'I'm Not Trying to Be Hardcore About Running Through Chemo'

When Gabrielle Grunewald lined up for the 1500 meters at the US Track and Field Championships on June 22, she was both in familiar and unfamiliar territory. Grunewald had raced at nationals the past seven years in a row and made the 1500-meter final every time; in 2012, she finished one spot off the Olympic team. But this year, she'd be racing the nearly mile-long distance during her off week from chemo.

Grunewald was diagnosed with cancer for the fourth time in March; she was first diagnosed in 2009 with a rare salivary gland cancer called adenoid cystic carcinoma while competing at the University of Minnesota. She saw a doctor after finding a small cyst behind her left ear. She had an unrelated thyroid cancer in 2010 and then did the best running of her life, notching a personal best in 2013 and winning the 2014 indoor title at 3000 meters. But in August 2016, the adenoid cystic carcinoma was back, this time in her liver. A purple scar curves across her stomach from the surgery to remove half her liver. Grunewald was easing back into form this spring when her doctors found two new tumors there.

Still, despite the deck being stacked against her, she wanted to compete at nationals. It was about normalcy for her; she wasn't expecting the moon. The day before the race, she told Tonic that "it would probably take a minor miracle" to advance out of the first round and into the final, but she relished just being at the meet. And by competing, she also hoped to help the American Cancer Society and USA Track and Field raise money for cancer research: The day before nationals, Grunewald announced a fundraising campaign where fans can pledge a donation for every medal that Team USA wins at next month's IAAF World Championships in London.

It was a difficult race for Grunewald, on a day that hit a high of 106 degrees, no less. She finished last in 4:31.18, a far cry from her best of 4:01.48—but she received a standing ovation and the athletes in her heat circled around her afterward. It was worth it, as she wrote on Instagram after the race: "Everything about this hurt. Everything about this felt good. I never knew a broken heart could be so whole. Cancer slowed me down, but I haven't let it stop me. Track, I'll be back."

Grunewald celebrated her 31st birthday on June 25 and started her next round of chemo the day after. We talked to her about running through chemo, staying positive, and misconceptions about cancer patients.

So this is an off week of chemo for you?
The way my chemo regimen is set up is that I have one infusion the first week, one infusion the second week, and then the third week is an off week. This is how it worked out in the schedule. I probably would have come [to nationals] anyway, but it works out well that it's my off week.

How are you feeling so far?
Since I've only had two infusions, I haven't had a lot of the big symptoms that people think about with chemotherapy. I haven't really had much nausea or anything like that. My hair is still intact, but we'll see how that goes. Mainly I've had headaches and some ear-ringing symptoms from one of the drugs, those have somewhat subsided. I feel pretty normal, I would say the biggest thing that I'm fighting at this point is fatigue.

How tough is the fatigue?
Walking around and doing my day-to-day life outside of running I feel pretty normal, honestly, but when I run I definitely feel different than I did before. Some days it just feels like my easy pace is harder to maintain, some days I've just had soreness. My calves were on fire when I tried to do a seven-mile run the day after my first infusion, so it turned into more a of run-walk.

And seven miles isn't a very long run for you, right?
No, most of my long runs are 13 to 15 miles when I'm in more intense training. I have definitely done less volume [since starting chemo]. I want to see what my body can do but I also don't want to push it over the edge and get sick or run down. Sometimes we adjust my workouts to make the rest a little bit longer than it would be, and sometimes I target a little bit slower of a pace. But I've been able to do workouts that I think are pretty decent. They probably feel a little harder than they should be but they're not bad.

Tell me about the conversations with your doctors about running during treatment. What are their thoughts?
Right now I'm mainly working with a physician's assistant who follows me throughout my chemotherapy. My oncologists are involved, but at this point they're not involved in the management of my day-to-day symptoms. The woman I've been seeing before my infusions knows I'm a runner and knows I'm not like your typical cancer patient. I think generally exercise is a good thing for people throughout treatment as long as they're not pushing their body over the limit, so I think it's a personal [tolerance]. I have to monitor that myself.

My husband's a doctor, fortunately, and he's been traveling with me. We're following my cell counts to make sure they're not—they're obviously going to get lower with the chemotherapy—but we're making sure they're not at a dangerously low level. If they were dangerously low, I probably wouldn't be attempting to race.

I'm at the point where hopefully the chemotherapy is killing the cancer, it's also killing some good cells along with it, but most chemo side effects are cumulative and will probably show up after I have more infusions. Since I've only had two, I feel decent. Basically the advice that I get is: We're cool with you running as long as you don't run yourself into the ground. There's a fine line and I think we've done a pretty good job of trying to find that.

I definitely am not expecting the same results out of myself in my workouts or in the race that I have in the past but I still feel like it's worth being out here. And since I came into treatment so fit, I think I can still maintain a level of fitness even through my treatment that is both safe and satisfying for me.

