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Gabe Grunewald Refused to Let Cancer Have the Last Word

Runner’s World logo Runner’s World 3 days ago Erin Strout, Photography by Ackerman + Gruber

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From a bed at Abbott Northwestern Hospital in Minneapolis on May 4, Gabriele Grunewald posted a photo of herself on Instagram asking for some “brave vibes” as she fought an infection, which forced her to miss her own “Brave Like Gabe” 5K to raise money for rare cancer research.

“It’s not lost on me that maybe this is one of the most poignant ways to show just how critical research is,” she wrote. “Cancer is nothing if not incredibly inconvenient and we need more options.”

Just five weeks later-10 years after she was diagnosed with adenoid cystic carcinoma (ACC), a rare cancer-Grunewald, 32, died on June 11, in Minneapolis.

a man jumping in the air: She thought her purpose was to become one of the fastest runners in the country. But living with incurable cancer, Gabe realized her role in the sport was bigger than any podium finish. © Ackerman + Gruber She thought her purpose was to become one of the fastest runners in the country. But living with incurable cancer, Gabe realized her role in the sport was bigger than any podium finish. She was one of the country’s most talented and beloved middle-distance track stars, an advocate for people around the world living with cancer, and a budding leader of her own nonprofit organization, Brave Like Gabe.

“At the end of the day people won’t remember the PRs run or the teams qualified for,” Grunewald’s husband, Justin Grunewald, wrote on June 9 in a letter to his wife on Instagram, “but they will remember that hard period in their life where they were losing hope but they found inspiration in a young lady who refuses to give up.”

Grunewald persevered in the past several weeks despite increasing health complications, which grew in severity over the course of 2019. During a phone interview in early April, Grunewald, who was the 2014 national champion in the indoor 3,000 meters, still held hope that she could compete next summer at the 2020 Olympic Trials. It was a goal, she said, that kept her moving despite her ongoing health challenges.

a group of people walking in the snow: Grunewald and her husband, Justin, run near their home in Minneapolis in December 2018. © Ackerman + Gruber Grunewald and her husband, Justin, run near their home in Minneapolis in December 2018. “I know it’s more likely that I won’t be racing at the Olympic Trials than it is likely,” she said. “However, so many things have been unpredictable, and I know that all it takes is finding one treatment that works for you. It could be this one or the next one I try.”

Although her last competition was in 2017, Grunewald never gave up on her professional running career. She was devoted to the sport, which eventually became a platform for another issue she gave equal fervor: raising awareness and money for rare cancer research, as well as encouraging others living with cancer to stay physically active.

“I need advances in medication to live for a long time,” she said one afternoon in May 2018, while getting ready for an eight-mile run from the condo in Minneapolis she and Justin shared, just a block from the Mississippi River. “Knowing that it’s not a given, it motivates me. This crosses my mind every single day, more than once, when I’m trying to sleep at night. I have no idea how much time I have left.” 

a woman sitting on a table: Grunewald takes a break from work on the Brave Like Gabe foundation with her Maltese-Yorkie mix, Perrie, this past December. © Ackerman + Gruber Grunewald takes a break from work on the Brave Like Gabe foundation with her Maltese-Yorkie mix, Perrie, this past December. ACC first presented in Grunewald’s salivary gland when she was a senior competing for the University of Minnesota in 2009. She found a lump under her left ear. She was away at a track meet at Arizona State University when her doctor called to tell her she had a disease that about 1,200 people are diagnosed with each year in the United States. It has no cure.

The day after that phone call, Grunewald ran a then personal best time in the 1500 meters, setting the tone for a decade to come-that living with cancer was never going to be an excuse to stop pursuing audacious, Olympic-sized dreams.

She underwent surgery and radiation, and came back the next season to earn All-America honors and finish runner-up at the NCAA championships. That scored her a professional contract with Brooks and a spot with the training group Team USA Minnesota.

