Horan eagerly spreads word of skin cancer risk

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Marty Horan never worried about the back of his neck more than two decades ago, when he joined IBM colleagues at lunch to run the back roads of Poughkeepsie, N.Y.

But he became one of the approximately 800,000 new cases of basal cell carcinoma diagnosed each year in the United States.

"I've been running since 1981, for 24 years," Horan, 45, a fixture in the Washington running community, said last week after his one-year follow-up appointment for the skin cancer. "I would use sunscreen sporadically. I was not consistent with it. But now I use it all the time. I lube up my arms, neck, face and legs. They say if you are going to have a type of cancer, basal cell carcinoma is the one to get if it is caught early; it is 98 percent curable or something like that.

"I never thought of the back of my neck being a high-risk area," added Horan, who wrote about his experiences in the Montgomery County Road Runners newsletter. "Glad it wasn't melanoma (the most severe of the skin cancers). It was a rude awakening to the realities of sunscreen. I can remember going to the beach as a kid and again, using it sporadically."

But Horan said he is not out of danger yet. His dermatologist, Walter J. Giblin of Rockville, told him there is a 50 percent chance he will have a recurrence within the next five years, and not necessarily on the same spot as the initial occurrence.

"So, needless to say, applying sunscreen has been a part of my daily routine, it's just like brushing my teeth," the Gaithersburg resident said.

Basal cell carcinoma is the most common form of skin cancer. In fact, it is the most common of all cancers, according to the Skin Cancer Foundation in New York, which claims to be the only national and international organization concerned exclusively with the world's most common malignancy.

One out of every three new cancers is a skin cancer, and the vast majority are basal cell carcinomas. These cancers arise in the basal cells, which are at the bottom of the epidermis (outer skin layer).

Excessive exposure to sunlight is the cause of almost all basal cell carcinomas, which occur most frequently on exposed parts of the body -- the face, ears, neck, scalp, shoulders, and back.

Which of course makes runners and other outdoor athletes very susceptible to skin cancer, no matter how fit you may be.

Horan said it started out innocently enough with what he thought was a pimple on the back of his neck. "I had a little bump on the back of my neck and I asked my wife, 'Hey what does that look like' and she said 'it doesn't look like anything I've ever seen and you should get it checked out,'" Horan recalled. A week and a half later, he was in Giblin's office.

"How do you know you have it," said Giblin, a licensed board-certified dermatologist for 16 years who said he does frequent cancer screening for members of Congress and Major League Baseball. "It can be difficult. Most often, it's not typically symptomatic. It's not typically painful. It doesn't itch. You don't notice it until it is pretty late. What we tell people is that observation is pretty critical. Look for moles or freckles that have changed size, shape, color or texture, or sores that aren't healing or are bleeding or a new growth that looks peculiar. The flip side, if you catch them early, they can be cured pretty easily."

For the older runners, the damage already may have been done with decades of sun exposure. Family history, according to Giblin, also is critical. "A positive family history of skin cancer is definitely a risk factor -- the closer the relative the more the risk," he said. "No question about it."

Prevention is paramount. "One thing I would say about runners, especially in Washington with the heat and humidity: Run in the early morning hours or late afternoon or early evening but stay inside [during the intense hours of 11 a.m. to 3 p.m.]."

Applying sunscreen is a must. Giblin suggested that a screen with SPF 15 is adequate for most people, although those who sunburn easily or who are on medication might need a 30 or 45.

"There are different kinds of sunscreen," he said. "One is a physical blocking screen, the other sunscreen absorbs the sunrays. Of the two, the physical blocker is more efficient. You want one that effectively blocks UVA and UVB rays. Some only block UVB, which causes sunburn."

He recommended products that contain Parsol 1789, titanium dioxide or zinc oxide.

And he pointed out that a visit to a dermatologist for a baseline exam may be prudent, especially for people with a history of significant sun exposure.

Said Horan about his future: "I don't feel nervous about it. I am just cautious about it and knowing that I am taking the precautions that I have to take. I don't see it as a life-altering experience. It's more of a minor thing in my life. It's just a matter of putting on sunscreen and that's not so difficult."