Hanging on to Fitness and a Few Strands of Hair Through Breast Cancer Treatment

I am a Medical Oncologist, a wife, a mother of 4, runner of 12 marathons training to run my 13th with a goal to qualify for Boston when the diagnosis of breast cancer caused a significant detour in my well-planned life. When I asked for guidance on how to continue to stay fit while receiving treatment, I received blank stares and found little data. While I never intended to be in this experiment, I find myself now generating my own data about fitness through the diagnosis and treatment of breast cancer. I am writing this in hopes to help others who find themselves in this same situation.


The Diagnosis

So much for pretending that I was fine for 3 more days. It was really not possible to pretend that I was fine. I was not fine. But I was trying hard to be fine. As if this would somehow influence the results of the biopsy, I googled things like “what is the differential diagnosis of a breast mass”. When I got this answer, “the majority of palpable breast masses are benign, but 10% of women who present with this finding will have a diagnosis of cancer” I temporarily felt better. But this temporary fix was indeed very temporary because it ended completely when I got the call from my primary care doctor later that evening. She said the preliminary biopsy results were back and it was breast cancer. So much for the uplifting google search. But at the same time, I was not surprised. The rational part of my brain that is also a well educated medical oncologist, knew that Dr. Google would need more information than just breast mass to give an accurate prediction about what to call the mass in my breast. If Dr. Google knew that the breast mass was in a 53 year old woman with a mother and grandmother who had a history of breast cancer, Dr. Google may have changed the odds that the mass was breast cancer. But now it doesn’t really matter what Dr. Google thinks it is, because there is no longer a differential diagnosis. There is now just one option and it is breast cancer. It is true. It is real. The line in the sand has been drawn and now there is no going back to my life before the breast cancer diagnosis. I knew that there was still a lot we needed to know before we knew what the treatment would be, but I knew that this was going to be a major disruption in my life. I was angry. Why was this happening? I really like my life right now. My running has never been better. I feel so healthy. I don’t know yet what the full treatment will be, but as an oncologist, I know that every aspect of treatment has risks and could change me forever. Surgery would at a minimum, result in a forced rest in order to allow tissues to heal. Chemotherapy, depending on the specifics, had the potential to result in permanent side effects such as heart and nerve damage. None of these things, if they happened, would help me run faster.

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