The Art and Science of Fitness | A fitness enthusiast bravely battling cancer

Cancer can be a scary thing to go through. With the diagnosis often – understandably – comes the fear of death. But it doesn’t always have to be that way. With advances in medicine and oncology, cancer doesn’t have to scare us as much as it used to.

And to prove my point, I’d like to take you through the journey of someone I know who was recently diagnosed with cancer and what he did after he found out.

While running, I often bumped into Rohit Pathak, who always seemed a fit and natural runner. But he wasn’t always like that. In 2016, he was 110 kg, he decided to start cycling with the Delhi cyclists, and two years later he was introduced to running by Adidas Runners. By 2021, he was down to 75kg and ran the Berlin Marathon. Not knowing the details of his transformation, we were merely exchanging pleasantries.

However, I found out last Sunday that in April 2022, having just turned 40, he was diagnosed with Hodgkin’s lymphoma, a rare type of cancer. And just a week ago, he reached the finish line of the Mumbai Marathon, a total of 42.195 km. I believe this incredible man’s story needed to be told to the world.

Hodgkin lymphoma affects the lymphatic system. We all know that arteries and veins carry blood from the heart to the rest of the body and back again. Along with arteries and veins there are nerves and lymphatic channels. While arteries are like the pipes that bring clean water into our home, veins are the pipes that drain the impure water. Likewise, the nerves are like electrical wires laid throughout the house, and the lymphatic system as a whole is like a defensive alarm system that detects any intrusion by any bad elements. However, once there is a breach, even the slightest inconvenience would lead to all sorts of problems. This happens when our body’s defense mechanisms are weakened. Our immune system goes into overdrive at the slightest infection.

Rohit faced this. He ran over 4,500km in 2020 and 2021 combined while training for two full marathons. And then he met Dr. Lt. Col. Manish Chaudhary at Batra Cancer Research. Rohit recalls, “I think meeting Dr. Chaudhary was a blessing in disguise, he patiently made us understand what this cancer was, the line of treatment, the pros, cons, do’s and don’ts. My only request from Dr. Chaudhry was if I could continue my physical training such as running, cycling and strength training. I was allowed brisk walks and home strength training. It helped enormously that Dr. Chaudhary was an ex-army officer and a runner himself, so he appreciated the physical and physiological benefits of being active. After meeting him, I don’t think we ever encountered fear, chaos or confusion in the entire course of treatment. We immediately decided that he would be my attending physician, there were no second thoughts here.”

Rohit runs the marathon.

Contrary to popular belief, Rohit’s excitement and Dr. Chaudhary’s advice are not misplaced. Dr Darren Player, scientist and academic at University College London (UCL) and exercise professional, with whom I co-authored MoveMint Medicine and La Ultra – couch up to 5, 11 and 22 km in 100 days shares what is being done globally based on evidence and research. “Lymphoma Action (UK) promotes physical activity and offers several benefits, including preparation for treatment, reduced side effects of treatment, reduced risk of infection and reduced risk of blood clots, among others. A meta-analysis of studies (one of the highest levels of evidence) published in the Cochrane Database showed that aerobic exercise can improve fatigue and depression in conditions such as lymphoma.

He added: “Given that fatigue is one of the most debilitating systems for these patients (as a consequence of disease and treatment), this suggests that all patients should engage in some form of aerobic exercise.” Exercise programs combining aerobic exercise with strength or resistance exercise have also shown physical and psychological benefits (Fischetti and colleagues in 2019). Resistance exercise should not be underestimated in helping patients with lymphoma, as increased muscle mass and strength will reduce fatigue as well as contribute to a whole host of other benefits for the body.”

Rohit went on to tell me what his journey had been: “The next course of action was a series of tests and a PET scan. After that, the line of treatment was four chemotherapy sessions every 14 days and about 10 radiation sessions after that. Surprisingly, I didn’t experience anything for the first few days after chemo and thought it wasn’t too difficult. This changed after my second chemo. I started to feel like I had been run over by a truck, with weakness, pain, diarrhea, constipation, nausea and lack of taste. And what’s more, all these came one after the other in the following days. But luckily, that too was over soon. In the first week of July we started with 10 sessions of radiation which was a breeze. I finally got the green light from the oncologist and the radiologist that I was cancer free.”

He said: “At the beginning of August, the entry for the Tata Mumbai Marathon opened and I registered in the Full Marathon category, giving myself just over 20 weeks to get back in shape to finish the marathon without my 5 hour target time. The walks turned into short runs and soon I was running. By the time I reached the finish line of the Mumbai Marathon, I had done it in four hours and five minutes. Besides Dr. Chaudhary, my oncologist, I have immense gratitude for Dr. Irfan Bashir (my radiologist), Dr. Sudeep Raina (my oncologist-surgeon) at Batra Cancer Research, Dr. Chandan Chawla (my sports physiotherapist) and Dr. Paridhi Ojha (my physical therapist) . I truly believe that having the right team of doctors is paramount. In my case, it was a blessing because every single one of them knew my background in endurance sports and how important it was for me to get back to my fitness. My Adidas Runners family, my wife Shaifali and my 6-year-old son were the main reason I got to the finish line.”

Rohit completes the marathon.
Rohit completes the marathon.

However, Dr. Darren Player warns us. “Of course, there are risks associated with exercise in people with lymphoma and they should always consult their specialist before undertaking any exercise. For example, chemotherapy can cause conditions such as thrombocytopenia, which can put patients at greater risk of bruising and bleeding. The treatment can also cause anemia, which can make the patient feel more tired when they exercise because of a reduced oxygen-carrying capacity. Scientific evidence also suggests that supervised exercise for patients with lymphoma has the greatest benefits, potentially because it can be monitored and challenged appropriately.

The take-home message, according to Dr. Player, that resonated with me is, “However, for most people with lymphoma, it is simply necessary to try to maintain physical activity levels during treatment. Managing side effects and listening to their body (and mind) to reduce the amount and type of exercise that can be done is something that only an individual patient can do.

Keep smiling and smiling.

Dr. Rajat Chauhan is the author of The Pain Handbook: A non-surgical way to managing back, neck and knee pain; MoveMint Medicine: Your journey to peak health and La Ultra: Couch to 5, 11 and 22 km in 100 days

He writes a weekly column, exclusively for HT Premium readers, that breaks down the science of movement and exercise.

Opinions expressed are personal

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