Kate is hair and clothes flowing, delicate voice, searching through bags filled with tissues, snacks, books, water, pens. She is ethereal, not quite of this world. She is reading poetry, surprising me with her voice. She is in my line of vision as I look up from my music, her face glowing under stage lights, as the final Amen of Handel’s Messiah rises.

Next to her, I am earth-bound and solid. I am laughing as we talk about Beowulf and the art (and science) of linguistics. I am spellbound by her voice reading poetry. I am thrilled beyond measure when she introduces me to a group of poets, “not a poet, but a beautifully poetic writer of prose.” I am heartbroken and in disbelief that she could no longer exist in this world.

This was what I posted on FB last week upon hearing of Kate’s death from breast cancer. And to that, I add other names from the last days and weeks.

Madonna, the beautiful Madonna. She was quiet grace, always gentle, always moving forward as we climbed Kilimanjaro. She was sharing a beer with her husband, tired but satisfied, smiling in my pictures. That is how I think of her, smiling. Next to her, I am coarse. I wish I had known her better, or at least longer. Madonna died of breast cancer three weeks ago.

Jody is light and strength. She is precise, she is articulate. She is advocate, she is leader. Jody is one of the founders of #BCSM – an online breast cancer community – tirelessly working to create something of value, and she has. She has just entered hospice care.

And so, I will launch into one of my periodic rants (rages). Here’s the thing about breast cancer, it can happen to anyone, it can kill anyone, and there is no cure, there is no “getting over” it.

Early detection is great, but it is not a cure. Estimates are that around 30% of people with breast cancer, no matter what stage, will develop metastatic breast cancer (MBC) – cancer that has spread to other parts of the body, where it kills.

Breast cancer can, and does return, no matter the stage at diagnosis. It can return 3, 4, 5, 12, 27 years later.

Positive thinking and a “will to live” are not a cure. It may help people feel better and enjoy their lives more, but it will not cure cancer. I guarantee that every person who has died of cancer really, really wanted to live.

Funny, or touching, or clever social media MEMEs do not cure cancer. Pink ribbons sure as hell don’t cure cancer. Nor do any of the feel good cancer campaigns.

What might? Research. Plain old, boring, slow-as-molasses research. That’s what might help. Targeted treatments for some types of cancer, which can seem practically miraculous to those of us who have been around a while, were developed out of years of painstaking research. But a useful treatment for one type of cancer does not necessarily mean it will help another. There is no one thing as cancer, so there will never be one “cure.” Each and every advance comes out of research. So if you want to do something useful, donate $$ to research – RESEARCH.

Don’t mindlessly give money to any organization without checking how they spend it – and this is true for any cancer! Is the money going toward research? Or is all the money going to make little ribbons?

“Awareness” campaigns don’t do anything to find effective treatments. And at least for breast cancer, are probably fairly unnecessary at this point – unless they’re targeted for underserved populations. A recent study pointed out continuing racial biases in pain management, and earlier studies show disparities in cancer diagnosis and treatment. There is also still little awareness of male breast cancer. Programs targeted populations which can still use some awareness are one thing, but really, middle-class white suburban women probably don’t need any more “awareness.” This is pointed mostly to breast cancer, but this does apply to other cancers. And that gets back to my previous point: if you want to do something useful in your grief, donate money to research.

Or go for a walk. Really. The American Cancer Society (in their 2012 Cancer Facts & Figures) estimates that a third of all cancer diagnoses in the U.S. are directly attributable to lack of moderate exercise and poor nutrition habits. And if you know someone who has or had cancer, take them for a walk. Based on various studies, breast cancer patients who exercised moderately had improved survival rates of 35-65%, depending on the study, the exact populations, and how is was measured. But benefits are not just for breast cancer, other cancers (colon, lung, prostate) have shown improvements also. But the results for these cancers are so strong that the AACR (American Association of Cancer Research) recommended that all cancer doctors should talk to all their patients about exercise, no matter what type of cancer.

