TORONTO - The spot was very dark, almost black, barely the size of a pencil eraser, and would bleed when Jackie Connors shaved her legs.
She initially chose to ignore it. But at age 20 while in nursing school and learning about the signs and symptoms of skin cancer, it soon would become a cause for concern.
"I still remember sitting at my desk thinking, `Wow, this is what I have,' and still trying to put it in the back of my mind of not wanting to think that it could be that," Connors recalled in a telephone interview from St. John's, N.L.
Her family doctor thought she was too young to have skin cancer, but referred her to a surgeon to have the spot removed.
About a week after he'd taken it off, the surgeon called her and confirmed her initial fears -- she had melanoma.
"I was devastated, I was, for a lot of reasons," Connors recalled of her reaction. "(Not) just for the diagnosis of cancer but also knowing I couldn't tan anymore."
"As scary as it sounds, that was one of the things that went through my mind was: `Oh my gosh, I'm not going to be able to tan anymore."'
From around age 16, Connors had frequented tanning salons, paying visits three times a week. She started out first using lie-down tanning beds which took 20 minutes then switched to the stand-up booths which took about half the time.
"I felt better, I thought I looked better with a tan, but just the feeling too, the heat, the warmth, knowing that you were tanning was one of the things I enjoyed, too."
Now 36, Connors is part of a new campaign by the Canadian Dermatology Association which features melanoma survivors encouraging young women to learn the facts about indoor tanning.
The CDA has long advocated against indoor tanning use. But with its "Indoor Tanning is Out" campaign, launched Monday, the organization representing Canada's dermatologists is targeting its message towards young women.
The association says melanoma has become the third most common form of cancer among young Canadian women.
Connors and three other melanoma survivors in their 20s will be among those featured in posters sharing their experiences. TV and radio PSAs will be aired until June, including March Break and pre-prom, when the CDA says many young people seeking tans use indoor tanning equipment.
Dr. Cheryl Rosen, national director of the CDA's Sun Awareness Program, said it seemed most logical to focus on young women in their teens and 20s as they seemed to be among those who most frequently use indoor tanning facilities.
Part of the issue is that for many people, having a tan is correlated to beauty, she said.
"We did focus groups a while ago that showed people felt a tan made them look sexier, made them look more beautiful," Rosen said.
"The tan is certainly valued by many people and our message is be happy with the colour skin you're born with because tanning is a response to the skin of being injured. Tanning is a way our skin protects itself."
Rosen said dermatological groups have been working towards having tanning devices banned for those 18 years of age and under. New Brunswick is currently the only jurisdiction in Canada that prohibits those under 18 from using tanning beds.
Last year, a working group of the WHO's International Agency of Research on Cancer classified ultraviolet-emitting tanning devices as "carcinogenic to humans." Tanning beds and UV radiation were moved into the highest cancer risk category.
Analysis of more than 20 epidemiological studies revealed the risk of skin cancer increased by 75 per cent when the use of tanning devices starts before the age of 30, the working group found.
The group said the findings reinforced current WHO recommendations to avoid sunlamps and tanning parlours as well as to steer clear of sun overexposure.
But the president of Canada's largest indoor tanning company disputes the links made between melanoma and UV exposure.
"As it relates to melanoma and UV light, there is correlative evidence but correlation does not mean causation," Doug McNabb of Fabutan Sun Tan Studios said in a phone interview from Calgary on Monday.
"There are studies that show correlation, just as there would be if you did swimming and drowning, but that does not mean causation."
McNabb said Fabutan's policy requires anyone between 16 and 18 to have parental consent when they purchase their tanning package. Those under age 16 must be accompanied by a parent at any tanning session.
Those who fall under skin type 1 -- redheads with blue eyes -- are asked not to tan. Clients are recommended to tan no more than every 48 hours, with the average session lasting between 16 and 18 minutes.
The WHO has said that in recent years, sunbeds have been manufactured that produce higher levels of UVB radiation that mimic the solar spectrum and speed the tanning process.
McNabb said he believes indoor tanning gives parents the ability to control the amount of their child's exposure.
"If their child wants to tan indoors with a parent's signature, that is a lot more controlled than a parent letting their child go out in the middle of the day at 14 to a lake or a beach or backyard," he said.
Shortly after the removal of the cancerous spot on her leg, Connors had to have a wider section of skin around the lesion removed.
In the years since, she has had treatment for two other melanomas -- one each on her neck and back-- and continues to go for routine followups.
While she has stopped indoor tanning, the spots still continue to surface. She just recently had another mole removed and is awaiting diagnosis.
"They say even one bad sunburn increases your risk of melanoma by a certain number of times and your skin is damaged and those changes take place within a certain period of time," she said. "That's something I've learned to accept and that can happen at any time."
Connors now ensures when she's outside that she protects herself, using self-tanners along with sunscreen.
While her background is in emergency medicine, Connors, a nurse, is now working in dermatology in St. John's with Dr. Ian Landells, who encouraged her to speak publicly about her own experience.
"There's this sense I guess of wanting to help other people, just try and get the message out there that there's other ways to look tan with the self-tanners," she said.
Connors said if she knew then what she knows now, she never would have gone to tanning parlours.
"It's a scary thing to have to go through, and it's something I'll have to go through the rest of my life," she said.
