Writing a skin care column has never been on my radar. I put Nivea, Aesop and Kora into the pantheon of likely popular candidates for the next generation of a Kids Spelling Show on commercial TV. Names I cannot pronounce (or spell) answering a host with the correct spelling of ‘M-E-T-A-S-T-A-S-I-S’. Or maybe they are constellations for star signs? I’m born June 28- making me… Cancer.
Which is the grave subject I am going to talk about today. I do find this a difficult topic, from an emotional perspective. I know a number of athletes who have died as a result of metastatic melanoma, some were good friends of mine. We’re a high risk group as athletes and have to take care to hit all the KPI’s for not getting burnt: Slip, Slop, Slap, Seek and Slide. I know I’m getting old because the last two seem new…but they were probably introduced in the nineties! Taking care of your recovery, training, hydration and nutrition are all made redundant if you allow yourself to get sun-damaged skin.
Unfortunately too, it’s not just the people who look like the leathery old duck from ‘There’s something about Mary’…it’s regular looking folk who get cancer too. So I want to split this piece into a few sub headings: Facts, Prevention and Surveillance.
Two in three Australians will have skin cancer at some stage of their life. This is a serious disease burden on both individuals, families and the health care system. And thoroughly preventable. GP’s are inunundated for skin checks: representing almost a million visits each year. Whilst melanoma is the most lethal (fewer than 15% of grade four sufferers survive 5 years), over 434 000 Australians are treated for non-melanoma skin cancers each year. In 2011, 11 570 Australians were diagnosed with melanoma. It affects younger people- it’s the most common cancer diagnosed in the 15-44 age category.
Yeah, yeah, yeah. Heard it all before with your slip, slap, slop, seek and slide. It’s so easy to switch off when you hear that mantra. Slip on a shirt, slap on a hat, slop on some sunscreen, seek shade and slide on some sunnies. So many ssss, it’s like parseltongue from Harry Potter! The S’s are helpful cues for day-to-day living, but what about triathlon?
In 2004, I got burnt to a crisp in the three Ironman races I competed. It seemed to me that this could be a serious performance issue…both on race day and long term. The redness going to my skin was wasted fluid, holding back my run leg at best. Also my recovery. Also my mental health- having to worry about getting melanoma in the ensuing years with so many Ironmen to do!
So I had Glen from Cannibal make me sleeved race suits (one-piece) which covered my shoulders and lower back. It allowed me to reapply sunscreen after carefully rubbing in a huge amount on my arms, leg, neck and face (including ears) during the bike and run. I carried small sachets of sunscreen which were in there from the swim- don’t mix them up with your gels! Letting volunteers put sunscreen on you is a trap- they don’t rub it in, and they’re rushing (as are you). Applying your own sunscreen makes sense from a race perspective too- not wasted stationary time.
It wasn’t just the race day either. I made sure I used clothing and small tubes of cream to good effect on long ride days. Similarly I wanted to avoid a growth on my eyes called a pterygium, so I used sunglasses as often as was possible riding and running.
Avoid solariums and remember that any tan is a bad tan. You shouldn’t be happy to be changing colour- it’s your skin’s way of saying it’s been exposed to sunlight. A tan is SPF 4…whereas you need to SPF 50+ to cope with the UV conditions in Australia.
You need to take some responsibility for your own skin. Look at all the places you can see and get others (a partner) to check your back. You can look using a mirror too. Look underneath hairlines (upstairs and down) to make sure you don’t have an odd mole. Look between your toes, nails and on the soles of your feet- frequently missed melanoma sites. If you find anything of concern, then seek care from a GP. If you’re still concerned, ask for a referral to a dermatologist for examination plus or minus a shave biopsy.
Suspicious moles are: itchy, red/pale/pearly, bleeding, an odd shape, new or changing. Especially on places that have to cope with a lot of sun. And remember that not everything is a melanoma- locally invasive SCC (squamous cell carcinoma) or BCC (basal cell carcinoma). Both of these can be nasty, so seek attention.
Be proactive about skin care- especially you gents. As they say, women get sicker and men die quicker…so get along to the GP for a chat and a skin check. It might just save your skin (and your life).
Dr Mitch’s Race Day Tips
1. Thorough application pre-race (use a mirror)
2. Choose race clothing that covers your lower back and shoulders
3. Wear UV rated arm coolers for scorching races
4. Take small sachets of sunscreen and apply bike/run
5. Wear a cap, not a visor
Dr Mitch’s Training Tips
1. Never go out swimming, running or riding without applying sunscreen- make it a habit
2. Get a friend to apply to your back for swimming
3. Always wear a cap and shirt running
4. Use a cycling cap under your helmet for long rides
5. Keep a small rube with your spares for reapplying
6. Keep your arm-warmers on and always wear an under-jersey
7. Don’t forget your ears!
8. Avoid training during high UV times
9. Mind reflected UV along side water courses
10. Wear gloves on the ride to protect the backs of your hands
Questions for Mitch?
Email him firstname.lastname@example.org or tweet/insta him @drmitcha
For more information on skin cancer: www.cancer.org.au