Of course, exercise is no guarantee. I’m a perfect example – very physically active, and developed breast cancer in my 30s. And all of my friends listed above: Kate did yoga, Madonna walked/ran/climbed Kili(!), and Jody loved to walk and cycle. But statistically, we’re the outliers. Statistically, you improve your health, and your friend’s, if you go for a walk regularly (or cycle, or dance, or swim, or skip).

So go for a walk. And support research. Because I’m so damn tired of writing memories.

And enjoy your friends while you can, because that’s so much more satisfying than writing remembrances.


Posted in #BCSM, Above and Beyond Cancer, benefits of exercise, cancer prevention, cancer research, exercise and breast cancer, exercise and cancer | Leave a comment

Enjoy….true confessions

Today’s Life-Cise Daily Tip is “Enjoy yourself!” It’s a phrase I’ve been thinking about a lot lately. And it’s an idea I’ve been experimenting with in my own workouts.

You know me – I’m a pretty driven, intense exerciser most of the time. Don’t get me wrong, I enjoy it, that’s partly why I do it.

But over the last year, I’ve fallen more and more into an exercise funk. Between family obligations, work, weather, little injuries, I fell off my training again and again. I gave up on various big races I had planned. And then started giving up on small races. It made sense at the time. Training for an ultramarathon (or any big race) takes a big committment – of time, of energy, of focus. And I just didn’t have that focus.

It was a good move. I think my body needed a break after several years of pretty constant training. And my mind definitely did.

But once out of the habit, it is so hard to get back into it. A lot of people have expressed surprise that I know anything about that…Of course I do. Everyone does. Or anyone who’s honest does – athletes, trainers, the most Type A person you’ve ever met.

As I’ve struggled to get back into the habit, I get easily derailed. Two weeks of regular exercise, and then I have a busy week or I fly out to see my parents or I’m just tired, and then it’s just easier to not go out for a run – “I’ll run tomorrow.”

But I’m trying something new. I’m putting all the training plans, the gadgets – the heart rate monitors, the GPS, the clock, the calculations – away. I’m concentrating instead on why I’ve always loved being fit – being outdoors, enjoying the way my body moves, seeing interesting things.

It started while I was down in Brazil at the beginning of the year (I was there for a writing retreat with my writing teacher). Fantastic trip! But I didn’t get as much exercise as I had planned. It was way too hot and humid, I was unsure of where to run that would be safe, and didn’t want to get lost since my Portuguese is VERY limited. But I walked. A lot. And when I got to the fishing village where I stayed for several days, I swam in the ocean every day, I ran barefoot on the beach. I don’t know how far I ran or swam. I don’t know how fast. I just ran and swam.

It was fun.


(my gym for a few days)

And since I’ve been back, I’ve tried to keep that same feeling. I’m not thinking about miles I need to cover if I want to race again. I’m not thinking about how much fitness I’ve lost, how fast or far I used to be able to run. I’m not thinking about my heart rate, my pace, my anything. Just fun. I’ve been hiking with friends. I’ve cross country skied in the blizzard. I’ve been running in the woods. My only thought is how my body feels and what I’m seeing around me. I’ve gone old school, back to what got me out and exercising in the first place – it’s a beautiful (or windy, or snowy, or sunny) day, let’s go out and play.

And it’s working. I’m getting out more regularly. I’m looking forward to it again. My body is starting to feel better. It’s making me happy. Enjoy!

IMG_1739IMG_1744 IMG_1746 (bobcat tracks, spotted on a recent trail run)


(Oh, and the writing went really well in Brazil – got tons of good work done! And if you’re in Iowa, or have access, one of my essays has just been published in The Examined Life, the literary journal of the University of Iowa Carver College of Medicine.)

Posted in beginning exercise program, benefits of exercise, exercise is fun, exercise while traveling, expectations, fun, goals, The Examined Life Journal, trail running, training, Uncategorized | 3 Comments

Step By Step Into The New Year

In the closing hours of 2015, I want to share my parents with you. Many of you have met them before on these posts: I’ve written about my mom doing pushups, my dad riding and adventuring, and both of them helping me out on my first 100M trail race.

