cervical cancer screening
The Preventive Health Issue

Being an Endurance Athlete Helped Me Survive Cervical Cancer

Patricia Salazar shares her experience with HPV and cervical cancer

Meet the Author

Patricia Salazar is an avid endurance athlete. After receiving an abnormal Pap smear, she was told she had Stage 2B Cervical Cancer. She underwent a radical hysterectomy, as well as other procedures and fertility treatments, to stop cancer from spreading. Patricia works in the nonprofit world and hopes to use what she's learned in her career to further her advocacy for women's reproductive health. 

I’ve been a triathlete for about five years now. I run marathons, hike miles of elevation, bike, and swim. Endurance sports have become a passion of mine.

When you’re an endurance athlete and constantly push yourself to overcome physical and mental obstacles, you feel invincible. I thought nothing could happen to me; I’m the healthiest I’ve ever been.

But even healthy people can get sick.

Patricia Salazar

Photo Courtesy of Patricia Salazar / Designed by Don Eschenauer and Jaime Yong

The Importance of Screening

In the past, a gynecologist told me that I had low-grade HPV (human papillomavirus), but my doctor said that the majority of people with HPV clear it on their own. It was never something that worried me.

I thought nothing could happen to me; I’m the healthiest I’ve ever been.

Around the start of the COVID-19 pandemic, I was casually dating. I figured I should go in for a Pap smear, but I had also switched jobs and insurance. Plus, COVID made getting appointments more difficult. So I put off my Pap smear and hit the road.

Due to travel restrictions and lack of races because of COVID, I decided to take a three-week-long solo road trip and ride my bike through all of the national parks in southern Utah. I did a 100-mile, 12-hour mountain bike ride that was insane.

I even met my now-fiancé while fearlessly hiking in Bryce Canyon. The trip put me on top of the world. And then I came home and finally got my Pap test. The test came back with abnormal results, which seemed fine because I had had abnormal tests before. I assumed I’d get cream or oral antibiotics, and everything would clear up. But it was recommended that I get a colposcopy (a close examination of the cervix, vagina, and vulva for disease).

My fiancé was deployed to Spain, so I went to visit him and scheduled the colposcopy for when I got back. Three days after the colposcopy, three weeks before my first full Ironman, my gynecologist scheduled a telehealth video call. I took it in my car in the parking lot of the gym.

She told me that I have squamous cell carcinoma on my cervix. She explained the next steps to me and asked if I had any questions. I asked her, “So you’re telling me I have cervical cancer?” 

She told me, “Yes, you have cervical cancer.”

Moving Forward With Treatment

There were some things that, in hindsight, were signs of cervical cancer. I had been spotting between periods and occasionally after intercourse, and had abnormal discharge. I always thought it was because I had just run 18 miles or biked for 12 hours. She’s just cleaning herself. What is normal for women anyways?

I went in for an MRI (magnetic resonance imaging) and was diagnosed with stage 2B, meaning the cancer had penetrated the parametrium, the area around the cervix. They were nervous that it was starting to spread to the top of my vaginal canal.

I was hoping that I would only need a trachelectomy, the removal of the cervix, rather than a full hysterectomy. My gynecologist warned me that I needed to be prepared if I was told that I couldn’t have babies.

The hardest part of this process was doing it alone because no one was allowed in the medical offices with me due to COVID. My mom, grandmother, and best friend would sit in the parking lot while I walked into cancer centers by myself and was poked and prodded in the most intimate areas. 

I went to get my first opinion at Stanford. I walked in with a list of questions that my fiancé and I had typed up. The doctor drew a diagram of what my reproductive system looks like. He showed me where the cancer was and told me that I wouldn’t be able to carry children. My two options were chemotherapy and radiation or a radical hysterectomy.

The questions on that piece of paper may as well have been in another language because my brain just shut down.

HPV-16 or HPV-18 are usually the variants that can lead to cervical cancer. There are vaccines now, but my generation didn’t have them. I was worried that the longer I waited to make the decision, the more it would spread.

At this point, I had only known my fiancé for four months. I had to call him and say that I would never have children and that I understood if this wasn’t what we pictured for us and would understand if he didn’t want to walk this path with me any longer. He assured me that we were in this together. There were several nights that he watched me cry myself to sleep over FaceTime. He’s been an angel.

