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In the autumn of 2016, I completed my second marathon. I was an ambitious 35-year-old athlete, participating year-round in activities that included running, road cycling, triathlon and alpine skiing. I was fit and well, and apart from pollen allergies I had not had any medical treatment. Approximately 3 hours after the marathon, I developed my first episode of bloody diarrhoea. As a doctor, I suspected this to be runner’s colitis but was not overly concerned. I knew that a proportion of marathon runners report gastrointestinal complaints.1
Persisting symptom led to a worrisome diagnosis
In the following days, my diarrhoea disappeared, but the blood in my stool persisted.
Without any worrisome thoughts, I first underwent a proctoscopy which showed small haemorrhoids. These were treated, but because I still had blood in my stool I had a sigmoidoscopy a few weeks later. At this investigation, the gastroenterologist showed me the tumour in my rectum, and I knew what this meant. I had a biopsy, and the information from this (and the requisite additional imaging) meant that I was needed radiochemotherapy and surgery.
Preoperative exercise training
Before the operation, I searched for additional support from sport and exercise medicine specialists as I knew this would help me through my therapy. I was …