Mom had hip surgery just before Thanksgiving – a re-do from hip surgery 2 years ago (really wonder if many docs keep track of their later failures). Because it was a re-do, it was a more complicated surgery. She was no weight-bearing on that leg for minimum 6 weeks. I went out for Thanksgiving, and stayed for a bit to help out. I was there when she was released from the re-hab facility, and helped to get her settled at home, just in time for Thanksgiving. She was able to get around a little, with a walker, putting no weight on her leg – not easy! Through this process she showed, once again, a great example of diligence and patience.

You may remember her from earlier posts, about how I taught her to do pushups at age 70. She started off doing easy wall pushups, and gradually progressed to incline, and then modified pushups on the floor. But she didn’t stop there. She kept building her strength until she could do full pushups – a lot of them.

In recent years, she’d fallen off of pushups because of pain in her hips. But she had learned the importance of upper body strength for daily tasks, so she still kept in pretty good shape. And that strength paid off with this surgery! Not only did it help her overall recovery, but her solid upper body strength made her rehab possible. Before she could be released from the rehab facility, she had to be able to get in/out of a chair/bed easily. She had to be able to get into the shower, transferring from the walker to the shower bench. She had to be steady as she scooted along with her walker. All of this was completely dependent on her upper body strength. All the PTs were amazed at how easily this little 78 year old could pull and push herself around so quickly after major surgery.

Once she was home, she kept up her hard work. She did her exercises with care and regularity – the PTs quickly got bored with her because they didn’t have anything to correct. And she walked. Every day. She went slowly and carefully. She didn’t overdo it. But she pushed herself. Each day she tried to go just a little farther, even if just a few steps.


And all the while, she was helped out by my dad. He watched over her, helped with whatever he could. He helped get her in and out of bed/shower/car. He ran errands, he cooked, he cleaned.

Caregiving is hard work! It’s easy to get so busy with caregiving that people forget about their own self-care. But Dad worked on that. Almost every day (we did miss a few), he got down to the pool or the gym and did his own exercise. Not always his full exercise, sometimes there just wasn’t time. But he would do something. He walked on the treadmill, plus I gave him some new strength and balance work – made sure he kept up the strength necessary for caregiving.

They both were models of all the things I stress in my training: diligence, patience, gradual progression. Well done Mom and Dad!

So, in these closing hours and into the new year, I hold both of them up as great examples for all of us to emulate.


May your New Year be healthy and strong!


Posted in pushups, strength training, upper body exercise | 1 Comment

Love overcomes evil ~ Eagles of Death Metal

In light of the events of the past couple of weeks, I’m going to step away from fitness and cancer for a moment. This blog is not a political or morality blog; it’s about fitness and cancer. But today I’ll stick my toes outside of my normal circle because it’s been impossible not to be thinking about and deeply troubled by recent events and reactions.

Last week I had been working on an essay about, in part, the weeks and months after 9/11. For a few days, I had been steeped in memories of terror and the goodness that arose from it. And then I turned on the TV to watch The NewsHour while I ate dinner. Images in real time flashed in front of me – my beloved Paris, awash in sirens and blood and fear. Of course, it’s not just Paris that I mourned. It’s also Syria, Lebanon, Russia’s plane, Nigeria, Mali, and the list goes on.

And then there was the expected backlash, but this time so much angrier than before. I have been ashamed of some of the hate-filled comments, which, to my ears, sound no different from the terrorists’ words.

I have no solutions, no answers for the big problems of the world. I have only a broken heart and sincere prayers for peace and comfort.

Instead of going further down this road, I want to veer onto another path. I want to turn to what’s close at hand. In the same way I think about fitness – taking small steps, making small changes, improving our bodies and lives with our choices – I would offer that one way to respond to chaos in the world is to look closely at ourselves and take the small steps that could make real improvement around us. Instead of shouting about hatred, try actually helping someone – especially someone who’s not just like you.

