[UPDATE: Luke Puskedra finished ninth in the Boston Marathon on Monday, at 2:14:45.]

Everything Luke Puskedra does is measured in minutes and seconds. He trains hard to shave a digital tick here and a tock there. Small improvements are huge, even in the longest races.

Yet as he looks back at 2016, 27-year-old Puskedra sees a calendar instead of a clock. What was important was measured in months, not minutes.

The former University of Oregon standout, who will run the Boston Marathon for the first time April 17, entered 2016 on a high. He had just run the best time by an American in the marathon in 2015 -- 2 hours, 10 minutes, 24 seconds at Chicago in October -- and hoped to make the U.S. Olympic team for the Rio de Janeiro Games at the marathon trials in Los Angeles in February 2016.

Instead, he finished fourth, just missing a spot. Then, just days after the race, he and his wife learned that their infant daughter, Penelope, had cancer. There were tests and hospital visits, chemotherapy and surgery. Running -- Puskedra's passion and career -- was put aside for about six months as his daughter went through treatments.

"Time went really slow with my daughter getting sick," he says. "That six months of my life feels like it was about 10 years."

Puskedra and his wife, Trudie, often drove between their home in Eugene, Oregon, and Doernbecher Children's Hospital in Portland, where Penelope stayed about two weeks early in the process. At first, the Puskedras were told she likely had a late-stage sarcoma and her chances of recovery were slim. Then, the diagnosis changed to neuroblastoma, a cancer with a strong cure rate. Doctors eventually were able to remove 95 percent of the mass that had grown on her neck.

"It was tough even getting out the door and maybe running for 20 minutes just to try to feel better and get what they call the runner's high," he says. "It just wasn't something that was enjoyable. And everything was so time sensitive, where they were squeezing us in here or squeezing us in there, so if I did try to go for a 20-minute run, the whole time I'm thinking, 'Maybe being gone for 20 minutes could be the difference of us getting into that appointment and having to wait another week.'"

On top of all of this, he had a problem with one knee that eventually required surgery in April to remove loose cartilage. Gradually, he began to do 20- to 30-minute runs about once every three days.

Just after the U.S. Olympic trials in February 2016, Puskedra and his wife, Trudie, found out that their daughter, Penelope, had cancer. Kirby Lee-USA TODAY Sports

Finally, good news came his way in July: Penelope's cancer was in remission. "It was a tough year," Puskedra says, "but with everything with my daughter, we were so lucky."

Soon Puskedra began structured workouts. His first race was a four-miler in Eugene, and then came the USATF 20K National Championships in September. He finished outside the top 10 at 1:00:13, after finishing fourth the year before in 59:30.

In October he returned to Chicago. This time he was 19th in 2:20:18. His fitness obviously wasn't what it had been in 2015. "I'd never hit the wall that everybody talks about," he says.

For the first half of the race, he felt strong, able to answer when the leaders surged. Then he met the wall. "After covering every single one of those moves with the first 10 miles, I think I just zapped my fueling," he says. "The last 10K was definitely the longest stretch of running. I felt I was moving in slow motion. That was a tough result."

After Chicago, he regrouped. He got back to doing track intervals for a different mental and physical stimulus. In January, he ran the Houston Half Marathon, finishing 12th at 1:03:14. Since then, he's done what he likes best: pushing himself hard, doing up to 150 or 160 miles per week. He's spending the last few weeks until Boston training at altitude in Flagstaff, Arizona. He feels strong, healthy and excited.

"I hope [Boston] caters to a runner like me that has a cross country background, with being a hilly course and a tougher course," he says.

Andy Powell, who coached Puskedra at Oregon and encouraged him to run Boston, says Puskedra is energized and his training has been strong. "I think it will be a good course for him," Powell says. "I think the harder, the better for him. That was kind of how we always approached cross country races when he was in college. If it was a difficult course, Luke could do really well."

Powell acknowledges that the past year took a toll on his friend emotionally and physically. Yet he believes there may be some benefit from it. Because Puskedra "trains harder than anyone," Powell says the running timeout of 2016 may have given his body a break. "I think he has a great perspective on things, probably a much different perspective than a lot of twenty-something-year-olds that are running," Powell says. "He has seen a lot and been through a lot."