PUBLISHED 06/10/2005
In the summer of 2003, Deena (nee Drossin) Kastor was on her way to the airport to compete in Europe when her dermatologist called. The biopsy results were in from two suspect marks Kastor recently had removed.
Diagnosis: Melanoma. Kastor told her dermatologist that with her busy racing and personal schedule, she'd schedule surgery for September. "I don't want to even wait until tomorrow," said the doc.
So Kastor, who regularly saw a dermatologist because of her fair skin and the amount of time she spends training in the sun, turned around and underwent surgery to remove the form of skin cancer that kills about 7,500 people every year. Kastor, 31, hasn't had any bouts with melanoma since, but she's diligent about seeing a dermatologist every three months. "I think no matter what your skin type, if your hobby or profession is to be in the sun, you definitely need sunscreen and to see a dermatologist," says Kastor, who finished second in the U.S. Women's Olympic Marathon Trials in April.
There's no data showing that runners get skin cancer--the most common form of cancer with more than one million new cases a year--more than anyone else. But simple cause-and-effect shows runners can be at greater risk. "Someone who runs in the midday sun four to six times a week, in a lifetime of cumulative ultraviolet exposure, has a very significant risk for skin aging, pre-cancers, and cancer," says Rodney Basler, M.D., past chair on the task force on sports medicine of the American Academy of Dermatology. Add in the fact that singlets and shorts provide about as much coverage as a Janet Jackson ensemble, and you have the perfect formula for skin cancer. Plus, despite being generally health-conscious, runners can be negligent about protecting their skin. According to a recent Runner's World online poll, 41 percent of runners never put on sunscreen before an outdoor, daytime run.
Skin cancer comes in two forms: mela-noma and non-melanoma. Melanoma has the most potential for being lethal, but is often curable if detected and treated early. In men, melanoma tends to appear on the torso, head, or neck. The lower legs are a common site of melanoma in women. Melanomas tend to be jet black with asymmetry around the border.
Non-melanomas are more common and include basal cell carcinomas and squamous cell carcinomas--which typically don't spread to other parts of the body and can be easily removed by surgery. Basals are generally characterized by a newly appearing fleshy mole that bleeds easily, while squamous ones generally are red, crusty, and appear in older age groups.
"Compared to all other forms of cancer, except lung cancer, it's the most preventable form of cancer there is," says Tim Berger, M.D., professor of clinical dermatology at the University of California at San Francisco. It's important to be on the lookout for any suspicious moles or markings, and contact your doctor as soon as you spot one. But they can be sneaky; Kastor didn't spot hers--her dermatologist did during a check-up. That's why the American Cancer Society recommends that people 40 and older have a skin-check once a year, and people 20 to 40 have a skin-check at least every three years. Here are other ways runners can reduce their risk:
Run early or late
The sun is most damaging between 10 a.m. and 4 p.m. Earlier is better, because there's still a residual ultraviolet effect in the afternoon.
Don't hide behind a t-shirt
If you're ultra-sun-sensitive, it's possible to get sun damage through a shirt, as T-shirts only offer an SPF of about 7. "A T-shirt loses some of its already minimal sun protection when you sweat," says Mark Rubin, M.D., assistant professor of dermatology at the University of California at San Diego. You can spring for clothing that contains built-in sun protection. You can also wash your running clothes once a month in Sunguard--a colorless dye that gives your clothes an SPF of greater than 30 (find it at ritdye.com). Or you can slap on sunscreen under your shirt.
Save face
Always protect your face with sunscreen and caps. "Have some common sense," Basler says. "If I take a dime-sized basal off your arm, it's not as big a deal as taking off a part of your nose."
Watch your top
"The scalp was never designed to get sun, so cancers develop more quickly and are more aggressive if they occur on a balding scalp," says Berger.
Don't ignore your legs
"They don't burn as easily, but they're still accumulating damage," Berger says.
Though Kastor still races in singlets, she always wears sunscreen and trains in long-sleeve T-shirts and a cap--no matter the weather. "I've gotten a lot of thank you's," she says, "from people who had melanoma removed after hearing my story."