But that’s just naive, why-can’t-we-all-just-get-along crap, you’re probably thinking. Yes, of course it is. It’s not going to fix the world. But perhaps, it might make a tiny corner of it just a little better. Perhaps instead of shouting about how the government has to close our borders and kick people out (talk which can only be called hypocritical in a country which is completely made up of immigrants), some people could actually do something useful, like volunteer at a soup kitchen in their town, donate clothing to homeless vets, feed hungry families, teach people how to read, clean up a local park so others can enjoy it, volunteer to clean up or rebuild synagogues, churches and mosques when they are damaged or destroyed by our own local terrorists (because a whole lot of heartbreak and damage in this country is caused not by radical Muslims, but by terrorists who are angry white men).

No, none of these actions will “cure” terrorism. Like with cancer, taking small steps like going for a walk will not “cure” the disease. But, done regularly, it will help you feel better in the short term, and studies show it may improve your survival longterm. There’s so much that we cannot control, in the world and in our own bodies, but we can take control of the things that we can change, and take concrete actions which can improve things a little bit. And a little bit is better than none. And sometimes adds up to big improvements.

A couple years ago, when I was running a 4-day stage race in the Indian Himalayas, I had the pleasure of meeting a man who exemplifies what I’m talking about. My friend Shreekanth was always looking around him for ways to make the world just a little better. He approached each day with gratitude for all the good things in his life. And each day, he strove to take small actions that made the world or someone a little better. I wrote a post about all the runners – their strengths, and what I learned from each of them. He’s been on my mind a lot this last week. No, his approach will not fix the whole world, but it certainly won’t hurt it.

You can read the whole post here. But the following is an excerpt – meet my friend Shreekanth.

~Shreekanth: the oldest among us, from Mumbai. Shreekanth was consistently last. He was also consistently the gentlest and happiest of us. Whether he was running or walking, fresh or tired, Shreekanth had a smile on his face. He approached each run with gratitude. It gave me great pleasure knowing that, no matter how slow or tired I may be, Shreekanth was somewhere behind me, smiling and taking in all the beauty around him. And along the way, he picked up trash. Each day he would come in and empty out his pack of other people’s garbage. Spurred on by his example, we all began to pick up trash along our runs. He cared nothing for his race time, only that he enjoyed his time racing, and that he left the world a little better, a little cleaner than it had been.

Although I would like to be a better, faster runner, and want to learn what lessons I can from these other runners, the person I wish to emulate most is Shreekanth. I wish we all could be a little more like Shreekanth – grateful for every moment, and doing our best to make the world just a little better than we found it.

Be good to each other. Make the world better. Or at least don’t make it worse.




Posted in Uncategorized | 3 Comments

No, It’s Not a Pink Ribbon

Julie – yup, me. For this last day of October, the last day of my own little breast cancer names project, I name me. Because I’m 14 1/2 years from diagnosis (and still counting) and still have No Evidence of Disease. Because although most people think of me as “cured,” I can never take my good health for granted. Because every single day I am grateful to be alive and still be healthy – every single day. Because breast cancer can and does come back, no matter the stage at diagnosis, no matter whether it was found early, no matter how many years have passed. Because far too many people I have known with this disease have died. Because I’m tired of saying goodbye. Because “awareness” is not a cure. Because scars are not cute or sexy. Because breast cancer is most definitely ‪#‎notapinkribbon‬.

This is how I chose to end my October campaign, with myself. All month long, I’ve been posting names of people I know or have known with breast cancer. The first half of the month were names of people who have dies. Then I transitioned into names of people living with the disease, most of whom are living with Metastatic Breast Cancer – breast cancer which has spread to other parts of the body. But even for those of us who are not Stage 4 or Metastatic, breast cancer is part of our lives forever. We live with the knowledge that our cancer can come back at any time. Early detection or early stage is good, but does not guarantee we will remain cancer-free. Many of the people I named had their cancer come back after 10, 15, 16 years or more. Many of the people whose cancer spread were initially diagnosed with early stage disease.

