I was on a business trip two years ago when I noticed a lump in my breast. Not being one to panic, I told myself, “It’s probably nothing, but you should get it checked out.” That led to a dizzying spiral of medical appointments and a diagnosis of breast cancer.
One day, between diagnosis and treatment I was making a grueling 4 mile climb on my cargo bike with my kids on the back. My mind was floating through various thoughts and questions about my cancer. “I feel powerful, stronger than I have ever been, yet within me are cells that can kill me, how can this be…why is this happening to me, I’m young, I’m healthy…what will chemotherapy do to me… how will I bare being apart from my bike…who will I be if I can’t ride my bike…will I ever feel this strong again…should I forgo chemo…” When I met with my oncologist 2 long weeks later she reassured me that many people are able to tolerate some level of physical activity throughout some or all of their cancer treatment. Remaining physically active during treatment can have several benefits for both your physical and mental health such as:
- Time to reflect on what you are going through and think though treatment options;
- Endorphins that elevate your mood;
- Promoting a sense of your own health and strength;
- Maintaining healthy habits and a healthy weight which have been shown to improve survival;
- Reducing fatigue and improving conditioning making your recovery easier;
- Helping you stay in touch with other active friends who may provide encouragement and support,
That year I took a lot of medications that helped my body rid itself of cancerous cells, but the best drug for my overall well-being was staying on my bike. Here are 10 things that helped me to keep biking through cancer:
Find a mentor
If you are an active person the advice that you get from your circle of support about how active you should be throughout cancer may not be in alignment with your own desires or abilities. The median age of breast cancer patients is 60, and breast cancer is highest in women over the age of 70 so the mainstream advice about physical activity is tailored for this population. In addition, many people don’t realize how far treatments for side effects such as nausea and pain have come. While my oncology team was supportive of my desire to stay physically active, other doctors and friends kept encouraging me to “take care of yourself,” “get plenty of rest,” “slow down.” This advice made me feel misunderstood.
I decided that I needed to seek out the advice of someone who had been through cancer treatment and could advise and inspire me. A friend suggested, Barb Grover, co-owner of Splendid Cycles. Mustering courage I visited her shop and introduced myself. At that moment I was worried about whether I was going to be able to pull off a bike camping trip that I had planned with friends. She had lots of good thoughts and strategies to share. After some tears I left feeling mostly confident that I could pull it off. Something about our conversation made me feel that she was willing to support me beyond this immediate crisis and I blurted out, “will you be me cancer mentor.” I was immediately overcome with embarrassment thinking “what is a chemo mentor, she is going to think you are a total weirdo?” This worry was needless, instead she hugged me and said, “sure, whatever your need.” It was a wonderful relationship, she was so positive and empowering and still a great source of friendship today.
Don’t limit yourself unnecessarily
Early on I wrestled with whether or not to take the advice about limiting my physical activity. In the end I decided I had been biking around with the cancer in my body for months, maybe even years, feeling wonderfully strong and healthy so why should a few cells growing out of control suddenly change that. I decided to take a trial and error approach. To my surprise, early on in my chemotherapy I was able to keep up almost all of biking as usual. Over time, I slowly became more fatigued and I made adjustments as necessary. I did have days that didn’t go as planned. One day I hopped on my bike to head up to the top of a large hill, for a work meeting. During the climb I felt great, when I sat down for my meeting it felt like my thoughts were swimming in a sea of cotton for about 30 minutes. I could not string together a coherent thought. It was really scary, mostly because I felt like my body was betraying me and behaving in a way that was foreign to me. In these early days I didn’t know what to expect, I wondered, is this the new normal, will I feel like this every day. Being able to check in with my mentor was reassuring. I came to learn that the side-effects of chemo are cyclical, getting worse for a few days and then improving. The day I made this challenging commute was the most sever day in the cycle. Through trial and error I learned I was able to make that commute on any other day of the cycle without these unwanted side effects.
Set a goal
It is difficult to know what you are going to be capable of while going through your treatment. Everyone’s experience is unique. Your own experience will likely be impacted by your treatment, your body’s reaction to those treatments, and the level of physical activity you engaged in before cancer. You might have days were you feel pretty normal and days were you can barely function. For me the pretty normal days were more common than the barely functional days. Prior to my diagnosis biking had been a strong part of my identity, it brought me joy and a sense of community. It felt important to maintain all of these benefits. I wanted to set a goal that I knew would be achievable even with the uncertainty of treatment. After talking with my mentor, I got the idea to set the simple goal to get on my bike every day even if it was just to go around the block. Most days I was able to maintain my normal bike commuting and social rides. On the days I wasn’t feeling up to riding it made me smile just to hop on for a quick spin around the block. What mattered most was that my goal helped me maintain a sense of control and optimism about my health.
Have a backup plan
When you are beginning treatment or when you are transitioning from one treatment to another it may be hard for you to predict what your body is capably of or how you are going to feel. I found it comforting to think through a backup plan in case I was too fatigued, sick, or dizzy to get home. I lived in a city with good public transportation, so I would look at my routes and take note of where I would be close to public transportation along the way. The day that I had the cotton head incident after biking up to the top of the hill I decided to take the bus to my next destination. If the area where you live doesn’t have good public transportation think of friends you might call on for support, let them know that this might be a possibility. Knowing that you have a back-up plan will allow you to be more confident and open to testing your limits.
