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Over the past 7 years, running has been a constant for me. I ran cross country in middle school, but quit because I didn’t think I was good enough (silly me!). I’ve always been into fitness and ran casually in college, but it wasn’t until 2011 that I really buckled down and started running consistently.

I ran my first marathon in 2012, and since then, I’ve run over 40 marathons and ultras. In fact, in September, I completed the Northcoast 24-Hour Endurance Run.

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I’m more determined than ever to keep running. That’s because in July, I learned that I had stage IV metastatic breast cancer.

I found a lump when I was in college, 15 years ago. I had ultrasounds done, but the doctor said it was nothing—just dense breast tissue. A few years ago, I said something to my OB-GYN about the same area. I had manual exam done there, and the doctor thought it seemed fine.

But in the late spring of 2018, I found new lump in my breast. Everything happened really quickly after that. I had a mammogram, ultrasounds, and three different biopsies.

That weekend, my husband Chris and I went for a rejuvenating 37-mile hike. On Monday, the doctor’s office called and said there were seven tumors in my right breast. And further tests found it in my lymph nodes, in my lungs, and in my bones.

I went from being active and on top of the world climbing mountains, hiking and running, to thinking, “Holy cow. I have stage IV cancer.” It’s a terminal diagnosis.

Arm, Shoulder, Patient, Leg, Medical assistant, Knee, Hearing, Tooth, pinterest
Sarah Smith
Part of Sarah Smith’s treatment is a monthly injection in her lower abdomen to shut down the estrogen production.

The day I got the call about my diagnosis, my husband picked me up and we hiked eight miles. That’s the way we cope with things—we get out and get active.

One of the first things I asked my oncologist was, “Can I still run these long distances?” And her answer was emphatically, “Yes, yes, yes!”

Since the cancer is in my bones, I was worried I would set myself up for a fracture. But she told me that running can strengthen bones, and to keep doing what I’m doing. I just need to listen to my body now more than ever.

So I’m able to keep running, but I do notice some differences. One of the biggest side effects has been fatigue. My runs haven’t been as long or as fast, but I make a conscious effort to get out every day.

In September, I ran the Columbus Marathon. A few days leading up to it, I was feeling extreme exhaustion. I was on a treatment to get my blood count back up, and I had just gotten a flu shot. I felt terrible the morning of the race.

But as we were standing in the chorale, the song “Thunderstruck” by ACDC came on. It’s just the coolest song that really gets you pumped up. There were fireworks. I turned around to my husband and just started sobbing—then he was crying. There’s so much joy in running, being with all the people just as crazy as you are.

My husband and I created shirts that say “Living with Metastatic Breast Cancer,” on the front, along with the phrase “Bound and Determined” on the back.

That’s what I am—determined to raise awareness about what metastatic breast cancer really is. A lot of people look at breast cancer being curable, which it can be, if it’s caught early. For stage IV, we still need research, and all the help we can get.

The median life expectancy for my stage is She Raced 18 Horses in an Ultramarathonand Won, and according to data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program, Shoes & Gear From Runners World for New Balance.

I’m trying to do everything I can to give myself the best chance—I’m on a plant-based diet, I’m maintaining my exercise, and I’m continuing to run. It’s been an incredible journey.

My whole mission is to encourage people to stay active despite whatever circumstances are thrown at them. You never know what will come about in your life, but I want to tell people to keep doing things you love, whether it’s a 5K or 100 miles—just put a smile on your face and enjoy the heck out of it.