We still need awareness. We still do need to improve awareness and access to screening for certain populations in this country. We do not all start on a level field. Poor women, minorities, and men could still use better awareness and better access to screening and care. Unfortunately, most of the big awareness campaigns do not target the groups who really need it. Too many are aimed at middle class white folks – just preaching to the choir. But most importantly, we lose track of the fact that awareness is not a cure.

And this is why I started listing names throughout the month of October. “Awareness” is not enough. Early detection is not enough. We are learning more and more that the type of breast cancer, the individual makeup of the cancer cells, is perhaps a more important measure of who survives. And to learn more, we need research.

Throughout the month, I’ve gotten a lot of comments from people. Some have asked to add names to my list. Some have started their own list. Many people have thanked me, and even more have offered hugs. Thinking about friends and colleagues who have died or are living with Metastatic BC every day does sadden me. And it angers me. But unexpectedly, I have also enjoyed it at times. I’ve thought about people I hadn’t for a while. Memories of them have made me smile. I’ve seen examples of tremendous beauty and grace from some of them. I have learned important things from them.

To everyone on my list, and so many more, thank you for enriching my life, even for a little while.

To everyone else, these are the names of breast cancer. We are not pink ribbons. We are not pink confetti or streamers. We are not “boobies” or “ta-tas,” with or without bras. We are people, women and men, with names, with faces, with families, with friends. Please keep us in mind. We are #notapinkribbon.



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Oh Grow Up! This Is Not A Joke.

Today, October 13, is Metastatic Breast Cancer Awareness Day. It’s one day during all the “festivities” of breast cancer awareness month which is dedicated to raising awareness of Metastatic disease, or METS.

But someone had the idea to overlay another day on the day. Someone had the idea to make today No Bra Day – supposedly to raise awareness of breast cancer. As if there is anyone in this country who is not aware by now that breast cancer exists. So instead of focusing on Metastatic Breast Cancer, MBC, people are posting pictures of young, bra-less babes (and a few are posting pics of their mastectomy scars).

A friend recently asked me to explain why I’m so angry about all the pink crap that has gotten associated with breast cancer. This, this is why I’m so angry.

Even if the organizers of No Bra Day had good intentions (and I seriously question that), it is hard to believe that anyone or any group could be so massively insensitive to the losses of those of us who have suffered from breast cancer. We are mutilated to save our lives. We are amputated. So I am angry to see a bunch of perky tits used to talk about my disease. It’s insulting, inappropriate, and puts the focus on exactly the wrong thing. So stop acting like a bunch of horny adolescents and grow up!

Any awareness of any disease ought to be about the lives of those who are affected.

And somehow, breast cancer seems to be the only cancer that gets this kind of prurient attention. I don’t see the same kind of inappropriate campaigns for lung cancer or testicular cancer. I can’t imagine anyone ever thinking it would be acceptable to start a campaign to raise awareness for childhood cancers by using the hashtag #noneedforbabysittersanymore! Because that would be outrageously insensitive.

So why does anyone think it’s OK to do something similar for breast cancer? And especially on the one day that’s set aside to focus on Metastatic Breast Cancer.

What is MBC? It’s breast cancer which has spread to other parts of the body. No one dies from cancer cells in breast tissue. They die when the cancer migrates to other, vital parts of the body. Once that happens, the cancer is incurable. Women (and men) with MBC can live many years, sometimes with a high quality of life, but their cancer can never be cured. Their treatments can only help to manage and slow their cancer. Typically, they’ll find a drug which is somewhat effective, and take that until their cancer cells find a way around the drug and it is no longer effective. Then they’ll try other drugs, searching for something else which will give them a little more time. In that way, they’ll work their way through the various drugs available, each time hoping that’s the drug that will stay effective.

Unfortunately, we don’t have a very good idea of who will become metastatic. Estimates are that 20-30% of people diagnosed with breast cancer, even early stage BC, will become metastatic. And we have little information of who that will be.

