She and her teammate, Jessie Diggins, became the first Americans ever to win a gold medal in cross-country skiing. In a race against two of the best teams in history, the women triumphed. “I knew it would be my last and I wanted to go out with a bang,” Randall remembers. “I was fully prepared to end my career with a sense of accomplishment, but to get that medal and put that stamp on it was really special. It was a dream come true. I really was on a high coming off of that.” The following months were a blur of celebrations in her hometown of Anchorage, Alaska. Randall was retiring. Shortly after her return from South Korea, she, her husband, and their young son moved to British Columbia. It wasn’t until Mother’s Day — Sunday, May 13, just shy of three months after she won gold — that Randall felt she had a chance to catch her breath. She and her family had been in their new home for only a few weeks, and they loved it. Her son had just turned 2, and the family of three had spent the day hiking among yellow wildflowers. “I remember thinking to myself, ‘I can’t believe how amazing life is right now,’” Randall remembers. That night, when she was getting ready for bed, Randall brushed against a hard spot on her breast. It was roughly the size of a pea. At first, she thought it was part of her ribcage. But she had a sinking feeling. “I immediately knew I needed to get it checked,” she says.
2 Tense Weeks, and a Diagnosis
Since she was so new to town, she didn’t yet have a primary care physician. So when Randall woke up on Monday morning, she headed straight for the local hospital, and from the parking lot to the hospital’s mammogram department. When the hospital told her she’d need a referral from a primary care physician, she drove to a walk-in clinic. Randall got lucky at the clinic. Many women under 40 who find breast lumps report that their concerns are dismissed because of their age. Most expert groups don’t recommend screening for breast cancer using mammograms or ultrasounds before age 40, because only about 5 percent of breast cancer cases happen in women younger than 40. But Randall landed with a doctor who took her seriously, and who knew enough to order not just a mammogram, but an ultrasound, which can better detect breast cancer in women who have dense breast tissue, in which it’s harder to spot tumors. In women with dense tissue, adding an ultrasound to the scanning process ups the accuracy of the screening. Randall would have to wait two weeks before her appointment, though. She spent those two weeks trying to convince herself that she was too young, that it was nothing, and trying to stay busy. Finally, she had the mammogram and the ultrasound. A few days later, as she was boarding a plane for Sweden to attend a friend’s wedding, she got a call from her doctor. She had cancer. The mammogram had not picked up the small cancerous lump, but the ultrasound had. In fact, it had picked up a second one, as well. She cut her trip to Sweden short and came home immediately after the wedding.
Fast-Growing Cancer, Aggressive Treatment
The biopsy revealed that she had fast-growing stage 2 breast cancer. A month after finding the lump, she discovered another, this time in a lymph node in her armpit, the first stop for cancer that is spreading. Scans would soon show that her tumors were doubling in size every three months. Randall had to return home to Alaska to get treatment. She didn’t yet qualify for health coverage in Canada. The U.S. Olympic Committee kept her on their health insurance plan as an athlete, even though she had retired, so she could get the care she needed. Her oncology team decided she would need chemotherapy, surgery, and radiation for good measure. Randall was concerned about her fertility. “We had already started trying for that other child,” she says. Many cancer therapies, including chemotherapy, the first one she was scheduled to receive, can impair fertility. Sometimes it’s temporary, sometimes it’s permanent. For peace of mind, Randall underwent a round of ovarian stimulation before starting treatment to retrieve her eggs, and was able to preserve one embryo she could potentially use for in vitro fertilization (IVF) after treatment was done. Then, she was ready to start chemo.
Exercise Reduced the Intensity of Symptoms
On July 9, 2019, Randall started her first round of chemotherapy. For the next three and a half months, she’d undergo six rounds of chemotherapy spaced three weeks apart. It became a rhythm she got used to. She’d feel fine on the day she got treatment, and then around day three, she’d start to feel like she had the flu. Sores crept up on the skin inside her mouth. This lasted until day five, when her side effects would begin to wane. “I would hit my stride by week two or so, just in time to start it all over again,” she remembers. The time it took her to rebound got longer as the treatment went on. Randall relied on her lifelong athleticism to combat side effects. She set a goal of at least 10 minutes of exercise every day. “If I was dragging, I would respect that as my body needing rest. But most of the time, that 10 minutes would make me feel better, and I kept going for longer,” she says. Randall continued to ski, and she also ran. She even rode her bike to every round of chemo. “Staying active helped my mind a lot but it also helped my body process everything, too,” she says. Some small studies support the role of exercise in mitigating the side effects of treatment. A review published in March 2018 in the Breast Journal, for example, found that exercise was better than medication at managing fatigue during cancer treatment. Another small study specifically on breast cancer patients undergoing chemotherapy, published in November 2019 in BMC Cancer, found that exercise alleviated chemo side effects like lack of energy, stress, and nausea.
A Year of Cancer Treatment
In October, scans showed that chemotherapy had kept Randall’s cancer from spreading, so Randall weighed her options for surgery. She decided to undergo a lumpectomy — which removed the cancer and some of the tissue around it — instead of a full mastectomy, or removal of the breast. If her cancer was widespread, a mastectomy would have been a better option. But chemo had contained and shrunk her tumors. After her first surgery, her doctors scheduled a second to get some of the tissue left in the surrounding area, to make sure they’d gotten all the cancerous cells. Then Randall prepared to be in Alaska for all of December and January, when she would undergo nearly two months of radiation, five days a week, even on Christmas. “Honestly, by that time I was feeling better and better. My hair started to grow back, and apart from a sunburn feeling, the radiation was fine. I felt good,” she says. “I felt like I got care that was individualized to me, which is really important especially for young women because a lot of the information out there is geared towards older women.” After radiation was done, Randall’s medical team continued her on smaller doses of chemotherapy until the following July, when she was deemed cancer free. Randall went through premature menopause as a result of her treatment, but she feels lucky that her symptoms were pretty mild — she got used to the hot flashes and didn’t experience any joint or muscle pain or insomnia. One day, with the help of fertility experts, she hopes to have another child.
Athlete, Patient, Activist
Today, Randall is still dedicated to being active every day and has more time to challenge herself in ways other than skiing. Since beating cancer, she’s run marathons in Boston and New York City and competed in a 90-mile gravel bike race. “After going through treatment, I am extra appreciative of how good it feels to be able to be active and have normal energy,” she says. She lives in Alaska, where she’s dedicating her time to giving back to the sport that made her an Olympian. Randall is the executive director for the Nordic skiing Association of Anchorage, a nonprofit organization that facilitates cross-country skiing in the city, and is on the governance boards for both the National Nordic Foundation and U.S. Ski and Snowboard. She also spend time advocating for breast cancer screening, especially in young women, through the American Cancer Society. She combines the two — cancer awareness and fitness — in her work with AKTIV Against Cancer, a nonprofit that helps people fighting cancer stay active throughout treatment. Randall gets screened for breast cancer every six months. “I like the security of going in and getting that thorough check,” she said. Her advice to other women is tried-and-true: Do regular breast self-exams so you’ll better know your body and be able to detect when something is off. “The stats are one in eight women will get breast cancer in their lifetime. When you look at your friends, you start realizing how crazy a statistic that is,” she says. As devastating as her diagnosis was, Randall says going through cancer gave her the ability to reframe the way she thinks about things, focusing on the things in her life that are amazing, like her son, who will be 6 years old soon. “I confronted what is important in my life. I can choose to focus on the good things and what I can control and let go of what I can’t,” she says.
