One in five people will get some form of skin cancer in their lifetime. The rate is higher if you live in Hawaii and magnified further if you are an outdoor athlete.
One in 25 people will get Melanoma skin cancer in their lifetime.
One person dies from Melanoma skin cancer every hour in the United States.
It sounds shocking, but these are facts and the reality athletes face everyday when we step out the door. And it doesn’t matter how dark your skin color is — everyone’s at risk.
Melanoma is the most dangerous form of skin cancer that develops when unrepaired DNA damage to skin cells — often caused by ultraviolet (UV) radiation from sunshine or tanning beds — triggers mutations (genetic defects) leading skin cells to multiply rapidly forming malignant tumors.
Local triathlete, Dr. Monical Scheel, who is a Board Certified Dermatologist, Pharmacist, and has been practicing for nearly 20 years, says she has seen a rise in skin cancer patients among those living in Hawaii who are spending most of their day outdoors training and racing.
Dr. Scheel believes that while education on prevention and early detection of skin cancer are very important, they are not substitutes for a yearly skin examination by someone who is a Board Certified Dermatologist. It could save a life.
“I think what’s most challenging is trying to help people know what’s right to do for their skin,” the Kailua-Kona resident said. “Sometimes they are not ready to listen. So it’s really hard when you know what’s right for someone to do. It’s trying to convince people to take care of themselves and usually they have to come to it on their own. And when they do, I’m ready to share with them.”
Skin guru
While Dr. Scheel’s highly respected reputation in her field has athletes worldwide seeking out her knowledge and expertise, it’s her humbleness, passion, and drive to help educate, detect, and prevent skin cancer in her community that has catapulted her as being the state’s top “skin guru” – winning numerous accolades and recognition along the way.
Her articles on skin care have been featured in popular magazines such as Oprah, Marie Claire, Sun Precautions, Fox News, Triathlete Magazine and most recently, the summer issue of New Beauty and upcoming September edition of the Honolulu Magazine.
Yet what sets her apart from all others is her generous free time offered to local events and charities despite juggling a 60-hour work schedule between her Kona and Waimea offices.
As a 2011 Kona IRONMAN World Championship finisher, a wife and mom to two chocolate labs, Dr. Scheel serves as president on the board of PATH (People’s Advocacy for Trails Hawaii) – a non-profit bicycle and pedestrian advocacy organization, offers year round free skin cancer screenings to businesses and athletic functions, and heavily supports local charities such as the Daniel Sayre Foundation, the American Cancer Society, Hospice, Kona Hospital Foundation, More Than Sport, Melanoma Research Foundation and Skin Cancer Foundation to name a few.
“I really feel like a big part of this community and I feel like this community really helped me to create that practice,” the 48-year old said. “So I want to give back to the community for allowing us to create what we are able to do, which is our passion as far as dermatology. And there are people who would not come into the doctor’s office. They might be afraid to come in or don’t want to come in but they would come to a free screening. So it’s nice when we can get out in the community to do free screenings and help out in that way.”
This weekend, Dr. Scheel joins the MS Hawaii Ride, a two-day cycling adventure riding 115 miles along the Kona and Kohala coast. The ride helps to raise money for Multiple Sclerosis – an unpredictable, often disabling disease of the central nervous system that disrupts the flow of information within the brain, and between the brain and the body.
It will mark her seventh time participating in the annual event, a passion that began in medical school when a woman with MS spoke to her group from a wheelchair about how she was a normal person and then realizing that she was going to die in six months – less than a year after being diagnosed with the disease. It touched Dr. Scheel so deeply that she knew the best way to help was to get involved.
“I’ve participated in seven MS rides and I’ve watched the treatment for MS change so dramatically that there are people with MS that now ride with us on the MS Ride,” she said. “And that’s been the level of care for this disease and I hope that can happen for many other diseases as well.”
Over the years Dr. Scheel has raised over $15,000 on her own, but the MS Ride – a national fundraising movement – has raised hundreds of thousands of dollars for Multiple Sclerosis research. Money raised for the MS Hawaii Ride though, stays in Hawaii.
So for those venturing out to participate in this weekend’s MS Hawaii Ride, or needing to put in long hours swimming, biking, running or paddling, Dr. Scheel has some advice.
