You can’t always get what you want (or more waiting …)

This past Tuesday was supposed to start with an appointment with my surgeon to review pathology results. It didn’t go exactly as planned. Even though it’s been five weeks since my surgery, the pathology report wasn’t ready yet.

The why? of that is a good question.

Canada’s healthcare system has been stretched to its limits (and beyond) and is still struggling to break a cycle — the backlog created from lack of monitoring during the pandemic, giving rise to too many patients needing monitoring now. When it comes to delivering test results, this is compounded by an aging workforce and the predicted shortfall of medical technologists entering the practice. Even when cancer cases are prioritized, the wait can be frustratingly long.

The Canadian Partnership Against Cancer lists ‘diagnos(ing) cancer faster, accurately and at an earlier stage‘ as a top five priority, to improve outcomes and reduce the stress and anxiety for patients — and their families and support networks — created by wait times. In talking with my surgeon on Tuesday, I also understood the frustration these wait times create for her in struggling to deliver a standard of care hampered by a system that is under-resourced.

The good news from my appointment was my incisions got a positive review — “healing beautifully” — and the pelvic washings done as part of my surgery came back negative. That means there are no cancer cells in the peritoneal cavity, an indication there may not have been spread beyond the uterus prior to surgery. Indication, not confirmation, so the pathology remains the critical missing piece of the puzzle.

Without the specifics to discuss a treatment plan — or if there is even a need for further treatment beyond surgery — my appointment became a much broader discussion about the relationship between endometrial cancer and cardiovascular disease (it depends on the type), things I could do to mitigate risk of recurrence (disciplined strength training seems to be in my future), and when I can return to running (two more weeks before I get to push my pace beyond a walk). I left with a promise from my surgeon to call if the pathology appeared before our next appointment in two weeks’ time.

At the end of the day, I didn’t get what I had hoped for — the clearance to return to running — or even the expected information that will be the basis for treatment.

What I got was more waiting.

I’m filling the time with online research, listening to podcasts as I walk, and wondering how to bridge the space between the medical and running communities.

What I’ve realized is there’s a significant gap between what’s offered by many cancer care centres — which tend to focus on general exercise guidelines — and sports medicine — that often does not have the expertise to address how cancer intersects with athletes’ aspirations. Spaces like the Exercise Oncology Lab (EOL) at University of Toronto, and their research team, are examples of how exercise oncology plays a role in quality of life for those of us on a cancer journey.

What I would love to see from research like this, is first-person stories from cancer patients who are athletes — both professional and recreational of all levels — at the time of diagnosis. There is room for so many stories about how training will be impacted by diagnosis, and – for me — what returning to running might look like as part of a recovery plan.

I don’t know yet whether my route will be working with a pelvic floor rehab specialist at the sports medicine clinic in my neighborhood, or if I will look for a running coach who has experience working with cancer patients. It will depend on the pathology report and whether further treatment is in my future. If surgery is the end of the road, I’ll likely work with a pelvic floor specialist, since my focus will be strengthening the muscles most impacted by surgery. If radiation and/or chemo are in my future, then my interests are much different, and include nutrition, managing side effects, and impact on bone density.

Cancer Care Ontario has produced Exercise Guide: For people with cancer, a useful reference whether you were active before your diagnosis or not. It includes some great questions to ask if you choose to work with a coach, physical therapist, or other professional as part of your program.

For now, I’m adding some structure to my walking so that it will flow into a modified C25K program when I do get the clearance to start running again and can work on an intentional training program to get back to racing.