The Latest on Tommy Rivs: Health Update and Return To Running

After surviving a rare lung cancer, the inspirational runner is back bagging miles on his own terms.


I first heard about Tommy Rivs several years ago on the Rich Roll podcast.

I distinctly remember the day because I was listening while doing a pool running workout, wishing I could be outside running.

I was dealing with my own physical ramifications of a trauma that were making it impossible to run and admittedly wallowing or feeling pity for myself that I couldn’t be out doing the sport I have loved my entire life.

To say that Tommy Rivs’s story is inspirational is about as understated as it gets. 

As I went back and forth that morning in the pool, my perspective on gratitude for not only my ability to be physically active but also for my health, my life, my loved ones, and my blessings to have the life I am living became deeper and deeper entrenched into my mindset.

I found myself gripping onto every word that Rivs and Rich Roll shared, and my usual monotonous pool running workout flew by.

I even stayed in longer than I planned because I wanted to hear the end of the conversation without interruptions from the outside world once I toweled off.

From there, my interest in following the profoundly inspiring story of Tommy Riv’s recovery journey and return to running was born, and I have been fascinated via social media from the sidelines ever since.

So, who is Tommy Rivs? What happened to Tommy Rivs? Where is Tommy Rivs in his health today?

In this Tommy Rivs Puzey profile, we will discuss who Tommy Rivs is not only as an endurance athlete but as a survivor of a rare and aggressive form of lymphoma, and his triumphant story of healing.

The Latest on Tommy Rivs: Health Update and Return To Running 1
Photo: Tommy Rivs’ Instagram

Who Is Tommy Rivs Puzey?

Tommy Rivers Puzey, commonly known as Tommy Rivs, is a professional ultra-runner, elite marathoner, motivational speaker, iFit trainer, physical therapist (DPT), husband to Stephanie Puzey (who goes by Steph Puzey in her inner circle), and father of three girls.

Adding to that list of impressive descriptors, Tommy Rivers Puzey is also an anthropologist, linguist who speaks five languages, a licensed massage therapist who works on some of the world’s top elite athletes, a Craft Sportswear athlete and brand ambassador (check out Craft Sportswear Teamrivs), and inspiration to distance runners, ultrarunners, everyday athletes, and cancer survivors.

After all, not only is Tommy Rivs an accomplished marathon runner and trail runner in his own right, but he has one of the most inspiring comeback sports stories from the last decade.

Although Tommy Rivs has been competing in ultramarathon and trail races, half and full marathons, and other endurance sports for years, his name became front and center in headlines throughout the running community in the summer of 2020 after contracting what seemed to be a mysterious respiratory illness that was originally thought to be COVID-19.

If you transport yourself back in time to the summer of 2020, that was just months after the start of the COVID-19 pandemic and still a peak time for contracting the coronavirus.

Therefore, not only were respiratory illnesses often assumed to be the coronavirus, but there was still a lot of medical isolation and social distancing going on.

Doctors had yet to understand the transmission and symptoms of COVID-19 fully, and there were other complicating factors that made the diagnosis for Tommy Rivs a drawn-out process.

Ultimately, Tommy Rivs was diagnosed with a rare form of lung cancer called Primary Pulmonary NK T-Cell Lymphoma,1Zhang, J., Wang, M., Yang, X., Liu, C., & He, X. (2017). Primary pulmonary extranodal NK/T-cell lymphoma of nasal type misdiagnosed as pneumonia. Medicine96(49), e8914–e8914. https://doi.org/10.1097/md.0000000000008914 which is said to be an aggressive form of lymphoma. 2Laohaburanakit, P., & Hardin, K. A. (2006). NK/T cell lymphoma of the lung: a case report and review of literature. Thorax61(3), 267–270. https://doi.org/10.1136/thx.2004.025767

‌Ultimately, in a truly harrowing story, Tommy Rivs was put on a ventilator and into a medically induced coma for months, spanning from the summer of 2020 until the end of October 2020. 

On the Rich Roll podcast (which you can find on Apple Podcasts or Spotify), Tommy Rivs admitted that it wasn’t until sometime in the middle or end of November, that he was fully aware that he had been on chemo, in a medically induced coma, and was in the hospital for lung cancer.

What Happened to Tommy Rivs?

In the Tommy Rivs Rich Roll podcast episode, Tommy Rivs describes how he first noticed he was sick. As I recall, he was helping a buddy who was doing a Grand Canyon solo ultramarathon-type event. 

While in the Grand Canyon, Tommy Rivs came across a woman who was woefully unprepared for the sweltering heat at the base of the canyon and didn’t have enough water or food.

Being the generous, caring person Tommy Rivs has always been, he gave the woman his fluids to help essentially save her life. 

Remember that this occurred during the COVID-19 pandemic when the Grand Canyon park rangers were not staffing the iconic park in Arizona, so there was no rescue help.

The base of the canyon can see temperatures over 115 or 120°F, and the woman and her group had at least 3 miles until the next water station.

This anecdote demonstrates the compassionate and giving nature that Tommy Rivs has always embodied, and it is also a key piece of the diagnosis story. 

Puzey noted that he was experiencing a relentless headache, a significantly elevated heart rate, and an inability to cool his body down over the next night and day when he was still trying to get through the Grand Canyon with his friend. 

At the time, Tommy Rivs attributed these physiological strains to dehydration, the elevation of the Grand Canyon, and lack of proper fueling.

However, things progressed, and he soon became unable to regulate his body temperature at all and was struggling to breathe. Eventually, he told his friend he needed to bail on their Grand Canyon ultramarathon plans and get home.

Unfortunately, the symptoms did not abate when he was back in Flagstaff, Arizona, at home with his wife and children. 