Which is why I’m tired of “awareness.” Which is why more money needs to be spent on research. Which is why I spend a lot of October feeling angry. Which is why I’ve been posting names every day of people I’ve known who have died from Metastatic Breast Cancer, and why the second half of the month will be names of people living with MBC. Because the focus needs to be on the women and men. Because breast cancer is not about tits. Because breast cancer is about lives. It is not fun. It is not sexy. It is not a joke.


If you’d like more information on MBC, please visit, or check out #BCSM on Facebook or Twitter.


Posted in Uncategorized | Leave a comment

It’s Not a Pink Ribbon!

It’s October. For months now I’ve been receiving emails alerting me to another “exciting, important event for breast cancer awareness,” which are so often just self-serving promotions, insensitive, or insulting. I’ve ignored them all. I have my own plan for October.

Every day of this month, along with Daily Tips, I will be posting names to my social media accounts. They will be names of women and men I have known personally who have died or are still living with breast cancer. The first half of the month, I will post names of people who died. The second half will be people who are living with metastatic cancer – people who’s breast cancer has spread. Today: Rosalyn #notapinkribbon.

Some people may find this kind of dark. Some may think I should be encouraging hope. Most of you know that I’m all about feeling as good as possible, and making the most of our bodies, no matter any limitations. But I also feel the need to reel in the hoopla surrounding breast cancer and October. In my own tiny way, I want to remind people that breast cancer is not just a pink ribbon, or a race, or a funny video. Breast cancer is thousands of lives.

Breast cancer is not “the good kind of cancer,” it is not a cold that you get and get over. It’s a disease that still kills far too many of us, and stays with those of us who haven’t died – in a thousand ways, every single day.

So, please, keep the people, the lives, in mind this month. Don’t just mindlessly repost funny/sad/touching pictures of pink ribbons/balloons/shirts/whatever. Don’t just mindlessly buy some product because it’s sporting a pink ribbon. Look at what they’re actually supporting (or are they truly supporting anything?). Pay attention to where the money goes if you donate – and that holds true for any cause!

And if you really want to do something useful for someone with breast cancer, cook a meal, drive her/him to doc appointments, take them out for a walk!


Posted in breast cancer, breast cancer awareness month | 1 Comment

Hello, I’ve missed you

First, I want to say thank you to the many people who reached out to me after the last Life-Cise newsletter. I stepped away from the computer (mostly) for a little while – no newsletters, no blog posts, no Daily Tips. I needed to help my parents move, work on my own projects, and just regroup. Part of that was the weird feeling of churning out material and never really knowing if it matters to anyone – hello, is anybody out there?? So it was very gratifying to when many of you responded to the newsletter explaining my absence with a big “Welcome back, we’ve missed you.”  Thank you!

I did have a little glitch in sending out Daily Tips last week because I was camping and had zero cell service. Of course, that’s not a terrible thing – getting offline is actually a good thing. And the hiking was fantastic!


I met up with a friend in the Adirondacks, which are like home to my soul. The fiIMG_2824rst afternoon’s walk, after we got our camp set up, brought us upon fairly fresh moose tracks. Since moose are not to be trifled with, we kept a close eye out. But it was good to see signs of the animals. And good to get out into the woods I love and say, “hello, I’ve missed you.”

Hikes over the next couple of days were beautiful, steep, and super fun. Our last hike was more of rock scramble than hike, and reminded me I need to get back to rock climbing.







It was a great trip, but almost didn’t happen. My friend and I talked a couple of days before our trip. Neither of us were particularly enthusiastic – we both wanted to just stay home, plenty of things to do at home, a long drive for just a few days, not in great shape, foot hurting, blah, blah, blah. But we talked ourselves back into it, and were so happy we did.

