How Running Prepared Me to Tackle Cancer
This is not about how I ran through cancer and was able to use running as a mental health break from the stress, or wake up every morning ready to head out the door before appointments.
Nope.
I actually struggled quite a bit with exercise from the time I was diagnosed with breast cancer (March 5th) to the time I had my mastectomy (May 15th). During that time, the most I could mentally commit to was 3 – 4 miles, tops. I wound up getting injured about a week out from my mastectomy, undoubtedly from the stress I was carrying. The same thing happened leading into my reconstruction surgery, and again heading into my thyroid surgery. As much I want to be the type of runner who can compartmentalize stress into neat little boxes and be the person who is able to set that aside and train, alas, I am not.
But, running – and everything I have learned in my 27 years as a competitive runner – shaped the way I approached cancer. Without that, I cannot imagine how different my experience would have been.
The very first thing I did when I found out I had cancer was set up a consult with a clinical dietitian, as well as a consult with my mental game coach.
I think this is something that most athletes can relate to, but I wanted to approach cancer the exact same way I would approach training for a huge race. I definitely had the immediate desire to "win" cancer, and I wanted to know that I was doing everything I could.
I had only been diagnosed with cancer for days and was already tired of the mixed messaging I was receiving about nutrition. Of course I had heard “cut out sugar completely” and “cure your cancer with Vitamin D/iodine/green tea” and “never eat or drink anything that brings you joy ever again.” I wanted to know what was actually evidence-based though, because that was important to me.
The verdict: sugar (glycogen) feeds ALL cells, so of course cancer cells also eat sugar. Depriving your body of sugar does not starve the cancer cells. Obviously for general health you should avoid excess sugar, but a zero carb diet is not going to cure your cancer, it’s just not.
Alcohol is a hard no, especially for estrogen positive cancer. I wish I knew what I know now about alcohol and how it’s a Stage 1 carcinogen (same as asbestos). I can’t say for certain that I would have done anything differently (no one expects the partying you do in your 20s and 30s to catch up to you before you’re 40), but I guess I wish I at least had the opportunity to make a more informed choice.
Cruciferous veggies bind free estrogen and eliminate it through your gut.
That’s it – that’s pretty much our understanding of foods and breast cancer. If I don’t have to sit through another lecture from a stranger about how I could have avoided a mastectomy by juicing and eliminating seed oils, I’ll be super happy.
Visiting with my mental game coach was also really important. What we talked about wasn’t much different from what I would have focused on before a big marathon: control the controllables, and visual outcomes. Controlling the controllables (attending the appointments, exercising, eating, sleeping) was all that I could really do. I couldn't control the biopsy results or what my surgeon would order next.
Visualizing how I would handle bad news was extremely helpful. At one point, I was asked to get a second biopsy. The initial biopsy indicated I had weakly estrogen positive Stage 0 DCIS (best case scenario). Because of the size of my tumor and the fact that I was only weakly estrogen positive, my surgeon was concerned I was actually triple negative (worst case scenario), and wanted to be sure. If I was triple negative, I would need chemo before my mastectomy. This was a huge blow because I had convinced myself leading into that appointment that I was just going to need a lumpectomy and some radiation.
Instead, the appointment quickly turned into: a lumpectomy is not feasible here, you should probably get a double mastectomy, and this could be way more serious than you thought.
I focused a lot on visualizing how I would receive the news that my cancer was triple negative, and how I would pull myself together to prepare for chemo. I told my family exactly how I wanted them to respond if I needed chemo. Instead of feeling sorry for me or telling me how awful chemo would be, I wanted them to respond by telling me how lucky I was that this surgeon was so thorough and did extra testing. I wanted to focus on the positives here, and that helped me a lot.
After that, there were many techniques I learned and use in my own running that I was able to directly apply to cancer:
Affirmations / “I am” statements
Affirmations are an important part of my training (and life in general), because the neuroscience is impressive. When we say, “I am,” our brain creates neural pathways that help us actualize the statements we are saying (https://www.mentalhealth.com/tools/science-of-affirmations). In training, I might say, “I am strong,” “I am resilient,” or “I am gritty.” In cancer, it was important for me to utilize this and say, “I am going to be cancer-free,” “I am handling this well,” “I am tough,” etc.
Positive Reframes
I use positive reframes often in my training. Common ones are, “if I am succeeding on a bad day, I’m going to be amazing on a good day,” or, “these challenging weather conditions are making me tougher,” or “tough training days make stronger athletes.” I tried to reframe what was happening in the same way. The additional testing (MRIs and biopsies) were really mentally difficult, but I reminded myself how lucky I was to be in a timeline where I had access to that technology. I told anyone who would listen how lucky I was that I found my cancer on accident. Finding a way to turn something negative into a positive was important for me. The more I repeated it, the more I was able to believe it.
When I talk about this, I inevitably hear something about toxic positivity. I think the difference is that I have the autonomy to say whatever I want to myself and it’s weird when people want to police my self-talk.
