Saturday, February 16, 2019

Skin Cancer Health

With spring and summer soon to be around the corner soon (fingers crossed). We figured this would be a great time to discuss skin cancer health. It's one of triathlon's dirty secrets. Pro Triathletes Dough Maclean and Leanda Cave are testaments to this.  How you protect yourself from over dosing from the sun in those early years through those forty years will effect you in your upper years. 

Jenell Butler is an FTR Ironman Triathlete and she shares her recent experience. 

It was over a year ago when a friend or two at work noticed a strange spot on the right temporal area of my head!  The neurologist who was working that day noticed it too and told me I better go get it checked out ASAP!  He thought it was a skin cancer.  I basically got busy with life ingored it for a good while!   The spot grew and got bigger in size!   

I finally decided to have a dermatologist examine the strange mole and she recommended getting the site biopsied   I finally agreed to have it biopsed.  I really did not think it would come back as skin cancer!  I was wrong!  When they told me the results I was a little bit nervous!  They told me the type of skin cancer I had which was a Basal cell carcinoma.   I was very lucky it was that kind. 

Basal cell carcinoma is very disfiguring and it grows and grows!  So the dermatologist said it had to be removed or it can grow further unto my face and can cause problems!  They told me the best way to remove it was doing the Mohs procedure.  The day after Christmas I had the procedure!.  I got nice little face lift from that procedure!  I now have a nice scar too!   The lesson learned from this is wear sunscreen and take care of your skin!   Don’t take your skin for granted!   It’s scary when you hear the word cancer!  Cancer can be deadly.  It’s painful to have it removed. 

What can you do protect yourself from the dreaded word skin cancer? 

Take Care of your Skin
We as athletes need to take care of our skin and be aware of the signs of skin cancer. Skin cancer can be deadly, if not treated in its early stages. We are at a higher risk for skin cancer, because we are out in the sun more. Our skin protects us against exposure to dangerous things in our environment, such as bacteria, viruses, and harmful ultraviolet rays from the sun. 
How do we protect and take care of our skin?
1.    The best way to protect our skin, if possible, is to avoid sun exposure between 10am – 4pm. Which is difficult to do for athletes who are training and racing.

2.    Next best line of protection is sunscreen. Use a broad-spectrum sunscreen with SPF greater than 15, higher for fair skin people. Key is to apply a generous amount to skin 20-30 minutes before getting into the sun. Apply to all exposed skin. Must reapply at least every 2 hours, as athletes, we must carry it with us.

3.    Wear protective clothing, cover your skin with long sleeved shirts, long pants, and wide brimmed hats.

4.    Don’t smoke.

5.    Eat a healthy diet and stay hydrated.

6.    Apply moisturizer to skin and avoid harsh chemicals.

7.    Manage stress.

8.    Examine your skin.

So, what are the signs of skin cancer? What do you look for when doing a skin examination? 

Look for the A, B, C, D, E Rules.
A = Asymmetry– That’s a warning sign, the benign mole is symmetrical.
B = Border– Non-cancerous moles have smooth even borders. Melanomas have irregular borders.
C = Color– The presence of more than one color blue, black, brown, tan, etc. or the uneven distribution of color is a warning sign. Benign moles are usually a single shade of tan or brown.
D = Diameter– Melanoma lesions are often greater than 6mm in diameter.
E = Evolution– The evolution (or change) of the mole is the most important factor. The change, if it changes color or size, immediately get it seen by a dermatologist.
Skin cancer is abnormal growth of skin cells, it mostly develops on areas of the skin exposed to sun rays. Skin cancer affects people of all color and races, although those with light skin who sun burn easily have a higher risk.
Types of skin cancer;
Actinic Keratoses – Least Dangerous - These dry, scaly patches or spots are precancerous growths. Most people see these after the age of 40. These develop from over exposure to sun. Treatment is needed because the cancer progresses to squamous cell carcinoma. 
Basal Cell Carcinoma– Least Serious - This is the most common type of skin cancer. BCC frequently develops in people with fair skin yet can occur in people with dark skin. BCC looks like a flesh colored pearl like bump or pinkish skin (mine). BCC develops over years of sun exposure and indoor tanning. BCC are common on the head, neck, and arms, but can form anywhere. 
Early diagnosis and treatment for BCC is important. BCC can invade the surrounding tissue and grow into the nerves and bones causing damage and disfigurement.
Squamous Cell Carcinoma– SCC is the most common type of skin cancer. People who have light skin are most likely to develop SCC. SCC often looks like a red firm bump, scaly patch or sore that heals and then re-opens. SCC tend to form on the rim of ears, face, neck, arms, and chest. Can also grow deep in the skin causing damage and disfigurement. Early treatment can prevent this spreading to other areas.
Melanoma is the most common type of skin cancer but is the most deadly and serious because it often spreads. Risk for melanoma includes over exposure to the sun. Melanoma is a form of skin cancer that arises when pigment producing cells known as melanocytes mutate and become cancerous. It’s rare in people with dark skin. Melanomas can develop anywhere on the skin but mostly chest, back, arms, legs, neck and face. It looks like irregular shaped moles with different dark colors. 
Treatment is immediate. This type of cancer has staging. People prone to this cancer have high freckle density, high number of moles (five or more atypical moles), pale skin, red or light hair color, high sun exposure, age, and family history.
Treatment for skin cancer is important.If skin cancer is not treated, it can be disfiguring and deadly.
For basal cell carcinoma, squamous cell carcinoma, actinic keratoses, melanoma a trip to the dermatologist will help decide the proper treatment based on the type of skin cancer and size.
Types of treatment for skin cancer are:
1.    Curettage and electrodesiccation for smaller size cancers (95% cure rate).

