I am very excited to be running the Marine Corps Marathon this upcoming weekend. I completed the New York City marathon during my residency in medical oncology in 2008, and although running through all five boroughs of the greatest city in the world was an amazing experience, after enduring innumerable blisters and needing to walk backwards down stairs for three days after, I resolved I would never again put my body through the strain of such an endeavor.
As is true for so many painful experiences in life, my mind seems to have walled-off the agonal memories, and when I reflect back on that day, I can only really remember what it felt like to cross the finish line. Recently, the opportunity arose to run a marathon right here in my new hometown, and somehow I found myself eagerly signing up to participate within the first few hours of registration.
You may be asking, "What does marathon training have to do with veterinary oncology?" At first, the similarities between the intensity of physical training required to run 26.2 miles and battling cancer in companion animals may not be immediately evident. But the more I thought about things, the more I realized there were a lot of parallels between the two. I’m not looking to make light of the significance of cancer, but rather to present commonalities between two vastly different life experiences in a manner that I find very relatable.
The first step in marathon training is the simple act of deciding to run the race. This is by far the easiest part of the entire process. Any individual can sign up for a marathon and races are held year round, so the only commitment typically made at this point is covering the entry fee. This is not unlike what I imagine pet owners go through when making the decision to pursue a consultation with a veterinary oncologist. Just as the marathon field will consist of runners with varying degrees of experience and athleticism, pet owners come to an oncologist with varying levels of personal experience with cancer; some have none at all, while others may already have been through the diagnosis with another pet, or have relatives or friends who have undergone treatment. Sometimes the pet owner is a cancer survivor. In any case, the decision is made, and the appointment (or race date) is scheduled.
Once you have picked a marathon and committed to running it, you have to select a particular training plan and stick to it. This is analogous to deciding on an appropriate treatment protocol for a pet with cancer.Just as there are many different ways to go about building the muscular endurance and fitness necessary for completing the race, for the majority of cancers, there can be a variety of treatment protocols designed to successfully treat or control the disease. At first, the options may seem overwhelming, but with careful research and guidance, a plan for training/treatment can be developed and tailored for an individual/patient’s needs. It’s important to remember that in both instances, plans are often altered along the way, and the only commitment made is towards trying to achieve the end goal.
After choosing a plan, the next step is typically the actual training period itself. For a marathon, this can be anywhere between 16 weeks to a year or more in duration.
During this time, there are a prescribed number of days per week you are required to train and a certain number of miles you have to run each day, typically enduring one "long run" per week, the distance of which will increase by small increments every seven days or so. During this time a runner will experience highs and lows, and sometimes even an injury that may delay the training for a short period of time, but once committed to the path, most people find the training part the most rewarding aspect of the marathon experience. This is analogous to the actual treatment period for pets; the commitment made towards pursuing anti-cancer therapy, which can last from a single treatment to weekly, bi-weekly, or monthly treatments, which can last a few weeks to a year or longer, depending on tumor type. It is expected that there may be “bumps in the road” and some adverse side effects, but overall the quality of life for the majority of pets going through anti-cancer treatment is great, and pets and their owners are able to enjoy their bond for an extended period of time than would be expected without treatment.
The actual event of running the marathon is the "reward" for the many hard weeks of training, and crossing the finish line represents the culmination of months of hard work and perseverance. For our oncology patients, in much the same way, we always celebrate their last treatment as their "graduation day"; a time of joy and happiness centered on commending them for completing their protocols, typically without a single complaint! Just as with a marathon, the vast majority of patients who start a particular anti-cancer treatment plan will complete it, and our goal for our patients after finishing treatment is to continue to provide them with an excellent quality of life and as much time at home with their families.
So I will be there on the starting line this weekend, and I really hope I will be able to finish (and if that finish were to be under 4:00 hours I would be really happy!) I know I can think of more than a few patients to help motivate me during those last tedious few miles when I know my muscles will be ready to give up.
The dogs and cats I treat for cancer are truly inspiring — as are their owners — and I honestly feel so privileged to be a part of their lives. If only one of them could speak up to tell me how crazy I am to consider going through this once again…
Dr. Joanne Intile