Then in 2010, cancer returned in another, unrelated form, in her thyroid. Surgery and radioactive iodine treatments followed in October 2011. Unlike ACC, this cancer was curable and once again, it didn’t hold Grunewald back. She jogged to and from her treatments, recovered, and in the next few years trained mostly uninterrupted. She enjoyed pockets of time in which she led a seemingly “normal” life, with the knowledge that ACC would likely return at some point, somewhere else in her body.

To be sure, professional runners have an unusual relationship with time. Success is based on fractions of seconds. Recovery comes in minutes or days. Training cycles are scheduled in weeks. Competitive seasons are blocked out in months. All of it is neatly planned in four-year increments, shoved into less than two decades of early adulthood.

If you also happen to be a professional athlete living with incurable cancer, the passage of time takes on added complexity. For Grunewald, mortality forced an urgency to achieve big goals in a condensed window, but she also simply wanted to survive long enough to give scientists time to discover treatments.

This year, however, became the most challenging. During the winter, she and Justin, who is a doctor, noticed the whites of her eyes turning yellow. Her skin turned jaundiced. She itched, some nights scratching herself until she bled.

“I went in and talked to my doctors because I was experiencing a lot of symptoms of either liver failure or a bile duct obstruction,” Grunewald said, during the phone interview in April. “One of my tumors just grew a lot between January and February.”

a group of people walking down a street: Grunewald runs near her Minneapolis home in January 2019. © Ackerman + Gruber Grunewald runs near her Minneapolis home in January 2019. She had a procedure in February to insert stents that allowed new pathways for bile to leave her body. They needed to be replaced soon after. Then the infection came on in May.

In the meantime, Grunewald had started a drug that’s awaiting FDA approval for ACC. She took three pills once a day-for a patient without insurance approval, the treatment would have cost an estimated $18,000 a month, she said.

“Technically, I think my doctors wanted me to wait as long as I could before trying this,” Grunewald said. “They want people to wait because it comes with a lot of side effects, but they don’t want you to wait so long that it doesn’t have a chance of helping you. I always knew I’d likely be on the drug at some point, I just didn’t know when.”

a man and a woman walking down a street: Gabe and Justin in Minneapolis, December 2018. © Ackerman + Gruber Gabe and Justin in Minneapolis, December 2018. In August 2016, Grunewald watched coverage of the Rio Olympics from a Minneapolis hospital room. The difference between where she was and where she had once hoped to be was devastating.

A weekend shift of ER doctors, nurses, and physicians’ assistants took turns counseling Grunewald while the gymnastics competition flickered on the television. She watched the diminutive athletes decked out in red, white, and blue tumbling, flipping, and flying for gold medals, 5,600 miles away.

“I was just hoping to be in Rio, and now I’m pretty sure that I have metastatic cancer and I could be terminally ill,” Grunewald recalled of that evening. “I could not believe that was my reality.”

To appreciate the contrast, go back to 2012, when Grunewald was a 26-year-old rookie on the professional running circuit. She just missed the London Games by placing fourth in the 1500 meters at the Olympic Trials in 4:07.38. But it didn’t feel like a defeat. It was a tantalizing outcome for the young athlete-a way to stay hungry through another four grueling years of training.

When the next attempt at qualifying for Team USA came in July 2016, however, Grunewald missed her shot again. She failed to advance in the 5,000 meters and in a last-ditch effort to make the team, she entered the 1500 meters. She lined up with a personal best of 4:01.48, but finished 12th in 4:18.73. Back home in Minneapolis, she wondered why she was unable to access her finely tuned fitness when it mattered most.

In the weeks after the Trials, Grunewald grieved. She shut down her competitive season and took a break from training, resolving to take another shot in 2020. The day before she planned to ease back into her first run, she passed Justin in the kitchen. He gave her a hug. Then he paused. He felt something hard on the right side of his wife’s abdomen.

As a then-two-time cancer survivor, Grunewald didn’t have the luxury of shrugging off abnormalities. The couple went to the hospital in search of peace of mind. Instead, they learned that Grunewald had competed in the 2016 Olympic Trials with a four-pound tumor growing in her liver, pressing against her diaphragm-a return of the ACC, and her third bout of cancer in seven years.