Tommy Rivs continued to experience night sweats, a very rapid heart rate, difficulty breathing, and, worst of all, a relentless dry cough that was so unending that he would cough to the point of passing out at bedtime rather than truly falling asleep.

He would wake up with blood on his pillow.

Rivs thought he had COVID, but after taking numerous tests (all of which came back negative) and seeing several doctors, it became clear that this was not the correct diagnosis.

However, because the coronavirus was continually mutating and testing was still not fully accurate, Tommy Rivs was dubious of his negative COVID-19 results and assumed that was still what he had. 

Because there were limited hospital beds in the Scottsdale, Arizona area and many people—particularly the indigenous Americans—did not have the same luxuries at home, such as air conditioning, running water, and a place to self-isolate, Tommy Rivs stayed out of the hospitals despite truly suffering from severe respiratory symptoms. 

Plus, the risk of contracting COVID-19 by being in a hospital surrounded by sick patients when he might have another respiratory illness made Tommy Rivs decide that it was better to treat himself at home. 

After all, he does have a doctorate in physical therapy and a background in health and had tremendous cardiovascular and respiratory fitness as an endurance athlete.

However, coughing, breathlessness, and symptoms continued to progress, and eventually, despite his stubbornness, his wife forced him to go to the hospital and get further evaluation.

It ended up taking quite a long time to diagnose Tommy Rivs with an aggressive form of lymphoma, Primary Pulmonary NK/T Cell Lymphoma lung cancer.

He was admitted to the Scottsdale ICU and put on a ventilator because his lung function was so compromised that he was unable to keep his oxygen saturation level high enough to support his life.

He underwent countless surgeries and medical procedures over the next several months, all while being in a medically-induced coma.

Meanwhile, his wife Steph posted social media updates on Tommy Rivs’s health status, along with lyrical, poetic musings about life, pain, grief, anxiety, gratitude, fear, and every emotion under the sun.

Ultimately, Tommy Rivs lost over 75 pounds of muscle, wasting away to just over 95 pounds. He was left with only about 20% of his lung function or lung capacity, a seeming tragedy for an elite endurance athlete.

Rivs had third-degree pressure ulcers on his tailbone and sacrum and other severe pressure ulcers, scars, and full-body atrophy from his treatments since they were unable to move his body or have him sit up during his time in the ICU.

Tommy Rivs had to relearn how to walk, talk, swallow, and sit up, all while trying to grapple with understanding what had happened during his time in the ICU.

He had to distinguish real memories from delusions induced by the high doses of steroids, morphine, and other pain medications that were pumped into his body during his months in a medically induced coma. 

One of the most poignant parts of the Tommy Rivs Rich Roll podcast episode was when Tommy Rivs vulnerably shared how tremendously difficult it was to wean off of the morphine and other opioids and pain drugs that he was receiving via IV in the ICU.

He went through about three weeks of extremely trying and painful withdrawal and detox.

Though Tommy Rivs was able to beat the lung cancer into remission, cancer is never fully “cured.”

It sounds like a bone marrow transplant may eventually be the best route towards long-term cancer-free living, but to undergo a bone marrow transplant, chemotherapy is needed to kill your own bone marrow essentially.

The body has to be in a certain state of robust health to survive the aggressive chemotherapy for this outcome. 

Does Tommy Rivs Still Run?

The good news is that although cancer nearly took his life, Tommy Rivs has continued to recover and thrive.

From a fitness standpoint, what began as needing to learn how to walk all over again progressed to the ability to take hikes with his daughter in the Grand Canyon and eventually walking and jogging for his own workouts.

In 2021, Tommy Rivs finished the New York City Marathon in 9:18:57, over 7 hours slower than his PR of 2:18:20, which he ran at the 2017 Boston Marathon.

Puzey shaved about 3 hours off his marathon time in 2022, taking on both the Boston Marathon (6:39:49) and NYC Marathons (6:13:54).

Last year, Tommy Rivs continued to run faster and get stronger, finishing the 2023 Boston Marathon in 4:53:44 and the New York City Marathon in 4:41:57.

These marathon times are dreams for many recreational runners and awe-inspiring for someone who had to relearn how to walk, let alone run, and still deals with compromised lung function, weakness, and scars from his illness.

There is truly no way to accurately or fully encapsulate the power of Tommy Rivs’s story from the point of recognizing something was wrong through diagnosis, treatment, recovery, and his eventual return to run the New York City Marathon and other endurance races.

I strongly suggest following him on social media and reading his wife, Steph Catudal’s new memoir, Everything All At Once. You will learn so much about the healing power of gratitude, resilience, and living life to the fullest.


Photo of author
Amber Sayer is a Fitness, Nutrition, and Wellness Writer and Editor, as well as a NASM-Certified Nutrition Coach and UESCA-certified running, endurance nutrition, and triathlon coach. She holds two Masters Degrees—one in Exercise Science and one in Prosthetics and Orthotics. As a Certified Personal Trainer and running coach for 12 years, Amber enjoys staying active and helping others do so as well. In her free time, she likes running, cycling, cooking, and tackling any type of puzzle.

5 thoughts on “The Latest on Tommy Rivs: Health Update and Return To Running”

  1. I am always in awe at the courage and determination of human beings and in this case, Rivs. I am glad that you were able to fight this, glad that you recovered from this. Know that there are people out there who believe in us, believe in the human drive to push on to overcome. I know how difficult that must have been for you and your family and am happy that you all never gave you. You are an inspiration to so many….we believe in you.

  2. Tommy is an inspiration to all who know his story. I started running after a 40-year “layoff” on an iFit Treadmill. I never could have made the progress I did without Tommy leading the way…! I’ll never be in Tommy’s league, but I owe him a ton… thank you, sir…!


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