Just get out. That's the motto of Patricia Novelli while undergoing chemotherapy, radiotherapy and immunotherapy. Patricia walks us through the struggles she encountered when continuing to enjoy the outdoors, walking and climbing, while being treated for cancer.
Will my son be OK? Will my husband be OK? Will my family be OK? My mind went in full overdrive mode as the breast consultant robotically muttered further details of my diagnosis. She had just told me my breast biopsy came back positive for cancer and I that needed surgery urgently. The world came crashing down on me. All I could think about was my family and whether they would be okay. Then my mind drifted straight to climbing. I have been climbing for around 25 years now and it is has always been a huge part of my life. It was inevitable that I thought of climbing next. Would I be able to climb again? Would I ever be able to climb again with my husband and son? All I could think about were all the holidays I wouldn’t be having with them and all the climbing crags and destinations I wouldn’t be seeing, visiting and photographing. I was gutted and deflated. I was lost.
That was autumn 2016. Fast (or should I say slow) forward to summer 2019, the last two-and-a-half years have been extremely challenging for me; not only physically but also mentally. The diagnosis of cancer has had obvious visible effects, but it is the invisible ones that have affected me the most. Even now when people say how well I look, hidden physical and mental issues are still simmering underneath the surface. Without a doubt walking and climbing have helped me enormously during my times as a cancer patient and have provided the respite I needed. Walking and climbing have also helped my immediate family, giving us a break from the harsh reality of what we were all facing together with my diagnosis. Two years on I have had two surgeries, chemotherapy, radiotherapy, immunotherapy, countless MRIs, X-rays, ultrasounds, a bone scan, blood tests, and consultations to name but a few. I am also currently on a five-year clinical trial taking chemotherapy tablets for the next five to 10 years. It is a miracle I am not fluorescent and glowing in the dark!
When I was first diagnosed I searched the climbing forums on the internet for advice. I wanted to know if one could climb with cancer, during treatment, and if there were many in my situation and what they did. There wasn’t much out there but I did get some advice, and the rest I improvised and learned as I went along. I spoke to a few climbers who had cancer and the fact that they kept on climbing really motivated me.
I just want to say to anyone reading this with a diagnosis of cancer that you can still be out there and walk and climb. You can. You just need to find a way.
Patricia at her favourite crag in the world: Nescliffe, Shropshire. Photo: Patricia Novelli Collection
Of course, I am not a doctor and every cancer is different with different treatments so what I’m writing here must not be taken 100% as gospel. However, I hope it gives some insight, inspiration, ideas and help to others in a similar situation and those helping a loved one with cancer.
My first advice is to “get out” – whether it be outdoors in nature or indoors at the wall. Whatever rocks your boat and whatever you feel up to, get out and don’t stop doing what you love. Even a small walk will make a huge difference to your health and morale. The same applies to going indoors even if it is for one 3+ rope climb. The grade does not matter. Doing something does matter. When you get out you could meet up with your friends, your family, or paradoxically make it the one time to escape and be totally on your own. But either way, just making the huge effort of stepping out of your door will help distract you and give your mind a break from the day to day realities you are and will be facing with your diagnosis. It will certainly help fight depression.
During my treatment I realised that I didn’t have to go climbing outdoors all the time but it was just being outdoors that was cathartic for me. I decided that hill walking would help me exercise and allow me to still be in nature whilst being gentle to my body which was going through a lot. Walking was what got me into climbing in the first place and I ended up going full-circle, rediscovering my love of the outdoors without having to worry about how many climbs I had done. I had a thoroughly great time being on my own digesting all my cancer thoughts. But I also went walking every so often with my friends and it was a great way of catching up with them when I was during the “better” weeks of my treatment. Everyone is always ready and willing to visit you when you are ill but it can be overwhelming. Walking with my friends was an easier way of seeing them as it broke the whole “explaining how I was” in manageable bite sizes throughout our walk. I initially aimed to go out walking at least twice a week and walk for at least half an hour to get me slightly out of breath. I managed to do this most times. Sometimes I managed more whereas other times a lot less. It didn't matter; I was out, that is what mattered.
My advice is to explore your hills, your parks, your National Trust properties, whatever you have nearby. You never know, you may discover new places like I did. In other words simply get “out”. Although you are not actually climbing, just being out will give you the break you need from the whirlwind of your diagnosis and treatment. You can be on your own and reflect in peace. You can be with your pet and spend some quality time with it. You can be with your family which during a difficult time is actually rather comforting. You can be with your local cancer support group as some of them organise walks. Just get “out” as much as you can in nature.