“[When Justin felt something], I was like, ‘What organs are there?’ And he told me my liver,” Grunewald said. “I just had a really bad feeling immediately.”

a man and a woman: Gabrielle Grunewald © Ackerman + Gruber Gabrielle Grunewald Despite the surgery after the Olympic Trials, which left a 13-inch purple scar across her abdomen, the ACC came back in the form of several smaller, inoperable tumors on her liver. Still undeterred by this fourth diagnosis in eight years, Grunewald spent the summer of 2017 crisscrossing the country to compete in the 1500 meters. Scheduling track meets in between chemotherapy treatments, she sought a 4:09.52 qualifying time to enter the USA Track & Field Outdoor Championships in Sacramento, California.

Her closest result was 4:12.29 at the USA Track & Field Distance Classic in Los Angeles. But she was granted a spot that June at the championships anyway, because too few women were entered. After battling a fever in the days beforehand, she fought through another 1500 meters and 4:31.18 of racing, placing last in her heat on a 100-degree evening. At the finish line, Grunewald’s competitors embraced her. Spectators stood and cheered for her strength.

a woman standing in front of a crowd: Gabriele Grunewald huddles with competitors after finishing the 1500 at the 2017 USA Track & Field Outdoor Championships in Sacramento, California. © Patrick Smith - Getty Images Gabriele Grunewald huddles with competitors after finishing the 1500 at the 2017 USA Track & Field Outdoor Championships in Sacramento, California. “The fact that she toed the line on chemo in Sacramento when it was hot out-I think that was the most miserable moment of her life,” Justin said during an interview in May 2018. “She wouldn’t say this, but that was humiliating for her. She loves running, but she also loves to beat people.”

Grunewald realized it was something she needed to do, to show that a young adult with rare cancer doesn’t have to quit.

“I knew I wasn’t in my top form mentally, emotionally, or physically, but I still felt like it was important for awareness of what I was going through,” she said.

That sweltering, humbling night in Sacramento marked a shift in Grunewald’s attitude and a resolve to expand her reach through running. Maybe her career was supposed to be more than PRs and titles and world championships teams? Perhaps not giving up on the pursuit of those dreams is all that matters, even if they are never realized.

“What is possible for me as a cancer survivor? I am constantly asking myself that,” she said. “How can cancer survivors still see themselves as people who can do big things, and keep their minds open to the possibility of being awesome at whatever it is they do?”

Cue the hashtag: #BraveLikeGabe

a man standing on top of a hill: Gabrielle Grunewald © Ackerman + Gruber Gabrielle Grunewald When Grunewald started receiving treatments at Memorial Sloan Kettering Cancer Center in New York in 2017, her friends wanted to help ease the financial strain of travel and other related costs. So they started the #BraveLikeGabe social media campaign and online fundraising drive.

“I like the word ‘brave,’” Grunewald said. “I am not the perfect cancer survivor. I don’t do everything right. I screw up sometimes…but I am brave most days. It’s not just about cancer-life can be tough for anyone; bravery is required in so many different areas.”

So much money poured in-more than $74,000-that the Grunewalds were also able to jumpstart their own nonprofit organization, the Brave Like Gabe Foundation. The mission is to support rare cancer research and empower survivors through physical activity.

Emily Richter, a long-time friend from the University of Minnesota who has helped Grunewald get the nonprofit off the ground, saw that establishing Brave Like Gabe allowed Grunewald to flourish in a new way.

“These past few years have become so much more than running. She’s been able to use running as a platform to advocate for those less fortunate, for further research, to help people get through tough things,” Richter said. “She’s taken this in stride, but really embraced this role, showing vulnerability, and showing the world there’s so much about living that she doesn’t take for granted.”

The organization’s first fundraiser in May 2018 was a 5K in St. Paul, Minnesota, and a companion virtual race. More than a thousand people ran, raising another $109,000 for Brave Like Gabe, which included a $50,000 gift from an anonymous donor. The second edition of the event in May this year sold out-and although Grunewald wasn’t able to be there, she and Justin attributed its success to their friends, who continued “to come through in all the desperate times of need.”

