

The doctor told Ondracek that a mole behind her knee had to be removed.

Ondracek said she could come back to the office after the family returned from Minnesota. “‘No, it needs to come off now,'” Finnegan told her.

Ondracek had the mole removed and went on vacation with her family.  With an open wound, she couldn’t go in the water.  After the family returned to Omaha, someone from Finnegan’s office called and asked Ondracek to come in to go over the test results.

“Right then,” she said, “I knew. I just knew.”

Even though Ondracek’s mole was only a little larger than the head of a straight pin, Finnegan had to go back and cut away a 3- to 4-inch section around the mole site to make sure all the cancer was removed. “The size of skin removed is dicted by the depth of the melanoma,” Finnegan said.  “The deeper the malignancy, the wider the diameter of skin taken.”

Ondracek said she feels fortunate her cancer was caught early.  She now must get her skin checked every six months, and she no longer wears shorts: The incision is ugly, ugly, ugly.”

Today, Ondracek gets concerned when she looks at teenage girls and young women who have dark tans in the dead of winter. “I think, ‘Oh, my God, you have no idea what this could be doing to you.'”