No more grapefruit and I am an athlete first

I mentioned a few weeks ago that I went in for a PET scan to see if the 5 nodules on my lungs, one of which had grown a little over the past year since they’ve been tracking it, were cancer. That PET scan was held on August 25th. 

Image of a grapefruit sliced in half
Grapefruits that look like breasts, hmmm

I went in to meet with my wonderful oncologist, Jocelin Huang, on August 31st. She told me that so far, the nodules on my lung hadn’t “lit up” in the PET scan, indicating that most likely the nodules are not (yet) cancer. 

However, an itsy bitsy (new favorite way to describe cancer) spot on my right chest, where I had cancer before and the side I had the mastectomy on, did light up in the PET scan. It didn’t light up very much, but it did light up, and that was cause for concern. She ordered an ultrasound guided biopsy so they could test the tissue that lit up. Because it had lit up so little, she was okay with me waiting to do the biopsy until I raced the Twin Cities 10-mile race on October 1st. 

The TC 10-mile race got canceled, sadly. Right away, the biopsy was scheduled for Friday, October 6th. My wonderful friend Lynn came with me for the biopsy. Let me tell you, if you’ve never had a biopsy, they freaking HURT. They pushed in a numbing agent and then they pulled out tissue from a few spots using a vice-like needle. Very painful, despite the numbing. 

I survived, despite the pain. After all, I am a survivor. 

I went to see Dr. Huang in person with my friend Anne on October 11, 2023. 

Not good news. 

There are three (not just one – which the ultrasound guided biopsy detected) itsy bitsy, meaning all of them are smaller than a dime, hypoechoic nodules on my chest wall. The tissue tested positive for grade 2 ductal carcinoma, strongly ER/PR positive, HER-2 negative. There are subpleural nodules that are indeterminate and could represent metastatic disease. 

Cancer lingo translation

What all of this means, for the sake of interpretation of how to understand all the cancer lingo, is that I have cancer AGAIN. And because it’s unclear what’s going on in all that is happening, I now have a diagnosis of recurrent metastatic breast cancer. 


This sucks so big time. 

Not only will I have type 1 diabetes for the rest of my life, I now will have cancer for the rest of my life. 

Two horrible chronic diseases that both require a huge amount of energy and focus. 

I’m not usually someone who cries, but crying lots and lots is what has been happening since that fateful diagnosis day of October 11th.

It’s a reminder of how quickly life can and does change. It’s another reminder to enjoy every moment we have. To live as if we could die tomorrow, because it turns out we could.

Granted, I have zero pain related to this third cancer. In fact, the oncologist suggested that my healthy lifestyle: daily meditation, all the home cooked healthy food I eat, the daily exercise – both cardio and weight training, along with the deep and wide network of loving friends I have, all contribute to cancer prevention and management. She strongly encourages me to continue my running, biking, cross-country skiing, weight lifting, swimming as we enter the coming phase of treatment.


My first step in treatment is to get my next COVID booster shot. I have reacted powerfully to each of the vaccinations I’ve gotten, so we want me to be fully recovered from the shot before I start the first-line therapy of letrozole. This is a pill I will take once a day. What this will do in my body is cause my body to decrease the making of the hormone estrogen. And yes, there are a whole bunch of possible horrible side-effects.

Oh, and in the week before I start this new aromatase inhibitor, I’m going to eat a bunch of grapefruit, because eating grapefruit when taking this drug is not allowed. 

The best impact is that it will cause the teeny tiny nodules of cancer on my chest wall to shrink, and hopefully, completely disappear. 

Then what

The next steps in treatment will be revealed as I go along. I will go in for another ultrasound scan of my chest about 4 to 5 weeks after I start the letrozole to see how the cancer nodules are shrinking.

Along the way, I will have regular PET scans to see how everything in my lungs are doing. Plus making sure nothing has spread anywhere else. So far, the rest of my body is doing really well. 

Stages of Grief

In my soon to come out book, Extreme Healing: Reclaim Your Life + Learn to Love Your Body, I talk about how those of us who get a diagnosis of a chronic health condition, we go through the stages of grief. We go through the stages – denial & isolation, anger, bargaining, depression and acceptance – in a hodgepodge mix of ways, rarely linearly and often quickly and abruptly.  

I’ve been ricocheting around the stage of grief as I come to terms with this horrific change in my life.

I find that I am swearing – helps me feel a sense of control to swear an extra amount, crying and sobbing, negotiating with God and the Universe, and stomping my feet in profound anger. Needless-to-say, I’m thankfully on a mini-work vacation, as my ability to concentrate is low. I even did an impromptu improv dance on the edge of the Mississippi River, asking the Universe to help me navigate what is ahead.

That’s my update for today. I will be back as I continue to integrate and breathe into how I will navigate and make sense of what is happening.

For sure I plan to still run the three races I’m signed up for in November!! After all, I am an athlete first and a person living with type 1 diabetes and cancer second. And I am an athlete who doesn’t eat grapefruit anymore.

With love,


Oh yes, it has not escaped my attention that this third breast cancer diagnosis arrives during Breast Cancer Awareness Month. Same as my first breast cancer diagnosis in 2004. Go figure.

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26 thoughts on “No more grapefruit and I am an athlete first”

  1. Mari, Oh, my! I am so sorry! This blog post, as your others and as your book, I am certain, are always chock full of such inspirational truth. I can’t think of anyone who lives their life more wide-eyed and passionately as you. May you have many more years of passionate inspiration to enjoy and to share. (Also, I just called you. Feel free to call anytime you want to chat.)