It’s so easy to find reasons not to do things – hike, travel, even daily exercise. We, or rather I, often want perfect or best, and miss out on good enough. Yes, it’s a long drive for just a few days. It would be so much better to have a full week. But a few days is what we had. Because of injuries and schedules, neither of us was in as great shape as we would have liked. The trip would have no epic, 15-mile, rough hikes like we’ve done in the past. But the trip did have some beautiful hikes. It may not have been perfect, it may not have been exactly what we hoped it would be, but the trip got us out into the wilds for a little bit. And a little bit is better than none.


Nature spontaneously keeps us well. Do not resist her! ~ Henry David Thoreau



Posted in adventure, attitude, hiking, motivation, nature, Uncategorized | Leave a comment

Protect Yourself from Germs? – Get Moving!

Labor Day is over, summer has ended (even if it doesn’t feel like it here in the Northeast). Vacations are done, kids are getting back to school, and now cold and flu season approaches. With kids and adults exposed to all kinds of germs in school rooms and offices, every sniffle and cough sends many people racing for the vitamins. There are two other things, however, that all of us can do to give our immune systems a little boost: exercise and relax.

Moderate exercise is linked with a boost to the immune system. The boost is short-term; it may only last for a few hours after exercise. However, the effect is cumulative, so regular exercise can prolong the boost (Nieman, “Moderate Exercise Boosts The Immune System, Too Much Exercise Can Have the Opposite Effect,” ACSM Health and Fitness Journal, Sept/Oct 97) .

In the cancer field, we’ve known for a few years now that exercise can help boost the immune system of people going through chemotherapy. Studies have shown that moderate exercise reduces the number of infections and hospitalizations during treatment, as well as helping the immune systems of exercisers bounce back faster after treatment is finished (various studies by Mastro, Courneya, Byne, and others).

Some of that research had just started being published back when I was going through cancer treatment, but few doctors were paying attention. So many people and books said I had to be so careful about exposure to germs because of my weakened immune system that I wondered if I would be able to go to the gym or even to the store. I had to ask my oncologist if I was allowed to exercise at the gym with all those sweaty, potentially sick people. Luckily, all my doctors told me I could – I just needed to call them if I did get sick (they were far more concerned with my cancer than a cold). I exercised regularly at the gym and pool, and didn’t get sick – except for Lyme disease the following summer during a later round of chemo. And within a couple of years, more studies came out which backed up the benefits of moderate exercise during cancer treatments.

Well, what’s good for cancer patients is also good for everyone else. A major study published in the British Journal of Sports Medicine in 2010 found that adults who exercise moderately 5 times per week had about a 45% lower chance of getting a cold. And if they did get sick, the exercisers had less severe symptoms.

It’s not clear exactly how exercise boosts the immune system, but researchers have a few ideas. The temporary rise in body temperature may inhibit bacterial growth, or the activity may help flush bacteria from the lungs. Exercise sends antibodies and white blood cells through the body, and also reduces the release of stress-related hormones. Stress lowers our immunity, making us more susceptible to colds and flu, so physical activity could reverse this (National Institutes of Health, Exercise and Immunity).

This may seem counter-intuitive. It might seem like the smart option is to rest if you are concerned about your immune system. But it turns out that the best thing for protecting yourself from a nasty cold or flu might just be to get moving. The key, as with so many things, is moderation. In your newfound enthusiasm, don’t suddenly jump in and exhaust yourself with a super-intense, 3-hour workout to knock out a cold – very intense exercise can actually cause a slight dip in immune function, which is why endurance athletes are sometimes susceptible to colds after a major endurance race (Nieman, ACSM Health and Fitness Journal, Sept/Oct 97).

And relax a little. Stress lowers our immunity. Regular exercise is a great tool in managing and reducing stress, which is always good. But also, try to take a few minutes each day to relax – whatever way works for you. Take a quiet bath after the kids have gone to bed, sit quietly in your car for 5 minutes before heading in to work, turn off your phone and computer for just 10 minutes. Or just go for a walk. That way, you’ll relax and get a little moderate exercise.


