June Robinson, a Crusader Against Melanoma
June Robinson, MD, was walking down Michigan Avenue in 1981 when a young lady handed her an orange ticket for three free tanning sessions outside of Water Tower Place.
“I remember standing on the corner and thinking, ‘This is the craziest thing I’ve ever heard.’ I didn’t even know about indoor tanning until she gave it to me,” said Robinson.
From that point on, Robinson, research professor of dermatology, has spent more than 20 years advocating for restrictions on indoor tanning. Robinson’s population-based study of Illinois teens in 1994 was one of the first to identify a 16 percent rate of indoor tanning use among adolescent girls. On June 6, 2012, Chicago’s city council passed legislation to ban minors under the age of 18 from using tanning salons without the permission of a parent or guardian. Robinson provided testimony supporting the ban. Here’s a look at her research, and the passion behind her advocacy.
What are your research interests?
My group studies skin cancer prevention and early detection. Skin cancer prevention consists of reduction in exposure to harmful rays of the sun, such as ultraviolet light radiation. When I first came to Northwestern University Feinberg School of Medicine, I was looking at ways of controlling the exposure of teens and young adults to indoor tanning. We’ve been enormously successful with the city council of Chicago passing the resolution prohibiting access to minors. It was just really a wonderful moment for us.
The other aspect of what we do is early detection of skin cancer, especially melanoma. I currently have an R01 grant, which is five years of funding, that will support a study of melanoma patients, their skin-check partners, and their ability to learn how to perform skin self-examinations to detect melanoma early. The study consists of patients who have different stages of melanoma and their skin-check partner, someone who is committed to helping them check areas of the skin they can’t see for themselves, for instance, the top of the scalp, the back, and the back of the legs.
We randomize them to three parts of the study. First part is the control where we just treat the patient. The second part is an in-person intervention where one of my four research coordinators takes the patient and partner through a structured teaching experience. The third part is to have the pair read a workbook of all the information that is in the one-person intervention. The workbook came from my previous research, which was derived and completed here at Feinberg and contains all relevant information and motivational ways for people to learn.
We want to see if people can absorb the information, implement it, and perform skin checks for a period of two years after they have the intervention. The goal would be to get to the point where we find out they can read it and implement it themselves.
Where did you get the idea for the study?
The idea for the study came from a patient. I had a male patient sitting on the table, and after finishing the surgery, I was trying to teach him the standard “a-b-c-d-e” rule for detection of melanoma. He looked at me and he said, ‘You know doc, I don’t really take care of that stuff. My wife does it all. Why don’t you talk to my wife?’ And I said, ‘Why that is a sensational idea. Where is your wife?’ So we brought in his wife and I gave her the speech. She was all over it. She was motivated, she wanted to do it, and she wanted to make sure her husband didn’t get another melanoma. From that point, we worked on looking at the willingness of a partner to engage in the information, teaching, and performance.
What motivates your work?
The greatest source of motivation is the patient. It is knowing what melanoma can do to young women and men and the tragedy that strikes a family when a child loses a parent very young. As a dermatologist, I’ve cared for patients for more than 30 years. I follow my patients and their families for years.
Another source of motivation is the students. Working with bright, positive medical and research students fresh out of college who are getting their feet wet and figuring out what they are doing with their lives renews me. The students always make further contributions to developing our ideas.
How did you decide to pursue a career in dermatology?
After medical school, I pursued an internal medicine residency to see what I wanted to do next. In internal medicine we saw a lot of patients with skin issues and we didn’t know what to do with them. So we would call consults, and dermatologists would come and diagnose the problem quickly. I thought, ‘Wow, that’s cool.’ I got inspired by what dermatologists did, how they did it, and how rapidly they made a difference in their patients’ lives by the medications and treatments they used.
So, I then completed my fellowship in dermatological surgery at New York University Hospital and joined the faculty at Northwestern in 1979.
What is next? What projects are you working on?
One of our projects this summer is studying the use of sun protection in people engaged in open field activities. People who engage in open field activities, such as soccer, baseball and drum corps, are in the full sun for eight hours a day. We are also looking at male attitudes towards sun protection.
Another project is looking at communication between mothers and daughters. The study examines women who have had breast cancer or melanoma and what they have told their children about their ability to develop it and what steps they may be taking to detect the disease early. For example, are melanoma mothers telling their daughters to get their skin checked by a dermatologist?
What is the ultimate goal of your research?
The ultimate goal of my research is to reduce the incidence and mortality of skin cancer in the United States, and to do that we need public awareness. One of our goals is to get doctors aware of melanoma and what it looks like and what they should be looking for. Unfortunately, for years, dermatologists have always been isolated from the teaching and primary care group. So with the help of Jennifer Bierman, MD, director of primary care clerkship, my group has done a teaching intervention with our own medical students to help them know what to look for and be able to make a decision regarding melanomas.