Ashley's Journey

For 15 years, Ashley Trenner paid good money to work on her tan. Without knowing it, she was also working on melanoma. The beautiful, fit and well-loved young woman simply thought she looked better tan. A resident of rainy Washington State and naturally fair-skinned, she maintained her year-round bronze by visiting tanning salons almost every other day. She used to say: "I don’t care if I die from tanning as long as I die tan."

Ashley started tanning in high school with her mom, at first just for prom and to develop a "base tan" before vacations. In her early 20’s her habit grew. She had begun working at Nordstrom, where she was a top salesperson, sometimes beyond the call of duty: a customer once wanted a dress that wasn’t available in her size, and since Ashley had that same dress at home, she gave it to the customer. She was a people-pleaser—a great attribute for a salesperson— and her employers rewarded her with a $500 bonus for exceptional customer service. It wasn’t just her work life that was going well. She also had a group of nine girlfriends who were like sisters. "People loved her," says her dad Bob. "She was very outgoing and had great relationships."

INSECURITIES PERSIST

But that didn’t keep Ashley from obsessing about her looks. Like many young women, she struggled with self-esteem, and became increasingly concerned about her appearance. "She was a vegan and watched her diet," says her mom Karen. "She was into looking good and being thin."

Ashley was blessed with a radiant smile that lit up a room, but felt her fair skin was a detriment, so she began tanning habitually; her skin was dark year-round. Living in the dreary climate of the Pacific Northwest and inclined toward depression, she became hooked on the mood-boosting effects from frequent visits to ultraviolet (UV) tanning beds. Studies show that UV light from tanning can increase the level of feel-good chemicals in the brain, leading to dependency, not unlike drug addiction.1

When she was in her late 20’s, her mom pleaded with her to stop tanning because one of her dad’s uncles had died from melanoma, but she couldn’t give it up. "I thought I was invincible and would never get skin cancer," wrote Ashley in a 2011 blog entry.

Then in 2003 while she was living in Arizona away from her parents, her years of tanning caught up to her. First, a tiny lesion the size of a pencil point appeared on her right buttock. She had it removed by a dermatologist, and the pathology report came back negative for cancer.

THE TUMOR RECURS

A year later, after Ashley moved back to Washington State, the lesion returned. This time, figuring it was benign again, Ashley ignored it. She was working as a barista at a coffee shop, and lacking health insurance, she didn’t want to pay out-of-pocket to have it removed again. This proved to be a tragic mistake. People with melanoma diagnosed in the early stages—before the cancer spreads to the lymph nodes or other organs—have a 98% five-year average survival rate, but once the cancer spreads, the chances of long-term survival plummet.

The lesion had grown to the size of a quarter and become painful, and only then did she see a dermatologist. At age 33, in 2006, she was diagnosed with melanoma. "I was scared and a complete wreck," Ashley wrote in a 2011 blog. A biopsy of the lymph nodes in her groin near the tumor showed that the melanoma had reached Stage III; melanoma cells had reached the nodes, and could easily spread through the lymphatic system throughout the body, so all the lymph nodes in that area had to be removed. The average 5-year survival rate for Stage III patients is 63%.2

"She could have come to us earlier," Karen laments. "But she was very independent and too proud to ask for help."

BUYING TIME

Once the tumor and lymph nodes were removed, Ashley began receiving injections of the melanoma drug interferon alpha-2b, meant to delay recurrence for as long as possible. It was a grueling experience. Patients on this drug often have severe flu-like symptoms. "It was brutal, and I was miserable for two months," Ashley wrote in a blog.

The treatment, however, bought her time. For three years she remained cancer-free. But in November of 2009 at Thanksgiving, she noticed a black and blue lump on her right hip. "I think the melanoma is back," she told her mom.

Her intuition was right. The lump tested positive for melanoma. In 2010, she started clinical trials for two experimental drugs to boost her immune system, but neither of them worked. Next, a local television station profiled her as she traveled from her home in Seattle to Portland to take part in a research study with yet another promising immunotherapy for late-stage melanoma patients. It didn’t work either.