  2. Mari, It’s both bitter and inevitable that our greatest heroes have to face the greatest challenges. No one deserves a triple helping of this misery, but no one else could survive it like you and come out fighting on the other side. You’ll continue to beat this thing like the Amazon warrior that you are, and you’ll continue to inspire the rest of us to overcome our own challenges.

    But, we all know that even heroes need support and I’m glad you have the amazing network of friends around you–both close to you in the cities, and further flung around the world. We’re all rooting for you and we love to see you succeed. I hope you’ll remember that you’ve got people everywhere who are ready to lend a hand or an ear whenever you need it.


    • Oh Nick, you are gifted with words. Thank you for expressing this love and kindness so clearly and so deeply. It’s not easy for me to remember my connectedness to people, but I am learning and listening at every chance. Thank you for this beautiful reminder of all that is possible.

  3. Mari, this is so profoundly unfair and I admire how you are leaning into your emotions and just letting it rip with everything from profanity to dancing. I hope the drugs work quickly and you get better news soon.

    • Thanks so much Margo. I love the visual of the drugs working quickly!! I will dance to that!!! Much love and appreciation!

  4. Mari – shit… I am so sorry to hear this news. I’m glad you’re still super active and eating super healthy. That I’m sure is a plus in your health as you move through this. It’s been awhile, my breast cancer warrior sister. Would love to meet up and give you an in-person hug my friend. My thoughts are with you, as is my swearing.

    • I miss you dear Kathy! Let’s at least talk on the phone soon, then a meet up in person for a walk!!
      Love you my fellow swearing sister!

  5. Holy grapefruit Batman! I hope the day comes soon when you are through this and you can eat all the grapefruit you want and the cancer is GONE! Mari, You live your life in such an inspiring way! You do so much good for others. May all those blessings that you give come back to you RIGHT NOW and lift your spirits. Let’s stop the cancer cells right in their tracks!

    • Thanks for your kind words Katie!! I’m visualizing those cancer cells just evaporating and disappearing!!

  6. Mari, one time sucks, so now three? I am sorry to hear you’re having to deal with yet another round of this crap. What I do know is that you’ve always been inspirational to me. Your story is incredible and you are a fighter. I believe this will be another part of your story of yet another obstacle you’ve overcome. I’m thinking about you and holding you in my heart.

    • Blessings and thank you Terry!!! Here’s to visualizing that this particular cancer journey will become another thing I’ve overcome! I appreciate the love and kindness my friend.

  7. So glad to see people speaking your truth and radiating out your awesomeness and truth telling. There are no words. I am, however, going to be doing more water coloring in honor of your healing journey.

  8. I am sorry to hear about this. The only things I can suggest are to do things you love every chance you get and do what your doctors suggest. Even though we have never met your writing about diabetes and health have always been an inspiration. I have type 2. Ps, not so long ago I discovered I know your aunt Anne. I came to know her when I lived in Fort Collins over 20 years ago and she is a friend on Facebook. She thinks highly of you.

    • You know Ann Ruddy!!! That’s wonderful! She is my dad’s older sister. Good human! Thanks for your kind words Donna!! Hang in there yourself!

  9. Oh Mari! I am so sad to hear this and a little angry myself. I cannot imagine what you’re going through. But I also know what an incredibly strong person you are. You’ll beat this. It just pisses me off that you have to fight it in the first place . I agree with cussing more. It does help release that anger in a situation like this. FUCK CANCER!! FUCK it all to HELL! I will keep you in my prayers daily, my friend.

  10. I am a lot like you…
    *Type 1 diabetic, *Gym Rat,
    *Cancer survivor (stage 2 lobular carcinoma, strongly ER/PR positive, HER-2 negative), but lumpectomy even though it had spread to lymph nodes on my chest wall.
    AWESOME Bora Lim is my cancer doc at MDAnderson in Houston. I went on Letrozole almost immediately after they determined I had cancer and I will be on it for approx 5 years. First two weeks is an absolute bitch. The bone pain will go away. After two months on letrozole the tumor shrank 50%. Lim then started me on Ibrance (oral chemo) and we did this for 5 months with no real side effects. Every two months we did a sonagram to make sure it was getting smaller. Before surgery they could not detect cancer (everything shrunk/died) but one lymph node still had a bit. Get second opinions. If you aren’t taking a systemic like Letrozole or Ibrance prior to surgery, shame on your doctor. Hang in there – call (832-707-1739) or email any time. I’m hoping this bullshit is behind me and pray yours gets a kick in the shorts as well.

    • Thanks Kathy for telling me your story. I’ve already had a mastectomy, so no immediate surgery, maybe no surgery as the skin over my chest has already been radiated and is very thin. This is my third time with breast cancer. Step one is the letrozole.I have an AMAZING oncologist.

  11. I am sorry re your health news!

    What’s the deal re grapefruit?! Never saw anything but photo. I don’t think you do clickbait so maybe I missed it.

    • Hi Laura,
      There’s a whole thing about people taking the drug I will be taking, letrozole, being told not to eat grapefruit because of a bad interaction. I talk about my appreciation of grapefruit and now I won’t be able to eat it!!

  12. Sending you big love Mari as you navigate this new path forward! I love your ability to figure out what will work for you in these moments of pure utter fuckery fuck fuck!

    Swear! Scream! Cry! Laugh! Run 10 miles! Run 3 races. You are freaking incredible!

    Fingers crossed, in 4-5 weeks, up at Camp du Nord, we not only will we be celebrating me turning 60 but effective kicking cancer out of your body (or at least the drugs doing their job and shrinking them so they disappear)!!!

    And as always, so grateful for you and your wisdom!

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