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What Athletes Should Know About Cancer

When I’m not running, I’m an oncology nurse and cancer recovery coach. Athletes (and many health-conscious people) are usually great examples to others. We take care of our health better than most, we get plenty of physical activity, don’t gain unhealthy amounts of weight, tend to balance our lives, and have more positive attitudes.

We go outdoors, have more energy, and avoid unhealthy habits like sitting in front of the TV eating garbage. We set goals and achieve them, see the country and the world, and know how to have a good time.

If I had a dollar for every time I’ve heard from a patient diagnosed with cancer, “I don’t understand how I got cancer. I ate organic foods, had a perfect diet, exercised, never smoked, avoided toxins, managed my stress…why did this happen to me?”… all those dollars would do wonders for my race bucket list.

Based on our current state of scientific understanding, we cannot absolutely prevent most cancers. Certainly there is a ton of evidence that exercise and healthy living can help you avoid chronic disease and make you more likely to live a healthier, more independent life into old age.

I’m not saying it’s futile, or you should give up, sit on the couch and eat trash out of bag until you roll onto the floor in a sugar coma. I do want you to understand that being an athlete will not absolutely protect you.

We don’t do a very good job of educating the public about a disease that is likely to strike somewhere between one-third and one-half of us during our lifetimes. There’s a lot of misinformation, and that can lead to completely over-the-top, irrational fear at the mention of the word “cancer”.

What cancer is

To make it as simple as possible, cancer is a wide range of diseases with a common characteristic: something goes wrong in the way the cells regulate growth, and results in uncontrolled cell growth. It happens deep in the cell at the molecular level, in the cell’s genetic material.

Cancer is not one disease, so there is no such thing as a single cure for cancer.

There are hundreds of different varieties of cancer, they all behave differently. That’s why they are all treated differently. What one person gets for cancer treatment can be completely different than what another person gets for cancer, even if their cancers started in the same part of the body.

Many people still equate cancer with death, and our society is in extreme denial when it comes to facing our mortality. Athletes (and health-conscious people) often trick themselves into thinking their sport, activities, or diet will give them immunity. Sorry to break the news, but your running shoes, kale and chia seeds won’t protect you.

But the good news is, athletes and healthy people are gifted with qualities that will often help them get through treatment and recover in a lot better shape than those who neglect their overall health. Determination, endurance, positive attitude, willingness to tolerate discomfort, and overall physical fitness are key qualities that can help achieve good outcomes during and after cancer treatment.

Fear and Judgment

Anyone can develop cancer, and it doesn’t mean you did something wrong. From what we know now, evidence seems to show that other than hereditary risk (mutations passed down in your family), and certain exposures and behaviors we know that are associated with cancer (like asbestos or smoking), it’s still pretty unpredictable. The older you get, the more likely it is that you will have it, and you might not even know it. Sometimes you might not even have to do anything about it but watch it, and it won’t kill you.

Unfortunately, cancer can kill people, but not nearly as often as it used to. Sometimes it’s bad luck- some people’s cancers are undetectable until a very late stage. Don’t assume it’s the person’s fault for not getting screened. It’s important not to judge.

No one is saying you shouldn’t fear something that is potentially life-threatening. But a little knowledge goes a long way- in terms of early detection, managing anxiety, and coping in case it does happen to you or someone you care about.

Cancer concepts and misconceptions

  1. Prevention. People confuse screening and early detection efforts with prevention. You really can’t completely prevent most cancers, with what we know now. Mammograms, pap smears, and colonoscopies don’t prevent cancer. They screen for it in hopes that it will be detected early enough to be treatable. By taking care of yourself, eating right and exercising, what you are really doing is reducing the risk, or likelihood, that you will develop cancer. Risk is based on statistics in the general population.
  2. Early detection and screening. Squeamish is no excuse. For example, suck it up (no pun intended) and get a colonoscopy. Don’t be so vain…believe me, they’ve seen plenty of butts, yours is no big deal. You won’t remember it, and I promise you they won’t remember what yours looked like either, even if you run into your GI doctor on the street.
  3. Know your family history. If anyone in your family has cancer, let your doctor know. This is reason enough to make sure you do your screenings. If several people in your family have cancer, ask your doctor about genetic counseling. Really. It doesn’t hurt one bit and it might save your life or someone else’s in your family. (Counseling first, never jump into testing)
  4. Learn about it- from the right sources. The National Cancer Institute (NCI) is a good place to start. Don’t ask Dr. Google.
  5. Use caution when reading online or ads. Here’s a great place to visit if you have questions about a study or claim you read: http://healthnewsreview.org Anything that says, “a study” showed… One study is not a body of evidence. Studies need to be repeated, on large numbers of people, put through rigorous trials on humans under strict conditions, study conditions and findings examined for bias by experts, and published in peer-reviewed scientific journals.

Know how to support someone who is diagnosed

For an athlete diagnosed with cancer, the decision to tell others is difficult. They are afraid enough for their life, not to mention losing their friends, their sport, and their social network around it.

When they do tell others, the lay experts come out of the woodwork like termites- suddenly everyone becomes an armchair oncology expert, especially when it comes to nutrition. Resist the urge to become one.