Make accommodations as necessary
Be open to the possibility that you may have to make accommodations. It is very likely that your treatment will involve surgery and the corresponding restrictions that follow. Ignoring these restrictions may further complicate your recovery and could lead to long-term complications. I had two surgeries, each requiring me to take a month off of biking. While I missed biking tremendously during that time, I adhered pretty strictly to the recommendations. You and your medical team can talk about what is best for you given how you are recovering. If you are going through chemotherapy or radiation you might feel more fatigued than usual, this is typically cumulative and may affect you more near the end of treatment than at the beginning. Before chemo I would commute on a cargo bike hauling my two kids and sometimes their bikes. This could be an intense workout when it involved long uphill climbs. I quickly learned that my most intense commute, a 16 mile round trip ride with a 3 mile sustained climb in either direction with both kids in tow was too much for me during chemo. Besides that modification I was able to continue commuting with my kids as normal for the first couple of months. After the 4th cycle of chemo I began to get a bit anemic and could no longer keep up with my husband with the kids on board. Going up one steep hill we actually slowed to the point that the bike tipped over. Don’t worry my passengers were scared but no one was injured. I had to admit that it was time to ask for support. My husband borrowed my cargo bike and took over the child hauling when I wasn’t feeling up to it. I would ride my daughter’s zippy Bike Friday folding bike which was much lighter. My mentor mentioned that she started using an e-assist bike. Any strategy that helps you stay on your bike is a good one.
Celebrate the good days
You’re going to have good days and bad days. Chemotherapy specifically has its ups and downs. Surgery too will require a break from your usual level of activity. These periods of involuntary separation from the activities I love only made my longing for them more intense. Making a plan to celebrate by indulging in a long or challenging ride when I was able to, or being flexible enough to seize the day when I was feeling good helped to elevate my mood and make living with cancer more bearable. I was lucky enough to have a lot of banked paid time off at work and not need much of it to deal with treatment. Instead, I used it to fit in long rides for my mental health on my good days. Once every couple of weeks on the best day of my cycle I would fit in a 30 mile ride. I would give myself permission to do whatever felt good. I would wear earbuds and blast my favorite music (while riding on a separated bike path: no nasty email from the safety police please!). I would stand up tip my face to the sun and lean into the wind as I whizzed downhill. I would bike in the pouring rain and head right for the center of the puddles sending fans of water spraying and giggle. It was about letting the joy back into my heart. Other times I would look for community rides so that I could connect with friends. On one memorable ride I rode with friends on a Saturday ride that stretched on for half of the day, we rode up and down two of the highest peaks in our city. I might have been the slowest bike of the bunch, but I felt gloriously triumphant at climbing these hills and taking in the spectacular views.
When you can’t bike get your fix in another way
If there are days when you can’t get on you bike due to surgery restrictions or fatigue find another way to stay connected to your love. I have several friends with cargo bikes who offered to pedal me around. I resisted the idea at first but after being separated from my bike for a few weeks I was desperate enough to give it a try. I had volunteered to lead a family ride before my diagnosis. I didn’t want to renege on my commitment so my husband offered to pedal me on my cargo bike. I got to sit backwards and keep an eye on all of the children. The joy and silliness of this experience opened me up to other friend’s offers and I was toted around town by my friends Madi from Family Ride and Chele. I think those were some of my favorite cancer memories. If you don’t have cargo biking friends get creative in other ways, a walk, a pedi cab ride, maybe even a motorcycle ride.
Harness the support of other bikey friends
Community is one of the benefits many people enjoy about biking, that instant connection you feel with someone else who enjoys the same things you do. This community can be a great source of support to you as you are going through treatment and trying to keep up your biking. I started a private Facebook group to keep my friends and family updated about what I was going through. I decided to add a few of my newer friends from my local biking community who I hoped would help encourage me to keep biking. At first it felt a little weird about sharing such personal information, but I figured they could opt out if it was too much for them. They turned out to be every bit as encouraging as I had hoped. One of these friends organized a Pink Mowhak Party for me when my hair started to fall out. Some people colored their hair pink, others wore colorful wigs, another friend brought a bunch of fake pink hair that the kids had a blast braiding it into their hair. I felt incredibly supported. There were times when biking was a real struggle, but my passion for it never resided. While others would question whether I was doing too much or advising me to take it easy, those in the biking community seemed to understand why this was important to me.
Make plans for the future
Dreaming up future adventures was a helpful strategy for getting through the overwhelming and tiring days of cancer treatment too. One of my favorite recreational activities is bike camping. I planned a couple if fun trips with family and friends for the summer after my treatment. Having these activities to look forward to made it easier to cope with the day to day hassles of taking multiple medications, attending chemotherapy sessions, fatigue, making accommodations to my normal activities, and being made to feel like a cancer patient. When I was getting down I would remind myself that there would be an end to all of this and fun was in my future.
I share all of this with the hope that those of you beginning treatment for cancer will have hope that you will be able to maintain the activities that you love to some extent. I also hope that this will help those of you supporting friends and family through treatment to understand the importance supporting your loved ones in maintaining the activities that bring them joy and health throughout their treatment.