Justin, however, has been Grunewald’s biggest supporter and constant companion through all four bouts of cancer-a loyalty that only deepened in the past three years. The couple met at “the U” (what the Gopher faithful affectionately call the University of Minnesota) and were members of the track and field team.

“I thought, ‘She’s a cute girl,’ but I liked her more as a friend. That’s a great way for a relationship to start, because with time, hopefully you end up marrying your best friend,” Justin said. “That’s essentially what happened. I think her personality and how enjoyable it was hanging out with her was probably the kicker. We had lots of long study hours where she put up with me and rewrote all of my English papers. It was good training for her Instagram posts.”

Those posts are where Grunewald documented her treatments and the vacations she and Justin took together. They were careful not to call it a bucket list-Grunewald didn’t believe in those, preferring to simply not procrastinate going places she wanted to see. After the ACC recurrence, they committed to visiting all the destinations they had longed to explore while her health was good, like Banff National Park, or climbing Quandary Peak, a 14,000-foot Colorado Rocky summit to celebrate five years of marriage.

Instagram is also where Grunewald updated followers about her charity’s progress. Brave Like Gabe disbursed its first round of funds early this year, including a $100,000 challenge with Cycle for Survival to create the Brave Like Gabe Fund for Rare Cancer Research at Memorial Sloan Kettering.

a woman sitting on a table: Brave Like Gabe gave Grunewald an opportunity to inspire others through her experience. © Ackerman + Gruber Brave Like Gabe gave Grunewald an opportunity to inspire others through her experience. The foundation’s early success has been aided by a chance encounter Grunewald had during a run in Central Park while in New York for treatments. A dedicated HGTV fan, she spotted Chip Gaines, who hosted the show Fixer Upper with his wife, Joanna Gaines.

She approached him casually and they chatted briefly about running. Grunewald ended up writing a marathon training plan for Gaines. But instead of signing up for an existing race, the Gaines’s company, Magnolia, created its own event in Waco, Texas, called the Silo District Marathon, which also included a 5K and half marathon. All $250,000 of the proceeds from the May 2018 race went to the Brave Like Gabe Foundation and an additional $300,000 was raised at the 2019 race, which also benefitted a local cancer treatment center.

Brave Like Gabe also strives to create a community for those coping with diseases like ACC. Grunewald wanted others to find inspiration from patients who are training for marathons or merely walking laps around the hospital floor when treatments are taking a toll.

“When I share my story-the hard parts especially-it makes them feel like they’re not alone. It also makes me feel less alone, so I really do appreciate hearing from people,” Grunewald said. “It helps me to try to keep going-even with my advocacy and fundraising-when I don’t feel great.”

a person standing in front of water: Gabrielle Grunewald © Ackerman + Gruber Gabrielle Grunewald During 2017, when Grunewald split much of her time between home base in Minneapolis and treatments at Memorial Sloan Kettering Cancer Center in New York City, the tumors seemed to stabilize for a while-a promising sign.

“For some patients, this tumor actually grows slowly or not at all for long periods of time,” said Alan Ho, MD, Grunewald’s oncologist at Memorial Sloan Kettering, during an interview in June 2018. “In Gabe’s situation… the tumors [were] not really bothering her or causing her any symptoms. What we use as guidance for treating her is the rate the tumors are growing in her liver and wanting to stop or slow down that process.”

The plan up until the beginning of 2019 (when Grunewald’s health declined), involved sending targeted glass beads of radiation through the femoral artery in the leg directly into the tumors in Grunewald’s liver.

Because this cancer is under-researched, medical professionals find it difficult to give a prognosis to patients. And Grunewald preferred to remain optimistic-during her final week, despite lab results that Justin described as “incompatible with life,” Grunewald insisted she wasn’t going to die.

“Not today,” she told Justin.

She lived nine more days, but not long enough to try more experimental treatments.

“We control the disease as long as possible. It’s rarely rapidly progressive and aggressive,” Dr. Ho said. “We need better biomarkers to predict or project the evolution of the tumors.”