Don’ts

  1. Don’t tell them about alternative treatments that you’ve heard of, or that you read somewhere about a study that showed some type of special juice cured cancer. Their LIFE is at stake here. If we knew the juice cured cancer, we’d all be drinking it.
  2. Don’t imply that they did something to cause their cancer. Don’t try to figure out why. You’ll come off as contemptful or judgmental, not to mention what this does to your friend with cancer who is already overwhelmed.
  3. Don’t freak out, look up statistics on their type of cancer, or give them information off the Internet. Let their doctors practice medicine and do what they do best- treat cancer. It might be hard to put yourself in their shoes, but try. If you had cancer, wouldn’t you want to choose the treatment that had the most evidence for success and rely on experts who have been trained specifically in treating cancer?
  4. Don’t make assumptions, no matter how well-meaning you are, that they can “beat” cancer, or tell them they are a “fighter”. Some people don’t want to hear this. If they do, then great, give them the kind of support they want. Ask them what they want, first.
  5. If someone is being treated for cancer, don’t recommend supplements or antioxidants to them. The chemotherapy is intended to kill cells, and that’s what you want to do in the case of cancer. You want oxidative stress and free radicals. Antioxidants can counteract the chemotherapy. Let the doctors practice medicine, you can practice being a friend.
  6. If they are getting chemo, don’t give them fresh fruits or vegetables, fresh flowers or plants, expose them to pets or sick kids, or go to see them if you’re sick. Their immune system is going to be weak until after they recover from chemo. This is not the time to bring them kale and chia smoothies unless they want it and their cancer doctors say it’s okay.

Dos

  1. Go here and click on the body parts to get some basic tips on supporting someone with cancer.
  2. If you’re finding yourself so freaked out by your friend who has cancer, examine your own reasons for your freak out. Do you have some of your own issues that are unresolved? Maybe this is a chance for you to get some counseling for yourself so you can give better support to the person with cancer.
  3. Remember, it’s not about you. THEY have cancer, not you. You have your health. Use the abundant energy that you were blessed with to help them. Do some footwork, offer to do laundry, errands, things they don’t have the energy for. Walk the dog, clean the yard, shovel snow. Use some of your own precious training time to do something for them. That shows you care.

If you are diagnosed- it doesn’t automatically mean the end of your athletic career.

  1. First, you’re going to panic. That’s normal. But I’m going to tell you this, as hard as it is, as an athlete, you need to take your lifestyle into consideration when talking with your doctors.
  2. Even though your first impulse might be: “Cut it out of me and get it over with!”, what you do and how you approach surgery and treatment decisions can make a big impact on your ability to recover and resume your sport, and your comfort in doing so. Take your time, it will be worth it in the long run.
  3. Don’t be pressured into choosing any one method of treatment. Make sure you ask the doctor how it will impact participation in your sport, and at the level you hope to achieve. Get a second opinion if you’re not convinced it’s right for you. If you can find a doctor who is an athlete, that’s even better.
  4. Cancer is very rarely an immediate life-threatening emergency. You should take the time to discuss any decisions with your oncologists, breast surgeons, urologist, plastic surgeons, radiation oncologist, or anyone else in your care. For example: certain breast reconstruction methods may be better for some athletes than others. Or if you use your upper body a lot in your sport, make sure your doctor understands how important your sport is to you.
  5. The approach with radiation treatment, which chemotherapy they use, the type of surgery, and any reconstruction can sometimes make an impact on your ability to return to and recover your ability to do your sport. For example, prostate cancer treatments can impact your comfort in returning to running and other activities because of urinary leakage. Ask what you can expect to experience after treatment.
  6. Depending on what type of cancer it is, you might need some combination of surgery, chemotherapy, radiation, or other treatments. It’s not easy, it’s not fun, and it takes time. Athletes are known for not giving up, for having endurance, and believing in themselves. You can use these mental skills in coping with cancer treatment and recovery, plus the determination to come back.
  7. Athletes also start out in better health than most patients giving them an edge. They are also more likely to be able to continue some form of exercise during treatment, which helps them throughout the process and in recovering faster.

It’s not over when it’s over, so don’t forget support afterwards

  1. After cancer treatment it can take a lot of time and effort to recover. While athletes have an advantage, there is still a lot of physical, emotional, and even social recovery for athletes with cancer.
  2. After treatment they have to regain their strength and fitness. They might be anemic, have lost muscle mass, or range of motion. They can feel abandoned by their workout buddies. Remember them. Don’t let your own athletic goals get in the way of being a friend to them. Make time even if it’s not in a workout, or offer to do an easy workout with them.
  3. Don’t expect them to jump right back into racing and training. It can take a while, but often, they can come back, and sometimes, stronger than ever.

Cancer Harbors is an online service that is designed for people after cancer treatment, as a guide to recovering, and can be given as a gift. It has special material and support for athletes with cancer, to help them physically and psychologically recover their strength and confidence. It provides emotional and social support, with interactive coaching and guidance. It is for anyone, including non-athletes, who need help in the anxiety-filled year after they leave their cancer doctors behind. It’s a thoughtful way to support a friend who is going through cancer treatment, to give them the edge in recovering and getting back to the sport they love. It’s also a great way to learn more about cancer in general.