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posted: 5/13/2013 5:00 AM

Cancer patient gets back on the bike

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  • After talking with her oncologist, the author got back on her bike and is now a dedicated cyclist.

    After talking with her oncologist, the author got back on her bike and is now a dedicated cyclist.
    Washington Post/William Lynn

  • For the author, riding has offered refuge from the physical and emotional ravages of fighting cancer.

    For the author, riding has offered refuge from the physical and emotional ravages of fighting cancer.
    Washington Post/Mark Blacknell

By Elizabeth H. MacGregor
The Washington Post

Nearing the end of chemotherapy for breast cancer, I peppered my oncologist with questions about how to prevent a recurrence. Should I avoid soy products? Processed foods? What about alcohol? I'd been surfing the Web looking for information.

My doctor gently interrupted and said plainly, "If you want to prevent a recurrence, you need to get your weight into a healthy range and get an hour of vigorous exercise every day."

I'd once been a runner. I ran as many as 40 miles a week and competed in races as long as 10 miles. But over the years, work, parenthood and home obligations had taken their toll, and I could no longer devote the time I once had to my own fitness. Eventually, I started commuting to work by bike. It was the most convenient way to get exercise but the first thing to be sacrificed when the schedule was too full. Still, when I was able to ride, it allowed me to continue to maintain my identity as the athlete I'd once been.

Then, in January 2009, at age 45, I was given a diagnosis of cancer. I had a mastectomy and went through six rounds of chemotherapy for Stage I invasive ductal carcinoma. For the six months between my diagnosis and the completion of chemotherapy, I didn't get on the bike or do any other real physical activity. During chemo, I gained 20 pounds, which I was told wasn't unusual.

As my oncologist spoke, I thought of the commuting bike, purchased two months before my diagnosis, gathering dust under the basement steps. There was virtually nothing I could control about the nightmare of my cancer, I thought. But give me one thing that I can take charge of, that I can do -- that I love to do -- and I'm going to ride as if my life depends on it.

Recent studies confirm my oncologist's advice. A study published last fall in the journal Cancer found that obese survivors of certain types of breast cancer were 40 percent more likely to have a recurrence than survivors whose weight was in a healthy range. Even women who were overweight but not obese were more likely to experience a recurrence. In 2005, the Nurses' Health Study found that breast cancer survivors who exercised as little as three hours per week after diagnosis experienced a lower risk of a fatal recurrence than survivors who did not exercise.

So I began to exercise just days after my last full chemotherapy treatment. (Under my regimen, I continued to receive infusions of Herceptin, a therapy for a certain type of breast cancer, for eight more months.) My return to the bicycle was accompanied by an urgency and seriousness of purpose that I'd lacked before. At the beginning, I felt as if I were starting from scratch. I rode slowly and got tired quickly. But I was patient, telling myself I was in it for the long haul. I settled into a mixed-mode commute -- 12 miles around trip by bike, the rest by train -- two days a week. I rode my bike for short trips and errands. In a gesture of defiance, I rode to and back home from one of my last chemotherapy appointments.

Gradually, this routine gave way to a bicycle-only commute, 29 miles around trip. And two days per week became three, which led to four, and then some riding on the weekend, too. I shed 35 pounds. Riding became a refuge; two hours of daily solitude in a life that was hectic and sometimes sad. It was a chance to get lost in thought or in no thoughts at all (sometimes, just to get lost). It became second nature. It made me feel healthy even as I harbored doubts about whether reality matched the brave front I put up.

Some women are empowered by a cancer diagnosis, but I was not. I only felt vulnerable. While I trusted the medical professionals caring for me and the treatments I received, I found my role to be unsettlingly passive. Cycling allowed me to be an active participant in my treatment; it gave me agency in my recovery.

I made other changes in my lifestyle, too. My oncologist assured me I could continue to eat soy and drink alcoholic beverages in moderate amounts. I became more deliberate about my eating habits, with an emphasis on fresh fruits and vegetables, whole grains and lean proteins.

Almost four years have passed since I finished chemotherapy, and I am still cancer-free. (I am taking a five-year course of tamoxifen, which blocks the effects of certain hormones, to help prevent a recurrence.) Riding has continued to be a refuge and an inspiration to challenge myself. I ride about 600 miles per month, most of it commuting. I have completed several centuries (100-mile rides) and a few local events. Last fall, I was certified as an instructor by the League of American Bicyclists, which means I can teach beginners and cyclists wishing to improve their traffic riding skills. My husband and I are also training our son's Boy Scout troop for a four-day, 187-mile bike ride on the C&O Canal towpath this summer.

I've realized my goal when I started bike commuting. By using my bike to get groceries, go to and from work and do many other things I need to do, I can maintain my fitness while going about my life. My well-being is the priority it always should have been.

I have a well-rehearsed answer when someone asks, "Is it safe?" Eighty-five percent of my commute is on a protected trail or bike lane. After all these years, the urban drivers and I know each other well and have long since made peace with our imperfect coexistence.

But really, I just want to reply, "How is it safe not to?" I'm a human being, a living creature. I wasn't meant to be passive. I was meant to be out in the world, to move, to power up a hill panting, to go flying down the other side as if ready to take flight. To feel the hot sun beating down on my back, to gingerly brace myself against a fierce crosswind on a dark, frigid night. To overcome the tedium of thousands of pedal strokes over the same route, day after day, by making it transcendent. To do more than exist -- to live.

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