The Best Christmas Present Ever!

My Christmas present came a little early this year. Actually it arrived this past Monday in the form of a voice mail message on my cell. The message began, "This is Robin from Dr. Levine's office and he asked me to call and let you know that your melanoma has been completely removed." I was so elated. What an awesome gift! I had an appointment to see Dr. Levine today (Friday) to have him check the incision and share the results from the wide excision done of a melanoma I had on my back, so getting the news 5 days early was such a relief.

Back on the 14th I posted about my experience with having the wide excision done during what I thought was going to be a consultation. Quite the shock. To read about that experience and how I discovered the mole in the first place, click here.

I posted about that experience and I'm sharing the good news now for three reasons. First, runners have a higher incident of skin cancer than the average non-runner because of our exposure to the sun. I knew this before discovering I had melanoma, but never really took it seriously. "It won't happen to me. I don't have any family history of skin cancer. I'll put on sun screen next time." I even blogged about the higher chance of skin cancer in runners. But when it came to practicing what I was preaching, I fell short. It took a brick falling on my head (actually a mole on my back) to wake me up to the seriousness of sun exposure.

Second, skin cancer, when detected early, has a very high cure rate. Runners, be vigilant about regularly checking your body for moles. Know the ABCDEs of Skin Cancer.

• Asymmetry-Normal moles or freckles are completely symmetrical. If you drew an imaginary line down the center of a normal mole or spot, the two halves would be symmetrical or look the same. With skin cancer, mole or skin spots will look different on each side.
• Border-A normal mole or spot has even edges. With skin cancer, a mole or spot will have blurry and/or jagged edges.
• Color-A mole or skin spot with more than one hue is suspicious and needs to be checked by a doctor. Normal moles and/or skin spots are usually one color. This can include lightening or darkening of the mole.
• Diameter-If a mole or skin spot is larger than a pencil eraser (about 1/4 inch or 6mm), you need to have it checked out by a doctor. This even includes moles and skin spots that do not have any other abnormalities (color, border, asymmetry).
• Elevation- Elevation refers to a mole that is raised above the surface and has an uneven surface. 

Use the ABCDEs of Skin Cancer as a guide in initially evaluating moles and skin spots on your body. But if you have any doubts, GO TO THE DOCTOR! Moles may never change, they make take a long time to change, or they can change fairly quickly. My mole began to change rather quickly. Problem was I couldn't see it. It was in the center of my back. Luckily my wife noticed the sudden change.

Third, you can drastically decrease your chances of skin cancer by wearing sunblock and/or sunscreen with an spf of 15 or higher.  Cover as much exposed skin as possible and wear a hat and sunglasses. My dermatologist it trying to get me to set a new trend among runners by wearing a big floppy hat. I'm not quite to the floppy hat stage yet, but I'm definitely now a daily wearer of sunblock.

Below is a sketch showing what was involved in the wide excision done to remove the skin around the melanoma on my back, followed by two photos of the incision on my back after the procedure. The first picture shows the size of the elliptical patch of skin about 2.25" wide and 4.25" long that was removed.

An excision is different than shaving off a mole or freezing the mole off. A wide excision is done after the mole has been removed and biopsied. If the biopsy reveals skin cancer, especially melanoma, then a wide excision is often done to remove the skin from around the area of the original mole. The entire layer of skin (down to the muscle is removed. Then the site is sutured. My wide excision had at least two layers of internal sutures and then the outer skin was closed using  steri-strips (see the middle picture below).

If you have a suspicious mole, don't let the pictures above keep you from getting it checked. I can think of a 1000 things I'd rather do than have a wide excision done, but I did it. The initial shots to deaden the area were the worst of the procedure. Honestly, I didn't feel much after that. The following week, my back was a little sore and I couldn't do much twisting or turning. My clients in the studio this week were awesome and helped out with toting weights around and re-racking them for me. I only needed the pain meds the doc prescribed me once and that was just the first night and it was more to help me sleep than for intense pain.

So check those moles frequently and slather on the sunblock!! I'm a practice-what-I-preacher now!

Runners! Block That Sun!

Like any sport, running comes with its risks. Typically things like shin splints, ITBS, and plantar fasciitis come to mind. But there's another risk that may not be as top of mind—skin cancer. In 2006, the Department of Dermatology at the Medical University of Graz, Graz, Austria did a study regarding marathon runners and sun exposure.

The doctors in the Graz University dermatology department realized that over about a 10-year span, they had treated 8 ultramarathon runners with malignant melanoma. The medical team discussed potential triggers of the cancer in these patients and UV exposure, immunosuppression due to long-term intensive exercise, or both surfaced as possibilities. This piqued the curiosity of the doctors and they decided to look closer at the risk factors for malignant melanoma in marathon runners. To do so, they examined medical history, genetic and environmental influences, sun-related and clinical variables in 210 athletes and compared them with those of an age- and sex-matched control group.

What they discovered was that although the control subjects exhibited higher sun sensitivity and more common skins spots and moles, the marathon runners exhibited more atypical spots, moles, and lesions suggestive of nonmelanoma skin cancer.

And interestingly enough, of the marathon runners, the ones who had trained more had more of these atypical moles. Findings also revealed that about 96.7% wore shorts (not too surprising) and 98.6% wore shirts that only partially covered their backs and extremities (not too surprising either). Only 56.2% of the runners used sunscreen on a regular basis.

End result? Basically the marathon group presented with an increased risk for malignant melanoma and nonmelanoma skin cancer. It's kind of like one of those "duhh" moments. But sometimes it takes seeing the numbers to have it hit home.

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Most likely that act of running has nothing to do with the increased risk, but the time in the sun does. If a similar study was done with construction workers or landscape workers, you'd probably find similar results. However, that fact that runners typically have on less clothing and have more exposed skin probably would still make them more inclined to a higher risks of skin cancer.

So what's a distance runner to do? Easy! Cover up! Actually the study recommends doing your runs during times of low-sun exposure, wearing adequate clothing, and regularly using water-resistant sunscreen.