When exactly did you find out your cancer had returned?
I had surgery to remove a large tumor in my liver and half my liver at the end of August. That obviously was really scary but ultimately they thought they got all of the cancer and I think they did. After that surgery, I had to take three or four months off where I was hardly running—it's a big scar on my abdomen and it affected a lot of those core muscles that you need to run. It took a while for my body to heal.

Around December, my body felt like it was ready to resume training, so I gradually got back into it. I envisioned myself having this awesome comeback and surviving cancer another time. I was making progress and I wanted to have a full season and be a contender for the Worlds team that's heading to London in August.

In March, I had my six-month post-op scan and I was hoping to be cancer-free and I know my doctors were also. We were hoping that I could at least get a break from the cancer for, like, a long time, maybe forever. I had no symptoms, my workouts were going great and I wasn't ready to race yet, but I was starting to get excited about where my fitness was going. But it all got a bit derailed when I found out in March that there were these little tumors in my liver.

While we were figuring out what my treatment plan was going to be, I ultimately decided that it would be worth it just to see what I could do with the limited fitness and the short amount of training I got in. I really wanted to try to qualify for US champs. I had a [qualifying] time from last year and I ran pretty close to that in May, but I thought I could improve on that. I didn't end up improving on it but I still qualified.

What's your goal for nationals?
This will be my eighth US championships 1500 in a row, and I just wanted to see what I could do. I really felt like it was going to help me get through the process of figuring out my treatment and help me have little short-term goals and things to look forward to even though I was going through something I was not excited about, obviously. My ultimate hope is that I'm going to get healthy after this treatment and maybe I can come back in 2018 and get a chance to race again and get more training in; not on chemo, not in treatment. I really believe that running this track season—even though I'm so far from where I want to be right now—I think running this track season is kind of a bridge to helping me get there next year. Just staying connected, keeping my feet in the water.

And keeping your streak of eight in a row!
Exactly, that too. [Laughs] Eight in a row, and I've made the final seven out of seven times. Honestly, it's going to be really hard to make the final; it would probably take a minor miracle for me to make the final, but it's still great to be here. I'm trying to view it as just a victory to get on the starting line and just maintain this pro runner side of myself.

Tell me about the fundraising campaign with USA Track and Field and the American Cancer Society.
You can pledge a donation per medal that Team USA wins at the world championships in London—75 percent of the proceeds will go toward the American Cancer Society and cancer research that they fund and 25 percent will go toward USATF athlete development programs. It's a win-win and it's a very cool partnership, especially for me to be a part of. I am obsessed with track and field and I'm in the fight for my life with this cancer and there's nothing more that I'd like to see than a world without cancer.

You wrote on Instagram that you thought you could run the nationals qualifying standard while on chemo, and then called yourself nuts. How are you balancing optimism with realism?
This is my fourth time battling cancer and I've been a runner and racing throughout all those experiences. Running has always kept me on track with getting through treatment and having something to look forward to in my recovery. And I think just being a runner makes you tough. It has given me a special set of skills to help me get through cancer, too.

I have my days where everything seems hard and I don't have the best attitude. But honestly one of the great things about running is that it's a natural mood-booster, and I always feel better after I go for a run. Having running stay in my day-to-day life while I'm going through this is helping me be hopeful about the future.

Does this experience make you look back on other times in your life when everything was going well?
Definitely. I look back on the last six years that I had as pro runner. It went relatively smoothly; I was a cancer survivor but I was mainly just focusing on being a professional runner. I'm grateful that I had all those years relatively stress-free that I could just focus on my passion of trying to run fast. I got to travel the world and go to all these cool places. It totally makes me appreciate those years that I had and I hope that there's still some of that in front of me, but it's uncertain right now. I definitely have a different perspective for sure.

Are there any dumb questions you're getting about running during treatment or misconceptions about cancer that you want to clear up for people?
Some people think that when you're a cancer patient, the best thing for you to do is just lie on the couch and rest. There's still a lot of stuff that you can do when you're a cancer patient. Maybe you can't do it as well as you can when you're not on treatment, but I think most people have a very limited view of what they think cancer patients are capable of. I guess I'm trying to expand people's minds to the possibility that you can still live your life while you're on treatment.

I'm not trying to be, like, hardcore about running through chemo, I'm not going to try to do anything nuts, and I'm not trying to make people feel bad if they're not feeling good enough to run on chemo. For me personally, I know that it's good for me, so that's why I'm doing it.

So people can continue with their normal lives even if they're professional athletes.
Yeah, or just maintain some of the things that make them feel good. For me that's running, for other people it might be something totally different. But it's just so important to hold on to those things, even when you're going through something difficult.

Interview has been lightly edited for length and clarity.

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