Hey Coach, set a good example: Use and share sunscreen

By Dev Mishra, M.D.

* Many types of cancers are strongly associated with repeated exposures to cancer triggers, and the association between sun exposure and some types of skin cancer isstrong.

* Sunscreen is a simple and effective way to reduce sun exposure risk.

* Only about 20% of young athletes routinely use sunscreen for daytime outdoor sports.

* Coachesare in an excellent position to positively influence the young athlete’s attitude and use of sunscreen.

Veteran soccer referee Randy Vogt wrote anexcellent piece in Soccer America’s Youth Soccer Insider about the importance of sunprotection for referees. The article encourages referees to take care of themselves with appropriate protection (hat, sunscreen), which sometimes requires the ref to challenge traditional dogma. Icouldn’t agree more. In this week’s post I wanted to examine the issue of skin cancer risk with an eye toward the young player.

Sun exposure increases risk of skin cancer inmany outdoor sports and young athletes rarely use sunscreen.

Ultraviolet (UV) radiation that comes with sun exposure is estimated to be one of the most important risk factors fornonmelanoma and melanoma skin cancers. Athletes practicing outdoor sports receive considerable UV doses because of training and competition schedules with high sun exposure, and in alpine sports, byaltitude-related increase of UV radiation and reflection from snow- and ice-covered surfaces.

Young athletes commonly have an indifferent attitude towards sun protection. In several publishedstudies it’s been shown that only about 20% of outdoor sport athletes routinely use proper sunscreen for daytime practices and games. For most of the athletes the reasons cited for lack ofsunscreen use were mostly psychological. They simply don’t think about it, they don’t know the association between sun exposure and skin cancer, or they may even be practicing resistancebecause some parents force sunscreen on to the young kids.

There are some physical reasons for not using sunscreen too, such as complaints that sunscreen combined with facial sweat will stingthe eyes, and some sunscreens are “greasy” resulting in decreased grip. These are valid points but the newer generation of sport sunscreens are designed to really minimize theseproblems.

Repeated “exposures” are key factors in several types of cancers

Our understanding of risk factors for various cancers is advancing rapidly over the pastseveral years. One fundamental concept is that repeated exposures to some toxic substances can lead to cell damage and this in turn can lead to formation of cancers. I don’t want to get overlytechnical here but for those of you interested I’d encourage you to take a look at thisvideo by Dr. Craig Thompson, CEO of the Memorial Sloan-Kettering Cancer Center in New York. Dr. Thompson explains the process in clear terms but here are some cancers with known links toexposures:

* Cigarette smoking dramatically increases lung cancer risk.

* Women with exposure to the human papilloma virus are at risk for cervical cancer.

* Obesity andconsumption of toxic foods (especially processed sugar) is associated with cancers of the digestive system.

* Sun and ultraviolet radiation increases skin cancer risk.

Dr. Thompsonstates clearly in the Wall Street Journal article that the links between some exposures and cancer is compelling and methods to reduce the risk are fairly simple and within reach for all of us. Hewrites:

“Don’t smoke, use sunscreen, avoid unnecessary radiation exposure, get vaccinated. Sometime this decade, it is expected that obesity, driven in large part by excess sugarintake, will surpass tobacco exposure as the No. 1 cause of preventable cancer in the U.S. Already, in terms of population health, we are putting this new scientific knowledge to use.”

Coaches need to set the example for the young athlete

Some of the studies on sunscreen use in young athletes note that the athlete may be practicing a form of resistance towardstheir parents if the sunscreen is slathered on before practices and required by their parents. It’s hard to know whether that might or might not be true, but one thing is common in most sports:if the coach requires it, it will generally be done.

In my opinion the coach is in a great position to positively influence good behavior in young athletes. Use sunscreen yourself and put alarge container in your sideline kit for your young athletes. If the sun’s out ask them to use it. It takes virtually no time, there’s nothing to lose and much to gain.

(Dr. Dev K. Mishra is the creator of the SidelineSportsDoc.com injurymanagement program for coaches. He is a Clinical Assistant Professor of orthopedic surgery at Stanford University. Mishra writes about injury management at SidelineSportsDoc.com Blog, where this article first appeared.)