Posted in chemo, chemotherapy, cold and flu, exercise and chemotherapy, exercise and immune function, immune system | 1 Comment

The Long Goodbye

Earlier today, I reached the end of an era. My oncologist said he didn’t think he needed to see me anymore. Well, actually, he asked how I felt about it, then we talked about it. And then it was decided: after 14 years, I am done with oncology followup.

We had already spent the exam talking about running, skiing, diving, and other exercise. So I said thank you – a lot of thank you’s. He gave me a last stern reminder about keeping vigilant, making sure I get colonoscopies (yes, got mine last year, I’ll get another in 7). And then I was out in the afternoon sun, fighting back tears.

I went to buy new running shoes, and stood in the running shop crying. The sales guy politely gave me my space, and then I got busy trying shoes. I couldn’t think of a better thing to do after the doc news. Exercise, and particularly running, has been such an important part of my recovery and cancer experience. No, I will not say that exercise is what saved me – no way of ever knowing that, just like there’s no way of ever knowing why I got breast cancer in the first place. But it’s been so important to me, especially during some of the darkest times. Exercise kept me feeling good about my body, helped clear my head, kept me engaged with my body and my life in a positive way. There is no way to overstate how important it has been. So buying new running shoes seemed a perfect fit.

We’ve spent a lot of years together – this is the second longest relationship I’ve had with a man. Fourteen years is a long time. I know a lot of people find it surprising that I have still been seeing my oncologist. This is just one example of how we’re all different. Just because you’ve known someone who had cancer, doesn’t mean that Uncle Jack’s, or your neighbor’s cancer treatment regimen has anything to do with mine or anyone else’s. Because of the high number of positive lymph nodes and therefore my high risk of recurrence, I continued seeing my oncologist for followup. And then there were ongoing hormonal treatments. And then there was a drug trial. And followup from the trial. And now we’ve been hanging out together for 14 years.

He was, in part, the reason I kept exercising. Back in 2001, absolutely no one talked about exercise and cancer. When I asked if I was allowed to exercise, he told me yes, but I might not be able to always keep up the same intensity. He made me promise to not rock climb during chemo (risk of infection if I scraped my hands), but told me to just listen to my body – push myself when I felt I could, rest when I needed it. Aside from any medical care, that piece of advice alone was enough to change my life. and remember, this was at a time when no one cared about exercise for cancer patients. (I’ll point out here that sadly there are still too many doctors who, despite huge amounts of evidence about the benefits of regular moderate exercise, still think their patients only need their drugs and a nap on the couch.)

He was one of the reasons I became the patient I was. He always encouraged me to do my research, and make informed decisions. He made sure I understood my risks of recurrence, and the risks of any treatments. Sometimes he was kind of a drag. At my 2 year, and again at my 5 year mark – landmarks that most people consider really important – he reminded me that, while it was great I had made it that far, I still had an “uncomfortably high risk of recurrence.” See? – a bit of a drag. But that’s what I wanted – the truth. That’s what I always loved and respected – the truth. If I don’t know the truth, how can I make a good choice?

And so, here we are at 14 years, saying goodbye. It’s kind of bittersweet. It’s good. I mean, there was a time when I thought I would be with him until I died. I haven’t died, and we’re able to part. That’s good.

But it’s also weird. I’m not really sure what to make of it. On one hand, it’s just one less appointment every year, one less blood draw. It doesn’t change my risk of recurrence (which is less with the passage of healthy time, but will never disappear). It doesn’t change anything except my schedule.

On the other hand, it feels pretty significant. I cried a lot today. Buying shoes, driving home, picking lettuce in my garden….I’m happy, I’m sad, I feel the weight of 14 years of cancer, I feel the loss of too many people. And I feel grateful.

So I don’t really know what to make of it yet. I bought running shoes. I came home and did some laundry and cleaned the bathroom because life goes on. That’s the whole point of surviving, isn’t it? That life goes on. Maybe eventually I’ll figure out what this milestone means. In the mean time, I’ll do some pushups. Because I can.

Thank you, PK, for all the time you’ve given me.


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