I decided to give myself a challenge with my walking and decided to walk as many of the local Shropshire Hills as possible and to find, discover and explore some new ones. I also have a passion for photography so I used that excuse to make a mini video diary to motivate and track my progress. For the majority of my treatment I was able to go walking several times a week and it helped my mental and physical state considerably. I was happy even though it wasn’t climbing. I was still in nature admiring beautiful views. By being kind to and never judging myself, it didn’t matter that towards the end of my treatment I walked considerably less due to severe bloating and swelling of my legs, extreme fatigue and horrendous nausea. Even walking once every now and then as chemo advanced was considered a milestone. One must remember that chemo accumulates and therefore towards the end of your treatment you will be at your worst physically. Any mild exercise will suffice. A copy of my walking video diary during chemo can be found on Vimeo. It was used in a local photography competition and I won first prize raising money for Climbers Against Cancer (CAC) at the same time. Yay!
Walking on the local Shropshire hills days before all her hair fell out from chemotherapy. Photo: Patricia Novelli Collection
Tips for climbing with cancer
If you are feeling strong enough to climb then that is wonderful. Sometimes I was amazed at how well I could climb. Other times I could barely do a route. Just be prepared to accept whatever happens with a smile. I found climbing indoors at a lower grade relatively easy for the first few cycles of my treatment. Here my advice is don’t worry about grades but instead concentrate on low-level reps. My aim was to get a bit out of breath and just keep my heart moving, much like my walking. I loved the fact that I was climbing and to me it didn’t matter whether I was at my grade limit but instead I lowered my climbing level and concentrated on doing reps. Autobelays were my ultimate love as I just went on those on my own at my regular wall and did laps. I did this for four out of six of my chemo cycles once to twice a week. I did a lot of top roping and even managed some easy leads. Anything was a bonus in my view. Unfortunately the last two cycles meant I couldn’t climb (or walk much for that matter due to swelling and fatigue and nausea) but I strongly believe that climbing for four cycles kept me sane and fit.
Something that I found really helped me was to buy a pair of loose comfy climbing shoes. Not super tight for performance climbing but instead generously oversized. I went a full size over my usual climbing shoe size. During chemotherapy your skin and nails suffer considerably. I ended up losing a lot of my nails both on my hands and feet and the idea of squeezing my toes into tight shoes really didn’t appeal to me. Even now two years on, I am still reluctant to squeeze into super tight climbing shoes. Wearing soft shoes actually kept me going for longer on the wall I am convinced. I sometimes even used socks to protect my fragile toes. I know shock horror! Who would have thought so!
Using an autobelay at The Boardroom Climbing Wall during FEC-T treatment Photo: Patricia Novelli Collection
With regards to hands, moisturising is the key. Chemotherapy dries your skin horrendously and nails become extremely fragile and brittle. I constantly moisturised my hands and toes after every climbing session. I applied moisturiser directly onto my brittle nails and rubbed it in thoroughly. I found this very helpful when I felt nails were about to split and crack. To avoid even further dryness I used chalk sparingly.
In my case with my medication, I lost all my head and body hair during chemotherapy, so if this is the case another tip is to splash out on some cool climbing clothes – especially beanies – and to flaunt them. What a great excuse to have as many climbing beanies as you can! You must keep warm as without body hair you cool down a lot faster than normal and by keeping warm you avoid injury.
It is extremely important to drink lots of water. I stopped drinking alcohol altogether as my liver had some chemo-induced damage. I am still tee-total now. It is also important to eat well and obviously the sensible five fruit and veg a day mantra really could not be emphasised more. In fact, it’s an understatement as it should be more like eight a day. Further advice I can give is to try new foods as your palate and tastes will have changed dramatically following chemo. New foods will also give your health recovery a twist. I have discovered shitake mushrooms, pomegranate seeds, all sorts of new herbal teas and the list can go on. Enjoy the process and experiment.
An interesting side effect of cancer treatment has been a noticeable loss of my cognitive abilities. This is known commonly as “chemo brain”. I suffered from it considerably and still do. So when climbing do not feel embarrassed and instead ask someone to check things through for you because literally there can be times when your brain is in a thick fog. Make sure your belay partner checks your harness and knots. When walking make sure you have your route details clearly mapped and marked in case you get lost.
When outdoors, a very important tip is to wear sunscreen and a hat, no matter what type of cancer you have. It’s especially important if you have had radiotherapy like me, as you need to severely minimise your exposure to UV even more than normal to avoid sun-induced UV damage. I cannot recommend enough the use of UV repellent suncream. I use children super dooper water and sand-proof Factor 50+, but also wear UV repellent clothing on top. There are a wide range of excellent UV resistant clothing and swimwear online, in shops and even in supermarkets. When climbing outdoors one tends to forget time and therefore to cover up. Don’t!
