For years Martin Dreyer felt bulletproof.

He had won seven Dusi Canoe Marathons and completed countless adventure events. Five years ago he represented South Africa at the Land Rover G4 Challenge, staged across Thailand, Laos, Brazil and Bolivia – and won. “It was the best experience of my life, out of this world,” he said afterwards.

But, also in 2006, this toughest of iron men was sitting in his dermatologist’s surgery, grimacing in pain. He had applied a special cream to his face a few hours earlier in the first steps of Photodynamic Therapy (PDT) for skin cancer.

Now he was sitting under a lamp, which produced artificial sunlight as the light and cream worked together to kill off cancer cells. “It burnt like hell,” he remembers.

Like most South Africans, Dreyer had been ignoring the threat of skin cancer for years. “When you’re doing hard-core things like dragging your canoe 17km over the top ice in an event in Sweden, and the ice cracks beneath you and you’re crashing into the icy water below – and then you survive – your attitude is, ‘Ag man, what’s a little spot?’ “But skin cancer is a reality.

“What we need in South Africa is a campaign like we’ve got for Aids, encouraging us to know our status and protect ourselves.” In his experience, sportsmen are “harry-casual” about skin cancer. “Hopefully my story will get some other guys to take heed,” he says.

Dreyer’s diagnosis of skin cancer is among the 20 000 new cases in South Africa every year, according to figures from the Cancer Association of South Africa (CANSA). The National Cancer Registry of 2000/01 found that about 700 people in South Africa were dying annually from malignant melanoma,the most dangerous type of skin cancer. Dr Dagmar Whitaker, president of the Melanoma Advisory Board of South Africa, believes this figure has probably doubled in the past decade.

According to CANSA, South Africa has the second highest incidence of skin cancer after Australia, but Whitaker suggests South Africa has the world’s worst incidence.
She has been collecting unofficial statistics in the Western Cape, and has found an even higher incidence of melanoma there than in Australia. She believes the figures are probably similar in other South African provinces, which would place South Africa at the top of the list. “Why do we have such a problem in this country? Well, we’re sitting under an ozone hole, which gives us an extremely high UV concentration in particular in summer,” she says. “And the rate of picking up skin cancer corresponds directly with the money spent on awareness campaigns, which have been implemented effectively over decades in Australia. The data clearly shows how skin cancer rates can decrease with greater awareness and behaviour change.”

On the face of it, at least, black people don’t seem at risk. Melanin, a pigment that darkens the skin, is the best-known sunblock and therefore very few black South Africans are diagnosed with skin cancer. However, Whitaker says there is no proper scientific study showing the incidence of skin cancer in black people anywhere in the world, and many black people may be misdiagnosed.

Recent research has found some black Namibians have skin cancer, suggesting that a black skin does not offer total protection. “I’m convinced that a whole lot of black South Africans are slipping through the net,” she says. While most South Africans neglect their skins, Dreyer’s story is an extreme one.

After finishing a B.Comm, he went to Canada to avoid military conscription in South Africa. He worked on a fishing boat on the high seas for an amazing six-year stint, in 18-hour shifts for 12 days at a stretch. The lifestyle caught the popular imagination with the Discovery Channel reality series Deadliest Catch.

“Phew, that exposure to the sun when you’re in your twenties is hectic,” Dreyer remembers. “There was the reflection off the water too, making it a double whammy. My face, nose and ears were constantly peeling. “But it was happening to everyone, so you just accept it and carry on working. We were there to make money, not to look pretty.”After several years he had saved up enough cash to last a while, so he took a year off to indulge in his passion, paddling. He won the Dusi that year and his sports career took off. “But it took me a hell of a long time to go to a dermatologist,” he says. “When I eventually went, he said, ‘Wow, your skin’s had it hard’.”

A few years later he went back with a spot on his forehead which kept changing shape. It was cut out almost immediately. Next, the spots on his face had to be burnt off. This treatment removed his several superficial squamous cell carcinomas, which are not deadly but must be removed or they can spread into surrounding tissues, causing disfigurement.

Later, when Dreyer’s dermatologist told him he would have to have his whole face done, he said, “No way! I know how sore it was the first time.” She reassured him that treatments had become more sophisticated and he could take a painkiller to lessen the burn, but he put it off, using his on-the-go lifestyle as an excuse. “When I went back to her after a year, she said, ‘What do you think you’re doing?’” he remembers. “My face was blotchy and looked terrible. But I had never found a right time to take eight days off and hibernate. In hindsight, there never is a right time. You just have to get on and do it.”

Dreyer now runs the Change a Life Academy, which he started in 2008 after winning the Dusi doubles with Michael Mbanjwa, the first black man to win the title. While training with Mbanjwa in the Valley of a Thousand Hills, he saw how keen other young men were to paddle, and pledged to help them. “This work is very close to my heart,” he says. Dreyer also got married recently and built a house. “And now I’ve got a baby boy, so I want to live forever,” he says. These days he takes great precautions over his skin. He wears a broad-brimmed hat when he’s in the sun and says that he also wears a long-sleeved lycra shirt for paddling, “even though I do get teased a bit”.

3 Misconceptions that could land you in trouble

You need sun exposure to get enough Vitamin D

You’ll get plenty of vitamin D from sunlight in South Africa, even if you use sunblock constantly, says Dr Robert Weiss, president of the Dermatology Society of South Africa. “I really wouldn’t suggest going and sitting in the sun to push up your vitamin D levels.”

If it’s cloudy, you’re safe

Recent research on US ski slopes found that skiers and snowboarders often got it wrong regarding UV radiation. They assumed they were safe on cloudy days and when temperatures were low, while they should have been more concerned about the time of the day, season, altitude and latitude. Bottom line: play safe.

Sun-beds give a safe tan

If your prettier half tans herself on a sunbed, stop her immediately, says CANSA. The International Agency for Research on Cancer, part of the World Health Organisation, includes tanning devices on its list of the most dangerous cancer-causing agents – a list that also includes cigarettes and plutonium.