"The last treatment involved injections in the tumors in her groin and were very painful," Bob remembers. "She was an incredible trooper through it all."

By January 2011, the cancer had spread to both sides of her groin, her upper back, liver and lungs. She was treated with yet another experimental drug, but again the cancer stubbornly held on.

ASHLEY SPREADS THE WORD

As her condition became increasingly grave, Ashley felt an urgent mission to prevent others from repeating her mistakes. "I didn’t listen when I was warned about the dangers of tanning beds and not using sunscreen," she wrote on a friend’s blog in May 2011.

The cancer continued to spread throughout her body, reaching her brain, and in October, 2012, she had gamma knife surgery, a non-invasive procedure that involves gamma radiation beamed onto tumor sites in the brain. She followed with a round of another immunotherapy, Interleukin-2, which was very hard on her body. "She shouldn’t have done it," says her mom. "She was always vomiting."

That May, Ashley was able to celebrate her 40th birthday surrounded by nearly 100 friends.

In January 2013, doctors removed four inches from her intestines to eliminate a blockage. After discovering tumors in her intestines, the surgeon told her parents the brutal truth. "Your daughter is a very sick girl. She has weeks to live," Karen remembers him saying.

THE FINAL DAYS

King 5, a Washington television station, visited Ashley to make a powerful video about her story. Lying in bed, Ashley had tubes hooked up to her veins pumping in pain medication. Tumors had invaded the right side of her face, leaving it paralyzed. But even then, Ashley continued to maintain her beauty. Everyone knew she loved the color pink, so a manicurist visited to paint her nails bright pink. A make-up artist applied fluttery, long eyelashes. Her face glowing with make-up, Ashley spoke to the camera about her regrets: "I paid money to be in the position I’m in now. I literally paid to get this terrible disease that is killing me." She was wearing a "Hello Kitty" T-shirt in the hope of reaching young girls to convince them never to tan.

After the video aired and went online, the family received a flood of cards from people saying they would never tan. Another letter writer from the East Coast said that after watching Ashley’s story, she cancelled her order for two tanning beds.

In March, after a week in a hospice care facility, Ashley asked to return to her parents’ home, where she could pass away peacefully.

On March 15, 2013 at 5 AM, Ashley passed away after a seven-year battle with melanoma. Her mother and father held her hands, her group of girlfriends and her boyfriend nearby. "They were all crouched together, watching her die; I was amazed that these girls were so in love with her," Karen recalls.

Ashley’s strong Christian faith helped her face death with grace. It also provided comfort for her parents. "We have a wonderful mantra; Ashley is on vacation and I’m going to see her again," says her dad. "She is no longer in pain and suffering. It allows you to accept that death is a part of life. But unfortunately she was taken away too young."

A few weeks before she passed, Ashley revealed her last wish: "If there’s one person’s life I can affect, that’s a beautiful gift I can give to somebody. I don’t want them to end up like me, it’s just not worth it."

By all accounts, she has passed that gift to many, especially throughout the Northwest. Inspired by Ashley, Dr. Brian Druker, Director of the Knight Cancer Institute at the Oregon Health & Science University in Portland, spearheaded a law in Oregon banning those under 18 from indoor tanning without a doctor’s prescription, which passed in April, 2013. Washington State passed a similar law that went into effect in June, 2014. "We’re really proud of both of these accomplishments," says Karen.

Ashley also directly affected the teen children of one of her friends. On the one-year anniversary of her passing, the girls, ages 12-15, brought pledges to their school for classmates to sign, vowing never to tan. Hundreds of students signed the petition.

References:

  1. Harrington CR, Beswick TC, Graves M, et al. Activation of the mesostriatal reward pathway with exposure to ultraviolet radiation (UVR) vs. sham UVR in frequent tanners: a pilot study. Addict Biol 2012 May; 17(3):680-6.
  2. American Cancer Society. Cancer Facts & Figures 2015. http://www.cancer.org/acs/groups/content/@editorial/documents/document/acspc-044552.pdf. Accessed January 9, 2015.