Mindful Language
You will never hear me say, “I’m so slow,” “I’m so out of shape,” “I’m bad at xyz.” Instead, you’ll hear, “I’m improving,” “My fitness is coming back,” “I’m putting in a lot of good work toward being able to do a pull-up post-mastectomy.” Again, what we say about ourselves can be self-fulfilling. It was important to me that I made certain distinctions when I talked about cancer. Instead of, “I have cancer,” I would make a point to say, “I have been diagnosed with cancer.” Instead of, “I have to have a bilateral mastectomy,” I would say, “My care team and I have decided a bilateral mastectomy is the best choice for me.” These changes may seem small, but they were important for my brain.
Energy Conservation
As a lifelong competitive runner, I’m very good at energy conservation. Some, like my husband, may even call it lazy. But, when you’re racing twice a week for years, you learn how to be comfortable staying off your feet. I treated the weeks before my mastectomy as time where I needed to be preparing myself for controlled trauma (i.e. like a marathon). I minimized my running so that I was doing enough to feel like I was getting a benefit, without adding extra stress that I needed to recover from. I carb-loaded for the surgery, and prepared everything I needed ahead of time: meals, clothes, work, boredom, etc. I’m very good at being comfortable with not being productive.
Maintaining Routine
Even though I wasn’t running as much, I was maintaining as much of my routine as possible for exercise. In the 6 weeks leading up to surgery I did the exact same track workout each week, because I could wrap my head around that. I maintained my normal exercise routine and started walking the day after surgery as a place holder. I didn’t go crazy, but I was able to walk 3 miles within a couple of weeks of surgery. Even just a walk around the block the day after surgery was helpful for getting me up and moving, and on the road to recovery.
Being Comfortable with Discomfort
I am extremely comfortable with mental and physical discomfort thanks to training. Each cancer experience had one particularly bad day.
For breast cancer, it was the day I had two scheduled biopsies: one for the tumor we already knew was malignant, and the other was an MRI-assisted biopsy of a new lump that was found. The first biopsy was difficult because it was aggressive, and included many more samples than the first one. I was bleeding, there was a lot of pressure, and I could feel more sharpness than I had anticipated. Breathing, counting, dissociating, and using all of my long tempo techniques got me through that. Then, during the MRI biopsy, my vein blew while they were injecting the dye. I had to be pulled out of the machine and was told not to move while they frantically tried to find a new vein. This biopsy involved 10 samples, and again, I was bleeding everywhere and was generally uncomfortable. It felt like a long progression run that becomes increasingly uncomfortable that you can’t escape. But, just like the long progression run, you know it will eventually be over. As soon as it was, I sobbed.
My thyroid biopsy was less physically traumatic, but I came to it with a lot of medical trauma. As soon as I was positioned and saw the same ceiling tile, I had a lot of flashbacks to my time being examined and getting biopsied. The sensation of having someone jostling around your neck, and the pressure associated with that, is uncomfortable. Since my nodule was on my pyramidal lobe and close to my windpipe, there was more of a sensation that the doctor was choking me while doing the biopsy. Something I am good at from years of training is telling my nervous system that I am safe, despite all signs pointing otherwise. This was one of those moments I had to call upon that training.
Boundary Setting
I’m very good at protecting my space, especially around races and training (not staying out late, going to bed when I know I need to, saying no). Although I have always been someone who doesn’t have a problem with direct communication, cancer certainly lowered my BS tolerance.
A week or so before my mastectomy, I had a hair appointment. I wanted to cut my hair so that it would be easier for me to manage while I didn’t have use of my arms. I was running around that day, and had a text that I was going to respond to later. It was not important. A couple of hours later, that person started sending me aggressive texts asking why I wasn’t responding, and saying she could see I was online. She then started making it about her and demanding I call her immediately to talk about me not responding. She wasn’t even someone I was close friends with. Before cancer, I entertained this behavior. I no longer do.
Failing Forward
You cannot have success in running without knowing how to fail. Period. Every failure is an opportunity to get better, to learn, and to grow. Cancer gives you the same opportunities.
In many ways, you can consider post-cancer life a rebirth. You have new perspectives, new goals, and a new sense of what’s really important in your life. Yes, we talk a lot about how difficult life is post-cancer, especially the transition from being in active treatment to survivorship. It IS difficult. It’s also an opportunity to start fresh, just like the start of a new training cycle is a new encapsulated opportunity to be your best athletic self. In many ways, the time spent in between doctor appointments (especially in survivorship when you are scheduled every 6 months to check for reoccurrences) feels like mini training cycles where you can focus on living your best life.
Goal Setting
Obviously, as a runner, I am used to goal setting. Big goals. Process goals. Daily goals. Mileage goals. These are all integral parts of the running experience.
Something I didn’t think I needed, but I’m very glad I did, was attend a post-cancer support group. Our main focus was goal setting for how we wanted to live our lives in survivorship. For many, it was healthier eating or exercise. For me, it was how I wanted to live differently.
My main goal: scrolling is not living. I worked toward setting healthier screen time goals, which is hard. I’m still starting and restarting. Getting cancer twice is scary, and I don’t want to waste the rest of my life glued to my phone when I could be doing cool things instead. Fortunately, even when I fail (getting cancer and needing surgery a second time was a huge set back for my screentime), I am good at picking myself up and starting over, just like I’ve been doing for the last 27 years, since there’s always a new goal to chase.
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