Courtesy of Colleen Kohl

In April 2005, while working out at her college gym in Rhode Island, 22-year-old Glenna Kohl detected a hard, golf ball-size lump near her groin. She left the gym and went home to put ice on what seemed like a sports injury.

When her roommate, Courtney Caulfield, now 25, returned to their apartment that evening, Glenna asked her to feel the lump. "I told Glenna she probably pulled a muscle," recalls Courtney. "She wasn't overly worried; she seemed more upset about cutting short her workout."

But the lump hadn't gone away by the time she graduated from Salve Regina University the next month. So Glenna, then living at her parents' home in Massachusetts, visited her family doctor. Puzzled, she referred Glenna to a surgeon, who scheduled a biopsy.

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A few days later, the surgeon handed Glenna and her family a terrifying diagnosis: The lump was melanoma, the deadliest of the three forms of skin cancer. When caught at an earlier stage, melanoma — which typically begins as an irregular-shaped mole or a bump on the skin — is highly curable. But by the time it reaches stage III, as Glenna's had, the cancer has spread beyond the skin and into the lymph nodes (that's why the lump she felt was in her groin, where there's a cluster of lymph nodes). Only about half the people with her level of stage III melanoma survive for 10 years.

The news came as a total shock. "No one in our family knew what melanoma was," recalls Glenna's mother, Colleen Kohl. "We did a lot of crying."

Mystified about how the cancer had reached stage III without Glenna spotting any suspicious moles on her body, the surgeon eventually pored over her medical records. He found something disturbing: In high school, Glenna did have an irregular mole removed from her leg. A pathology report identified it as benign, but the surgeon tested it again. The lab had made an error: The mole was an early stage melanoma.

"We can't know for sure, but her odds of beating melanoma would have been greater had it been diagnosed earlier," says Donald Lawrence, Glenna's oncologist and clinical director of the Center for Melanoma at Massachusetts General Hospital (MGH) Cancer Center, in Boston.

The misdiagnosis infuriated Glenna's parents. But she didn't share their anger, says her mother. Even when the Kohls' lawyer confirmed they had a case of medical negligence, Glenna — positive thinking and not one to dwell on the what-ifs — agreed to let the lab settle out of court. "She wasn't resentful; she focused on getting better," says her father, Bob. "Back when we all first got the news, it wasn't a matter of if but how soon she'd be cancer-free."

A Deadly Habit
It's hard to imagine a less likely cancer victim than Glenna. Growing up on Cape Cod, she'd always been a stickler for health. A vegetarian, she did yoga, hiked, jogged, and rowed regularly. She was just 5-foot-3 and 105 pounds, yet she was strong enough to work as a beach lifeguard five summers in a row. Health interested her so much that she applied for jobs in nutrition before graduating from college, despite having majored in finance.

But Glenna did indulge in one unhealthy practice: tanning. Like millions of young women, she believed that a bronzed look made her more attractive. While life-guarding, she exposed her naturally pale skin to the sun's rays for 40 hours each week, protected only by sunscreen with an SPF of 4, says her friend and fellow lifeguard Jillian Blumberg. (Dermatologists say that sunscreen with an SPF of 15 is the minimum needed to safeguard skin.)

To maintain that copper glow, Glenna booked time at tanning salons. She began at age 16 and continued through college, baking under a sunlamp as often as once a week.

Though she knew that all that outdoor sun and indoor-tanning time were bad for her skin, she didn't think there was a serious risk. "As health-conscious as Glenna was, she didn't connect tanning with skin cancer," says Colleen.

Yet tanning is connected to skin cancer. Studies have shown that exposure to UV rays can trigger changes to the DNA in skin cells that may lead to cancerous growths. The two most common types of skin cancer, basal cell carcinoma and squamous cell carcinoma, are almost always linked to UV exposure. And 90 percent of cases of the less common but more deadly form, melanoma, also are attributed to UV exposure, says Darrell S. Rigel, MD, a professor of clinical dermatology at New York University.

Sun exposure sans sunscreen is a big culprit. But indoor-tanning beds also can result in cancer. A major report released this past August reclassified tanning beds as "carcinogenic to humans." And a person's melanoma risk rises 75 percent if he or she started using a tanning bed before age 30.

Glenna's diagnosis was, sadly, part of a trend: Melanoma is the second most frequently reported cancer in women in their 20s, and it's third only to breast and thyroid cancers for women in their 30s, reports the National Cancer Institute. "Melanoma is one of the few forms of cancer that's on the rise," says Dr. Rigel. The tan look so desired by young women may explain why 20- and 30-somethings are diagnosed with the disease at alarming rates, he adds.

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