Gabriele Grunewald didn't like to catch her own smile in the mirror, but flashed it often on the track.
The first of her cancer operations, soon after the discovery of the disease in 2009, damaged a nerve in her face and permanently altered her smile, which she told Women's Health made her cringe when she saw it.
Another series of operations to remove tumours on her liver left her with a purple sash of a scar across her stomach.
Writing in the New York Times, Michael Powell said the bright scar was the only real thing that set her apart from the other elite competitors at athletics meets.
Grunewald spent 10 years competing at the highest levels of US middle-distance running despite having an incurable metastatic cancer known as adenoid cystic carcinoma.
She died on Tuesday at the age of 32.
Grunewald discovered she had cancer just over a decade ago while a college senior, but decided to embark on a professional athletics career regardless.
In fact, she ran a personal best time of four minutes, 22 seconds in the 1,500 metres at a meet in Arizona the day after learning she had the disease.
Three months after that initial surgery, she was back on the track and running faster times than before.
Her mantra was "Brave like Gabe" and she strove to inspire other athletes struggling with illness. She started a rare cancer research foundation of the same name, encouraging patients to continue to exercise.
"My scars teach me to embrace my body and honour its strength," she wrote on Facebook this year.
"My scars are a physical manifestation of what often feels like an invisible disease. My scars tell my life's story, and I'm pretty glad it's not over yet."
Though she last competed in 2017, Grunewald still dreamed of qualifying for the 2020 Olympics — she narrowly missed out on Rio in 2016, after making the final at the US trials, and for London in 2012, by a single place.
While she endured the spread of the disease, operations to remove tumours and aggressive chemotherapy, she managed to become an NCAA all-American and win the national indoor championships over 3,000 metres.
Her best 1,500 metre time of four minutes, 1.48 seconds makes her the 11th fastest US female runner ever.
She also found time to get married in 2013 to marathon runner Justin Grunewald.
On Wednesday, he posted about his wife's death on Instagram.
"I know life is scary and I know we have won the lottery of uncertainty, and it's not fair, but I still choose our life of uncertainly and at times fear, over any alternative option I could think of," he wrote.
"I have so much fun with you and have learned more from having you as my best friend and wife than I learned in the rest of my life combined.
"Brave flails in comparison to what you are to me and to so many people out there facing the simplest and silliest of struggles in day to day life."