On October 19 2015, I completed one of my best marathon swims–a strong 10-miler in 64-degree (F) water from Corsica to Sardinia with two friends. Our time of 4 hours 30 minutes included feed stops every 30 minutes. My training—a demanding uphill mountain bike trail ride to a lake atop the Shawangunk Ridge, followed immediately by a brisk 2-mile lake swim, usually completed in under 55 minutes—had indicated that, at 64, my fitness was as good as at any time in my adult life.
There was one disquieting element during our swim: After the first hour, I was unable to pee, and twice had to climb onto our escort boat to empty my bladder. The previous month during a 10K race at Coney Island in water of the same temperature, I’d had to drop out after completing 5K when discomfort from a full bladder became too great to carry on. This had never occurred previously, even during an 8-hour Manhattan Island Marathon Swim in slightly cooler water.
The reason for my bladder problems became apparent a week later. My physician sent me for a prostate biopsy after sensing irregularities during my annual checkup. The biopsy revealed that I had prostate cancer. My ‘Gleason’ score of 4 + 3 indicated an aggressive variety requiring immediate treatment. A bone scan a month later carried more sobering news: The cancer had metastasized to my pelvis, putting it in the stage IV category. I wondered how I’d gone from being in the shape of my life to having an incurable, life-threatening illness in a matter of weeks.
The original plan for prostate surgery was shelved. I began treatment with testosterone-blocking hormones. Doctors typically expect one to two years of cancer suppression from this treatment. My cancer resumed its advance in the second month, which my oncologist described as “the far side of bad news.” A week later, I began chemotherapy.
Around that time, I had a 26-hour dizzy spell. A brain scan to learn the cause showed that I’d had a small stroke—a known side effect of prostate cancer. The stroke left me with blurred vision and feeling unsteady on my feet. This immediately became a more pressing concern than cancer as it threatened to limit mobility and leave me unable to read or write.
These were only the beginning of a series of discouraging occurrences:
- Between April and October, I received eight (of a planned 10) monthly infusions of Docetaxel, a chemotherapy drug. Blood tests showed an encouraging response the first two months. In the third month, critical markers began creeping in the wrong direction again, growing to alarmingly large reversals in months seven and eight.
- With the cancer progressing rapidly, my oncologist switched me to monthly injections of Xofigo (radium 223), which more directly targets tumors in bone. Like the previous ‘standard of care’ treatments, this stabilized my condition (at its new more-threatening level) for a few months, until lab tests conducted when I received my fifth treatment indicated that my tumors were again growing rapidly.
- Though the doctors had scrupulously avoided any mention of mortality rates for my cancer type, the radiologist who administered Xofigo gave me a pamphlet describing how it worked. Perhaps he didn’t realize it included this sobering statistic: Men receiving this treatment typically saw average survival time increase from 24 to 30 months.
Thus far this ‘cancer chronicle’ has read like a fairly standard account of how someone’s life is upended by an aggressive disease which quickly develops resistance to everything the doctors throw at it. But there’s another side.
Immediately after the stroke, I shifted to a plant-based diet and began to practice meditation and the Chinese healing art of qi gong, during which I visualized the free flow of qi throughout my body. During yoga classes, I visualized the flow of healing prana throughout my body. I adopted these ancient healing practices and visualizations to lower my blood pressure and promote circulatory health to heal the effects of my stroke and prevent a recurrence.
Within weeks, my blood pressure was lower than at any time during my adult life and the effects of the stroke began to ameliorate. Three months later, my vision was clear and I was again steady on my feet. This experience strengthened my resolve to be an active, empowered participant in healing myself, rather than a passive patient, awaiting treatment.
Reading the Xofigo pamphlet was the first documentary evidence I’d had of my situation’s significant gravity. As with previous discouraging revelations, I experienced anxiety for a day or two then regained emotional equilibrium. I shared this news with my friend Mike Joyner M.D., an anesthesiologist/exercise scientist at the Mayo Clinic. He said, “With all survival projections, there’s a ‘long tail’ of people who survive far longer than average. The strongest predictor for being in that cohort is your state of health at the time of diagnosis and how healthy you remain during treatment.”
As I started chemotherapy, I’d seen an Australian TV documentary about a rigorous study of the effects of exercise during cancer treatment. Subjects who did regular cardiovascular and strength training survived twice as long as sedentary patients. I resolved to swim, do yoga, or lift weights nearly every day, including days I received a chemo infusion.
In 2010-2011, I’d been privileged to witness a remarkable phenomenon when one of my students, Dr. Jeanne Safer, was diagnosed with breast cancer then—shortly after being declared cancer-free, received a diagnosis of leukemia, unrelated to the breast cancer. During two years in treatment, Jeanne rarely ever missed our weekly lesson. She would come to our Swim Studio directly from a treatment session. Though she walked in each time looking utterly drained, she would regain energy and vitality during our hour together. Jeanne referred to the pool as her ‘illness-free zone.’
I experienced the same thing during 18 uninterrupted months of treatments that were often harsher in their effects than the disease. Though I often felt tired or ill, a stunning transformation would occur while taking yoga class or practicing swimming. Especially while in the pool or lake, I would feel vibrant health.
I’d felt a passion for swimming since adopting a kaizen (continuous improvement) ethos in the early 1990s. Now my gratitude for the ability to swim with flow and grace became boundless. I would feel a magical connection to the water with every stroke. I also brought to swimming the habit I’d learned from yoga and qi gong, visualizing healing energy flowing through my body with every stroke.
Since my mid-50s, when I’d reached my (age-adjusted) lifetime performance peak, I’d learned to embrace my physical self—with its gradually diminishing capabilities and increasing limitations through my late 50s and early 60s. That process became dramatically concentrated after my diagnosis and the onset of treatment. It seemed as if I experienced 10 or more years of loss of speed and lessening of endurance in just over a year.
Yet my sense of purpose and the pleasure I took from swimming became, if anything, greater. Even as I proceeded to set new ‘lifetime slowest’ marks in my favorite races and repeat times on almost a monthly basis, I never became complacent about trying to eke out the best performance of which I was capable.
- In March 2016, I swam 1650 yards (equivalent of 1500scm) two minutes slower than I’d ever swum it before, yet in an Adirondack Masters 60-64 record time of 23:10. I described it in this blog as the most satisfying race of my life, because of the absolutely unwavering concentration it demanded.
- In November, despite training just 3000 to 4000 yards per week, I completed two 10K swims on consecutive days in the Red Sea with Total Immersion Israel. Though I tired after 8K on the first, I finished the second with abundant energy. I told those who swam with me that it was the best day of my life.
- In December, I swam 1650 in a time of 26:57, nearly four minutes slower than previously, yet good enough for an Adirondack 65-69 record and equally satisfying because the time was possible only because of several energy-saving adjustments I’d refined as my endurance and strength went south.
Since April, I’ve been in a clinical trial of an experimental treatment from Germany that, at the moment, seems to be working. I’ve had less pain, fewer days feeling ill, and more energy than in many months. I have no time for anxiety, anger over my situation, nor fear of the future. I’m far too preoccupied with taking pleasure from a glorious season of open water swimming, yoga classes, and my work, creating new TI content. In fact, I’ve been more productive, engaged in—and excited by—writing and video production the past year than at any time in the almost 30 years since I started TI.
Life is good!