As with indoor climbing, when outdoors lower your grade, chill and just enjoy the moment for what it is: consider it some time off from a difficult stage in your life. Any climb is a bonus. Chemotherapy and radiotherapy can weaken bones so the last thing you need is a fracture from falling, more surgery and hospital visits. Being sensible is the way forward.
After I was battered and bruised from chemotherapy and radiotherapy I decided to rebuild my fitness slowly. I have never been a lover of high intensity sports, much preferring climbing and yoga, however as my heart had been damaged by immunotherapy I decided to try the NHS Couch to 5K app. This is available on your phone and I thoroughly recommend it. Michael Johnson and his soothing voice kept me going comfortably for nine weeks and I can now run for 5km in around 30 minutes. Not bad for a running hater. In fact I entered my first 6km race this year and completed it. That is where I will stop with my running but never in a million years did I think I would run 5km sub 30 minutes at the age of 46. There are many Couch to 5K apps and once you find one that suits you it’s a great way to get your fitness back because you’ll be enjoying the outdoors. Getting out being the key here again. I used Strava together with the Couch to 5K app. Not being a Strava fan before, I found it logged my progress, however small, and gave me lots of virtual rewards, which egged me on. I also used Strava when on my walking days. There are countless other fitness / navigation apps that can help you. I even used a HIIT one when I had to temporarily stop running. This allowed me to exercise in my room in private with minimal gear. Currently I am enjoying an app called MyFitnessPal to monitor my diet. From day one it was clear I was not eating enough fibre. Small changes can make a big difference so now I am a big fan of wholewheat pasta.
Following diagnosis I was able to go on a climbing holiday after one year. The BMC insurance proved a life saver because they were still able to insure me for my climbing trip even though I had a cancer diagnosis. They didn’t cover me for anything cancer-related but realistically in a two-week holiday, once the main treatment was over, it would have been highly unlikely I would have needed cancer cover in that window. Now two years on I can get full BMC Insurance. I cannot recommend them enough – just ring them and discuss your case to see what they can do.
Enjoying Sweden's Bohuslan Granite in between Herceptin injections. Photo: Patricia Novelli Collection
It is important to listen to your body during and after active cancer treatment. In my case I was able to climb during four rounds of chemotherapy and walk through five rounds of chemotherapy. I knew that when I was out of breath I had to ease off but I knew that sometimes I could push a bit more to keep my levels of fitness steady. Do listen to your body and get advice. MacMillan recommends keeping fit to reduce the symptoms of chemotherapy and radiotherapy, so anything is a bonus. In fact chronic fatigue took its toll on me months after my main treatment. It is affecting me badly now as I write this. This is quite common so be prepared to suddenly feel like you have been hit by a bus. All perfectly normal and again simply going for a walk will help.
I don’t know how long I can use the excuse that I was diagnosed with cancer for my current low standard in climbing. However I wouldn’t wish my cancer experiences on anyone, not even Donald Trump. Yes I wasn't amazing before but undoubtedly my body has changed irreversibly affecting my climbing for the worse. Some chemotherapy side effects are only showing the light of day now. I am plagued with weight gain, digestive problems, severe incontinence, severe daily cramping in my legs and abdominal wall (that can be very funny half way up a wall), severe bloating, anal fissures, anal piles, haemorrhoids, dry skin, dental problems, drop in eyesight and memory loss but to name a few. But cancer does have its benefits and it has given me a drive to try training again from the start just like a beginner.
It’s the journey that’s the fun bit not the end. I remember starting as a beginner at Mile End Wall in London all those years back and the thrills of achieving new heights in my prime. I cannot wait to do new things with my son who is now better than me with my new aged, changed, battered and bruised body. The fun bit starts now. I may actually start training for climbing. Wish me luck. I just seconded Sacre Coeur in Devon, a long dream of mine, and top roped a 6c at my local wall. I know it is nothing in comparison to other climbing achievements, but for me this is huge. Utterly huge. My cancer diagnosis has driven me to try and work through my original tick list and to add some more climbs to it on the way. Not sure how many I will get through as am not sure what the future holds, but it is comforting to dream and plan.
PS – Good luck to anyone else going through cancer. www.climbersagainstcancer.org
Seconding her dream route: Sacre Coeur, Blackchurch Rock, North Devon. Photo: Christopher-Novelli-Cain, age 11
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