Her devotion to physical fitness could have been an important factor in how long she lived, too. “The healthier, more fit patients always have ultimately better outcomes,” Dr. Ho said. “Whether it’s because, physiologically, there’s some interaction between a patient’s fitness and their ability to live with cancer or their ability to tolerate treatments that we give them.”

Though much of her energy in 2018 and 2019 was devoted to Brave Like Gabe, Grunewald still craved a good sweat every day, even in her final months. She’d bike alongside Justin during his runs or try an elliptical session if she was up to it. Running, however, didn’t agree with her for much of this year.

“I have tried running, but it hasn’t felt great,” Gunewald said in April. “I think whichever tumor grew, it’s making me uncomfortable when I run. I don’t think I want to run with that level of pain… I think it’s smart for me to keep things a little chill for the moment.”

She may have felt too fatigued to log any miles this spring, but make no mistake: Grunewald’s competitive spark was still there in April.

“Even if it’s just a sliver of hope that helps me get through my day and inspires me to tie up my shoelaces one more time, that’s what I’m looking to,” she said. “The 2020 Olympic Trials are next June. I can’t throw in the towel now. It’s just not the right time. It’s too far away.”

Dennis Barker, her longtime coach, always believed in her, still seeing “flashes of talent” on days when there should have been no logical reason why she could hit a workout as well as she did. He knew that given a chance at consistent training, she would have seriously contended for a spot on Team USA next year. But beyond her athletic pursuits, he had a seat in Grunewald’s life that allowed him to watch a young woman meet a challenging adulthood with equal parts grace and tenacity.

“She smiles really easily. It doesn’t take much of a suggestion for her to get involved in something she thinks is fun,” Barker said, during a phone interview last year. “But she also has a real good analytical mind. By the time she calls to talk to me, she’s already run over it in her mind quite a bit and has the arguments for doing this or that. It’s good because she’s not an athlete who says, ‘just tell me what to do.’ She wants to understand it and know the process that’s involved and why she’s doing it.”

At the very least, Grunewald always wanted the opportunity to leave the sport on her own terms.

“I would love to say goodbye to professional track without cancer being the reason I’m done,” she said. “I have a hard time considering myself an Olympic hopeful at this point, but I also know that if I didn’t have cancer, I would be an Olympic hopeful.”

Grunewald’s younger sister, Abby Anderson, understood that the woman she described as her “second mom” didn’t want to be known as “the cancer runner,” but admired the evolution Grunewald went through to arrive at the intersection of athlete and advocate. It’s an important example for others, she said during an interview in May 2018.

“She used to not want to talk about the cancer,” Anderson said last spring. “But now that she’s telling her story, she gets strength by being so open. It makes it less scary for her, because she can mold this however she wants, to take back some control in her life.”

Cancer or not, Anderson says her sister’s presence was big, sassy, and often comforting, whether in front of a crowd crooning her favorite karaoke song (Whitney Houston’s “I Wanna Dance With Somebody”) or helping Anderson open her first bank account. She always took the lead.

“I will say, I beat her mile time in high school-I broke her school record,” Anderson said during an interview last year, laughing. “But Gabe has the grit that I never had. When she faces adversity, she’ll just run it down.”

a person standing in front of a building: Staying active helped Gabe stay motivated even in her final months when running became more uncomfortable. © Ackerman + Gruber Staying active helped Gabe stay motivated even in her final months when running became more uncomfortable. Just harboring that Olympic dream was the reason Grunewald was ultimately in a position to make her greatest contribution, giving rare cancer a spotlight, uplifting others with diseases like her own, and raising funds that will offer more hope for the patients who follow her. It’s this legacy that drove Grunewald in the last three years.

A year ago, Grunewald gave an indication of what she wished to leave behind for the communities she cherished-cancer survivors and runners.

“What am I going to be thinking about on my final days here? I just want to be proud of what I did. I hope what people mainly see is that you can still make something beautiful and something powerful out of a really bad situation,” she said. “You can still find some good in it. I will never let cancer have the last word.”

To contribute to the Brave Like Gabe Foundation visit the website.

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