Today on MadisonOnline

Surviving skin cancer: a patient's story

Anna Tremblay ('02) sees link between her use of tanning beds and disease

By Katrina Putker ('08)

Something was not right

In the months before starting her senior year at JMU, Anna Tremblay ('02) noticed a mole on her lower hip. It had, in fact, been there for some time, but she was sure that its shape and color had altered during the summer break, and she wanted to have it examined by a professional.

To this day Tremblay doesn't remember when or where the lesson had been learned, but she knew that the changes that she saw on her skin warranted a level of concern. "I remember the skin cancer lesson from high-school health class -- where they show you those terrifying pictures of people who have had skin cancer for years and years and didn't realize," she says.

On her first trip to a dermatologist, Tremblay didn't know what to expect. But she suspected something was not right with that mole.

According to her doctor, it was a matter of "imagination." Tremblay was told that she was just having trouble dealing with the aging process and the subsequent moles. She left the dermatologist's office feeling frustrated and embarrassed. "I felt like I wasn't listened to," she explains. The doctor had treated her dismissively and made her believe she had been foolish in her doubt.

Anna Tremblay and her boyfriend, Ryan, prepare to ring in the new year on Dec. 31, 2006.

Anna Tremblay and her boyfriend, Ryan, prepare to ring in the new year on Dec. 31, 2006.

A second opinion, and a diagnosis

Tremblay wanted a second opinion.

When she returned to Harrisonburg for the beginning of fall semester 2001, she booked an appointment to see local dermatologist Christopher Sheap. He took one look at the questionable mole and told her it had to be removed immediately.

Although scared to go ahead with the biopsy, Tremblay trusted Dr. Sheap. He gave her a "painful local anesthesia that felt like millions of little bee stings on her hip." Then, she says, "He took a chunk of skin."

Tremblay didn't understand how the skin cancer grew in such a strange place; an area of her body not generally exposed to the sun. Sheap asked her to tell him about her time at JMU.

As soon as she began to detail her regular use of tanning beds -- since high school and throughout college -- Tremblay knew how ridiculous it sounded. She had been tanning generally three times a week for years. And she had been using the beds unclothed, fully exposed to their harmful UVA rays.

A tanning "addiction"

"For me, the misuse of tanning beds was almost like an addiction. ... It was a social thing that we would do," Tremblay says. "Go to the mall, check; grocery store, check; tanning, check."

Two days after her appointment, Tremblay received a phone call from Dr. Sheap who said that he had some bad news. The mole was in fact an advanced melanoma. She had skin cancer.

"That wasn't a part of my plan," she says.

Tremblay was on her way home to upstate New York when she found out about the cancer. Dr. Sheap called her two and a half hours into her drive home -- just after she had crossed the Pennsylvania border. She pulled off at a rest stop ready to receive the bad news.

Immediate surgery required

He said that she needed surgery right away. She returned to Harrisonburg for the operation the following day. Tremblay was shocked at the news and scared to think of what may lay ahead. "You just don't hear good things about young people with cancer," she says.

Tremblay sat alone in her car for a moment before calling her parents, primarily, she says, to arrange the logistics of getting someone down to Harrisonburg right away. She knew she could not go through this on her own.

From that point on, she stayed on the phone with family and friends. She wanted to let them know what was going on, and she needed to make arrangements for mid-terms.

"I remember getting through it," she says, "because I was talking about it almost as the business of cancer as opposed to the emotion of it."

Tremblay's mother arrived in Harrisonburg just shortly before the surgery at Rockingham Memorial Hospital was scheduled to begin. Suddenly, all of the emotion Tremblay had been suppressing up to that point was released as mother and daughter lost themselves in each other's arms and cried. "When you see that familiar face, it's enough to tip you over the edge," Tremblay says.

With only a local anesthesia, Tremblay remained awake throughout the surgery. The doctor took a large section of skin from the site of the melanoma. Due to its concentration of lymph nodes, the area around her hip was extremely vulnerable, and the cancer may have attached and spread to other parts of her body.

Two other suspicious sections on Tremblay's waist were also removed; one of which, she was later told, would have become a melanoma had it not been removed that day.

"Basically my whole midsection was just completely cut up. It was horrible," Tremblay remembers.

Throughout surgery, Tremblay spoke to the doctor and nurses to keep herself sane and asked if she could see the cancer that had been removed. She wanted to know that the cancerous melanoma growing on her body was gone.

Time for new habits

She returned to Dr. Sheap's office for a follow-up one week later. Everything had happened so quickly. The surgery was over with and the cancer had been removed, but she needed a chance to understand what it all meant.

Tremblay knew she needed to make some lifestyle changes. Sunscreen would have to be worn every day, large Jackie-O-inspired sunglasses were now required, and Dr. Sheap told her, "a one-piece bathing suit was absolutely critical."

Tremblay and her friends were planning a trip to South Beach that summer and the idea of wearing a one-piece really wasn't what she preferred. But she knew a bikini wasn't really an option.

Tremblay's vacation girlfriends, the same friends who were with throughout her ordeal, continued to visit tanning salons prior to the trip.

"I guess it's like what must happen to people when they have lung cancer, and then people around them continue to smoke," Tremblay says. "It's their prerogative, and it's their own thing." In Tremblay's opinion, however, their actions showed a serious disconnect.

Tremblay is now 26 and has survived the diagnosis of a third cancerous melanoma at the base of her back -- a year after her original diagnosis. She cites her prolific use of tanning beds for accelerating the development of the abnormal cells that caused this cancer.

Thorough checkups become a fact of life

"I'm probably not the typical face that you would think of as someone who would be a skin cancer survivor," Tremblay says. "I know people want to go to tanning beds, of course. I get that. I really get that ... but the fact is that it can cause sunburn, wrinkles and skin cancer. ... I just don't think people think that it could affect them."

Tremblay will have to see a dermatologist every six months for the rest of her life. She must be thoroughly checked for signs of potential or developing melanoma, even having her hair blow-dried in the doctor's office, so her scalp can be examined.

Her entire body is thoroughly checked in between her fingers and toes; under her arms; all over her back, legs, arms and breasts; under her nails -- even on the roof of her mouth.

Dr. Sheap also reminds Tremblay that she must check yearly with her gynecologist because people who have had melanoma are more susceptible to malignant tumors throughout the body.

"... It's not just about you, it's about you and your family. And it's about your future children."

Damaged DNA a serious consequence

Her future children may also feel the consequences of her actions.

The UVA light from tanning beds is known to damage DNA and that can lead to the mutation of the abnormal cells responsible for skin cancer. For Tremblay, that means there is a greater risk of her passing on damaged DNA to her children, thus, increasing their chances of getting skin cancer.

Tremblay's future children will have to go with to a dermatologist every six months for a lifetime. "It will just be a part of our family practice," she says. "I did so much damage to my body with the tanning bed that my DNA is damaged and that means my children are more susceptible to melanoma because it's likely that I will pass that on ... it's going to affect them. There are very serious consequences to using tanning beds. It's not just about you, it's about you and your family. And it's about your future children."