“I would tell them to have a great time and no matter how you do it, just protect your skin. We live here in Hawaii, it’s beautiful and it’s wonderful to get out there to train, but never forget to protect your skin.”
For more information and to donate to this weekend’s Bike MS Hawaii Ride visit bikemshawaii.org.
WHAT UP DOC?
Q & A WITH DR. SCHEEL
With summer in full swing, soaring temperatures reaching record highs, and many athletes spending the bulk of their training time during peak UV exposure hours (9 a.m.-4 p.m.), Dr. Scheel spoke candidly before her Saturday bike ride on sun protection, education, prevention, and skin cancer awareness
Q: In your field of practice, what are the top three types of skin ailments you commonly see among endurance athletes who train and race in the sun?
1. Precancers and skin cancers (Basal cell carcinoma, Squamous cell carcinoma, and Melanoma) – treatments vary from liquid nitrogen, to prescription creams, to surgery.
Prevention: Wear sun protective clothing, sunblock, avoid mid day UV radiation, and get a yearly full skin examination by a Board Certified Dermatologist.
2. Staph infections – from ingrown hairs to boils. Some need to be drained surgically others are treated with a topical antibiotic.
Prevention: Antibacterial soap and topical antibiotic ointment to sores.
3. Acne – Can be related to high carbohydrate/milk diet, skin care habits, pollution, dehydration or stress from training.
Prevention: Acne wash, lower glycemic carbohydrates, avoid dairy products, stay hydrated and use topical over-the-counter salicylic acid.
Q: With summer season extending year round in Hawaii, what are your recommendations for sun protection for the endurance athlete?
Sun protective clothing is your first line of defense. Cover as much of your body as possible with long sleeve shirts, arm sleeves, ball caps, skull caps, and bike jerseys. Exposed skin should be covered with SPF30+ Water resistant (80 minute) sunblock with at least 7-percent zinc oxide. Exercise before 8 a.m. or after 5 p.m. or get some of your workouts done indoors.
Q: What is the difference between sunscreen and sunblock?
Sunscreen is a chemical that absorbs into the skin and breaks up UV radiation at a cellular level. Sunscreen should be applied at least 15 minutes prior to sun exposure to be effective. The SPF (sun protection factor) rating only tells you about the product’s ability to block UVB (ultraviolet B) rays which cause both sunburns and skin cancer. UVA (ultraviolet A) rays, which cause skin aging as well as skin cancer are not necessarily blocked or part of the SPF rating. So the most misleading claim on sunscreens is a label that says “broad spectrum,” as there isn’t any rating of how much UVA rays are being blocked. The good news is that the FDA is currently working to make sunscreen manufacturers rate the level of both UVA and UVB protection.
Sunblock is a physical block to UV radiation to the skin. The most common sunblocks are Zinc oxide and Titanium Dioxide and are the most effective for both UVA and UVB protection. I recommend sunblocks containing at least 7-percent zinc oxide. Because sunblocks sit on the surface of the skin, make sure that they are water resistant from getting wet or sweating. The FDA rates water resistance of sunblocks at either 40 minutes or 80 minutes. When the time is up, you need to reapply.
Q: What are some tips when shopping for sun protective clothing?
Look for clothing that has a UPF (ultraviolet protection factor) of 30 or greater. UPF is a standard for rating clothing with UV protection. The SPF rating in sunscreens only covers UVB blocking ability, while the UPF standard covers both UVA and UVB. The UPF rating also applies if the fabric is wet.
Q: What are the warning signs or the “A, B, C, D, E’s” of Melanoma?
Moles that are flat and brown-black that are changing or growing should be checked. Basal Cell skin cancers can also be colorless so it’s important to get a spot that’s growing checked as soon as possible. Over 90-percent of melanoma skin cancers have some of these characteristics:
A: Asymmetry
B: Border Irregularity
C: Color variation
D: Diameter bigger than a pencil eraser
E: Evolving or changing appearance
Dr. Scheel added that while 2-3 Melanoma cases and more than fifteen pre-Melanoma cases are seen every month in her office, only 30-percent of the skin cancers diagnosed in office are the patient’s chief complaint. The other 70-percent of patients come in for something else and then skin cancer is found during the examination.