I wanted to have the option of having biological children in the future, so I immediately started fertility treatment. But before that, I had to have a laparoscopic biopsy to ensure that cancer had not spread to my lymph nodes, which meant five more incisions on my abdomen.  

Once my lymph nodes were determined to be clear, I started 12 days of injections before my eggs were harvested.

When I go into a race, I get my big curly hair braided into cornrows. I call them my battle braids because I race hard; I go into battle. I decided that I would have battle braids for my surgery as well. My fiancé had his hair braided, too.

Two weeks after my eggs were harvested, on December 15th, I went in for surgery. They took out my cervix, uterus, and fallopian tubes, and performed an oophoropexy, pinning my ovaries higher in my abdomen, in the chance that I would need radiation. I was so thankful to keep my ovaries, avoiding menopause at 32.

The Road to Recovery

Everyone warned me that this would be a hard recovery and that I wouldn’t be able to wake up and run a marathon right away.

My form of therapy has always been exercise. My body just didn’t feel like my own for two and a half months. Between the hormones and the pelvic exams, I almost became numb to it.

The hardest thing was taking the bandage off of my vertical scar, stretching from the top of my pubic bone to the top of my belly button. I cried in the arms of my fiancé for an hour and a half. It was a visceral reaction because it’s there, and it will be there. It was external proof of the internal battle.

I wanted my body to feel like my own again. Before cancer, I could look at my pace and splits and judge my strengths on a numerical basis. The strength I was gaining from this journey was a different kind of strength.

Five weeks after the procedure, the doctor called me to discuss preventive radiation. Based on the size of the tumor and its invasiveness, there was a 30% chance of recurrence. I didn’t want to risk it, so I went to radiation five days a week for five weeks.

The radiation took a toll on my GI (gastrointestinal) tract and bladder. Retaining nutrients was hard, and I was dehydrated most of the time. I also had constant headaches and nausea.

I posted on social media that I would walk to and from radiation every day, and whoever wanted to join me could. Some days I felt like crawling because I felt so crappy, but I had family, friends, colleagues, and people from past jobs and college supporting me every day.

It wasn’t an Ironman, but it was what I could do at the moment.

I’ve always had a training plan. Every day there was a run, bike, or swim to do. I treated cancer the same way. There was a finish line; I didn’t know when I would get there. I knew that there would be tough weeks, just like tough workouts. Some days would feel easier than others.

Finding Strength in Advocacy

I started sharing my experience on Instagram to convince people to get their screenings, see their gynecologist, and listen to their bodies—especially athletes, because we are already pushing our bodies past normal limits. There was a three-year period when I didn’t have my period because I ran marathons. Who knows if that contributed to my situation.

If I could change one thing about this experience, I would have said something sooner. I felt embarrassed because cervical cancer is associated with HPV, and I felt like, who am I to advocate for reproductive health if I didn’t take care of my own? But I’m not the only person who’s experienced nervousness around an abnormal Pap.

(About) 85% of women will experience HPV. It just depends on how your body reacts to it. The HPV vaccine has helped women a lot, but you don’t need to wait three years to get a Pap, especially if you’re having unprotected sex (even if you’re vaccinated).

Self-advocacy is also huge. I made sure the doctors knew that my future sexual health was important to me in all of my appointments. I asked how specific procedures would affect my partner and me, and how long would I have to wait to be sexually active again.

Finally Feeling Like Myself Again

I could easily spend days in my bed crying because I’ll never be able to birth a child, which I just got to see my younger sister do. But at the same time, I’m still here. I’m still able to get on my bike. I’m still able to run. I have the potential to have biological children, and to me, that trumps every negative thing.

Even with my scars, there is strength. I told my best friend that I would have to make up a cool story about how I got them, and she said, “How about the fact that you survived cervical cancer? That’s a pretty cool story!”

A few weeks ago, in the Sea Otter Classic in Monterey, California, an annual bike festival, there was a 25-mile gravel race with 3,000 feet of elevation. At mile 18, I said out loud while biking, “This is who you were before, and this is still who you are after.”

Battling cancer took such a physical and mental toll. My biggest fear was that I wouldn’t be able to get out there, be active, and feel like myself. At that moment, I felt like myself again.

By Patricia Salazar
Patricia Salazar is a cervical cancer survivor and endurance athlete