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I rode in the MS150 about 15 years ago. It was the hottest day of the year with a head wind for the entire 80 miles of the first leg. Riders - experienced riders - were dropping out by the dozens. Some called it the MF150 after that.
They would throw them in the back of pickups and haul them to aid stations and treat them for heat exhaustion. But I learned a little secret on that ride. At every aid station I would get a glass of ice water and pour it on my head. If you keep your head cool you can take the heat with no problem.
But of course the real, real experienced riders, the greyhounds because that's what they looked like had no problems, they finished the whole 150 miles in one day.