2.    Mohs micrographic surgery (99% cure rate)

3.    Excisional Surgery

4.    Radiation

5.    Cryosurgery

6.    Topical medications

7.    Oral medications

Treatment for melanoma

1.    Radiation therapy and Mohs surgery.

Written by Jenell Butler, Ironman Triathlete 

Wednesday, January 16, 2019

You Should be Training Your Gut

You Should be Training Your Gut

Most endurance athletes have had some GI distress during training and racing. It varies from athlete to athlete and is much more common for runners. GI distress or exercise induced gastrointestinal symptoms include both upper and lower gastrointestinal issues, and can substantially decrease your performance. It is much more likely to occur during high intensity efforts, high heat and dehydration.

The good news is that your GI system is highly adaptable and trainable. Yes, your regime should include gut training.
Some good guidelines to get your GI track to absorb more carbohydrate and fluids without upset and result in better performance. 

* Regularly consume your race morning breakfast before long training sessions. At least 2 hours before your session consume 60 - 65g Carbohydrate, triple it if its 3 hours. You can also try small amounts of low fat protein. Sip on sports drink (Gatorade) pre exercise for the sodium and extra hydration. This is all highly subjective and modifiable.

* Train, when possible, in the same conditions (hot & humid) as your expected race conditions.

* Know your sweat rate per hour, (this time of year may not be ideal for sweat rate testing). Try to consume around that amount per hour during all sessions lasting an hour or longer, however max absorption is usually at 32 - 40oz per hour.

* Pre-hydrate leading up to big events.

* Consume around 60 - 90g carbohydrate per hour of all sessions longer than 1 hour. If you can't handle that much, start with just 30g and work up. Experiment now, so that you have nutrition nailed down by race day.

* Consume 15 - 20 mg sodium per fl oz per hour. That will be 360 - 480 mg per 24 oz bike bottle.

Some athletes use Gatorade, but it does not have enough carbohydrate or sodium for sessions over 3 hours, and the Osmolality is not ideal. Some athletes use multiple sources for carbohydrate, sodium, and fluid and in the process over complicate their race strategy. For sessions lasting more than 3 hours, Infinit Go Far would meet all these requirements and is a good place to start.

* To decrease risk of GI distress, avoid NSAIDS leading up to and during big events.

* Reduce fiber intake leading up to and during races and long training sessions.

   Ricardo Costa, the senior author of a study on GI training has written a guide to managing GI symptoms in ultra-endurance sports, which is available on the website.  Costa concludes:

 * There is no substantial evidence to support the acute or chronic consumption of dietary supplements to reduce exercise-induced GIS, and subsequent symptoms.

*  To date, there is no evidence to support the acute and longer-term consumption of probiotics to reduce exercise-induced gastrointestinal syndrome, and subsequent symptoms.

*  To date, there is no evidence to support adherence of a gluten free diet in non-celiac runners to reduce exercise-induced GIS, and subsequent symptoms; unless specified by a health practitioner in response to a positive diagnosis of intolerance.

FTR Coach, Ironman Certified Coach & NASM Personal Trainer
Sherril Wade