Running & Skin Cancer ÛÓ Cause & Prevention
by Jane Wolkowicz
(from a previous issue of NER)
Training for a marathon? You’ve probably already picked up a copy of one of the thousands of guide books available for runners. Take “Marathon Training for Dummies,” for example, which gives runners advice on everything from hill running, to what to eat while training, to making a pit stop during the raceÛÓall very important. Nowhere in the guide, however, does it mention that runners spending all that time outdoors should be applying sunscreen every few hours.
And, runners beware. Missing out on this vital information, according to a new study out of Graz, Austria, could be a big problem. Big enough to make anyone run for cover.
The study, conducted by Dr. Christina M. Ambros-Rudolph and her team of dermatologists, observed a steady increase of patients in recent years that had two things in common. They were all marathon runners, and they were all being treated for skin cancer. Ambros-Rudolph and her team observed 210 marathoners and 210 members in a control group. The individuals in both groups matched for age and sex, and all subjects were whiteÛÓan increased risk factor for melanoma.
Dr. Rudolph’s findings were not exactly shocking. Marathon runners spend hours and hours training in the sun, and, in the end, had more solar lentigines and solar lesions (age spots caused by long-term sun exposure) than the non-runners. Fifteen percent of the marathon runner group ran more than 45 miles a week, and those in this category had the highest rate of skin lesions.
Again, more time in the sun equals a higher risk of skin cancer. No major surprises there.
On the other hand, the study did raise concern about a new worry for distance runners. Although the health benefits of exercise are vital, according to Rudolph’s study, high-intensity training over time can weaken the immune system and suppress immunity functions.
Dr. Jean-Claude Bystryn, from the NYU School of Medicine Dermatology Division, doesn’t advise runners to ditch their training shoes just yet, however. “Any activity where you are outside increases your risk of getting skin cancer,” he says. “But the relationship between sport and cancer, resulting in a weak immune system cannot be proven. If you are fair skinned and blonde, you are at risk, no matter if you are out running for hours, or sitting on the beach for hours.”
Still, Dr. Bystryn noted that he has seen an increase in his patients who are athletes in recent years who are being treated for symptoms of skin cancer. When asked why he thinks this is, he replies, “People seem to have more leisure time today, which is often spent outdoors. They can travel to the beach, go away for the weekend, or take the time to train for a race.”
With individuals spending more time outdoors, taking the time to prevent skin cancer should be more fundamental. One recent poll revealed that 41 percent of runners never apply sunscreen before going outside to train. In the “long run,” this could result in severe consequences.
Professor Paul Josephson of Colby College is a long time marathoner, and often can be found training for multiple endurance races in a single month. Josephson runs in all conditions; but, as one would expect, spends a lot of time in the sun. “I foolishly seldom wear sunscreen,” he admits. “I justify this wrongly, by assuming that my olive complexion protects me from cancer, and I want to look like an Adonis. I come pretty close, don’t you think?” he jokes.
At April’s Boston Marathon, in which Josephson competed, runners braved leftover conditions from an unexpected Nor’easter. According to race organizers, however, the rain and cold wind were unusual for a race having a history of heatÛÓespecially in recent years. “I have burned a few times, especially at Boston,” recalls Josephson. “In 2004, it was sunny and 86 degrees. I had a tan shadow of a singlet on my chest for two weeks afterward.”
Dr. Martin Weinstock, from the Rhode Island Hospital of Comprehensive Cancer Center, says that is enough of a risk factor in itself. “Anyone who has burned over three times in their life is at risk,” he says. “Anyone who has ever sunburned at all should always wear sunscreen outdoors to prevent skin cancer. It’s an awful disease, but in most cases, it is a preventable one.”
“Prevention is the key,” stresses Dr. Bystryn. “Any type of skin cancer is not only dangerous, but deadly. Runners may want to skimp on clothing, but this is a bad idea. A T-shirt does not count as covering up, because the UV rays can filter right through it.”
This was a major issue that came up in the Austrian study. Ambros-Rudolph found that out of eight ultra-marathoners with malignant melanoma, six occurred on the upper back, an area not often covered by T-shirts.
So what can concerned runners do to protect themselves?
For starters, don’t run during peak hours of the day. “Early in the morning, or late in the afternoonsÛÓthose are when sun exposure is the least damaging,” notes Dr. Bystryn.
Jen Paludi, a fair skinned runner from Santa Barbra, California, says she always tries, “To wear sunscreen when running outdoors. Paludi has competed in three marathons. “There is no reason not to use sunscreen. There are new versions out now which allow you to sweat.”
Options include Banana Boat Quik Dry Sport, which has an SPF of 30, and comes in a spray bottle for easy application. Or, try BodyGlide, which is a sunscreen and lube combination with an SPF of 25 that also protects against chafing.
Beyond sunscreen, new products geared to protect runners are emerging all the time, both at specialty running stores and online. These include hats and special shirts, pants, and even socks with tight-woven fabric featuring added UV-protection. Nearly every major clothing brand that is geared toward runners now offers a special product offering sun protection.
Yet, if only 41 percent of runners tend to reach for sunscreen before heading out to train, would they really splurge for clothing with extra protection?
Dave Smith, the owner of the specialty store “Runner’s Edge” in Farmingdale, New York, doesn’t see it happening. “We used to carry a whole line of clothing with extra UV protection, but there wasn’t a big demand for it,” he recalls. “I think it was a nice thing, but if there was a difference in price for two shirts, one with UV protection, one without, people went with the cheaper item.”
If the UV-clothing trend turns out to be a flop, perhaps small steps are the best measure for runners wanting to take extra precaution. “Some day soon, sunscreen will be passed out along with Gatorade at every major marathon,” speculates Paludi.
In the meantime, Dr. Martin Weinstock advises, “I recommend looking over your skin once a month, especially in high exposed areas such as your arms and upper back, and check on your running buddy, too.”
That’s running camaraderie taken to a new level.
As it turns out, the results from Austria are certainly noteworthy, but perhaps not as dismal as doctors originally thought. With preventative measures, the skin cancer link to running should not shatter anyone’s marathon hopes and dreams. Ambros-Rudolph and her team are currently conducting a follow up study.
“If anything, they have heightened awareness of the disease, and that is a positive thing,” notes Dr. Weinstock. “Personally, I like the American cancer society’s guideline for preventing skin cancer best: “Slip, Slop, and Slap on the sunscreen.” Watch, people will take note of that slogan more than any study,” he adds.
Still thinking of training for a marathon? Follow that advice, and you should be covered.