[music]

ASCO: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience and conclusions. The mention of any product, service, organization, activity or therapy should not be construed as an ASCO endorsement.

You’re listening to a podcast from Cancer.Net. This cancer information website is produced by the American Society of Clinical Oncology, known as ASCO, the world’s leading professional organization for doctors who care for people with cancer.

There are many benefits to being physically active during and after cancer treatment. However, the side effects of cancer treatment can make it challenging to get to a gym or complete standard exercises. In this podcast, we discuss these challenges, tips for staying physically active, and the benefits of participating in a fitness program designed for cancer survivors, like LIVESTRONG at the YMCA.

This podcast will be led by Kristin Leung, a volunteer Senior Leader in the LIVESTRONG Foundation and LIVESTRONG at the YMCA Instructor, and Rachel Dudasik, who is a LIVESTRONG at the YMCA Instructor Trainer and Program Manager.

ASCO would like to thank Ms. Leung and Ms. Dudasik for discussing this topic.

Kristin Leung: Hello, everyone. My name is Kristin Leung. I'm here with Rachel Dudasik. We are both LIVESTRONG at the YMCA instructors as well as volunteer leaders for the LIVESTRONG Foundation. And we're here to talk to you today about exercising and physical activity after cancer.

So little bit about myself. I am a mother of a 15-year-old. I'm a middle school science teacher. And I have been working with cancer survivors since 2011, when my local YMCA in Princeton, New Jersey brought the LIVESTRONG at the YMCA program to our facility. If you are unfamiliar with that program, it is a 12-week fitness and wellness program for adult cancer survivors aimed toward gaining physical strength, endurance, flexibility, and balance, and bringing it back to their lives after cancer treatment and diagnosis.

I have been LIVESTRONG at the YMCA instructor trainer. That means I'm working with personal trainers and group exercise instructors. And I am certifying them to work with cancer survivors since 2014. Rachel?

Rachel Dudasik: Hi, everybody. Again, I'm Rachel Dudasik. I'm in Asheville, North Carolina. I am also a LIVESTRONG of the YMCA instructor trainer and project manager here in our association. I got involved when we launched the program in 2011, '12. I am also a 3-time survivor and so have actually had the privilege of going through the program myself as a participant at another Y where my office is not located, so I could take the work hat off for a minute. So I've seen kind of first-hand on both sides the benefits of this program and I think there's wonderful work going on in the areas of research and treatment. But survivorship is a large number of us now and so I think having a program that focuses on the what happens next is really important.

Kristin Leung: Absolutely. So, Rachel, I'm not a survivor but I've worked with survivors. I have a lot of cancer in my family. I'm curious to know, what brought you to the LIVESTRONG at the YMCA program?

Rachel Dudasik: Yeah. So actually, I was diagnosed my first time when I was 22. And I was working at the Y, actually at the front desk. And I had found it one day, doing a random search on the Internet, and so kind of started asking around. And then after I finished treatment, I was able to bring the program to our Y and started as an instructor. And I think, when you're going through treatment, even, actually—I don't even want to say, “forget treatment,” because that's a hard thing to forget—but the aftermath, I just found myself not able to recover. I felt like I was young and active. And I still was out of breath walking from my car to the grocery store or walking up the stairs. Or reaching above my head to grab things in the pantry became a real problem for me.

And so to find this program that addresses just that was incredible. And so I was really fortunate that our area and our community jumped on that opportunity. The medical community is really supportive. I think one thing that's great about this program is not even 10, 15 years ago, it was said, "Don't lift anything heavier than a hand basket or a hand bag." And now, there's a lot of medical evidence—this is an evidence-based program that's saying, "Yeah. Get active. That's going to make you feel better." And I think that's what we're all looking for is to feel a little better, so.

Kristin Leung: Yeah. I can tell you that my mother just finished cancer treatment about a month ago. Her mother is finishing in the next month. And my mom, I took her to my local Y. I had her sign up. And I have not been able to get her to actually take a class yet. She's been complaining about, yeah, the same things you were saying. Just trying to do everyday activities, sometimes even just getting out of bed, she's so exhausted and everything hurts. And the thought of going to the gym, which is kind of already daunting to begin with—she wasn't a gym kind of person to begin with—it's overwhelming.

And I think that for a lot of folks, it's probably the same. I hear a lot of stories from the survivors in the program that they didn't go to the gym to begin with. It was always a little bit scary. And now they're going through the effects and aftermath of treatment. And they're in pain. And they're tired. And they just don't have any motivation. And sometimes if they do go out there, they might not necessarily have a great experience. They might find a gym and there aren't any staff that necessarily know how to work with cancer survivors or know how to modify properly, as well-meaning as they are.

So I think that's 1 really great thing about LIVESTRONG at the Y is because we have very specific training that has been geared toward working with cancer survivors. So we're not just throwing anybody in there. And not only are we empathetic, but we are aware of what modifications to make to make the exercises comfortable for their survivor-based, whatever treatment. And in addition, any other coexisting conditions so that it can be a safe and welcoming environment and kind of easing them into it so they want to come back. Is that the experience that you had?

Rachel Dudasik: Yes. I couldn't agree more. And a lot of folks here at our Y have heard me say this till I'm blue in the face. But I think the idea that you mentioned of it being daunting to come back is true for anybody. And then add the trauma that you've just gone through with cancer. But coming back and just starting slow. Start low, and progress slow, and building up to that. We're not going to put you on the treadmill running a half marathon at the beginning here. And I think, as my grandma says, "No matter how slow you go, you're lapping everybody on the couch." So just getting folks active, just little steps at a time and building up—I think the national guidelines of the American Cancer Association and the American College of Sports Medicine recommend is 150 minutes a week of physical activity. And again, they would recommend building up to this, so not all at once. It's not so daunting. Brisk walking is a great activity. I think folks have this idea sometimes—like you said, kind of starting at the max speed. And that's not what we're about. We're about meeting you where you are and moving forward on not only what's appropriate based on your diagnosis, but also on what you like to do. We want these activities to be things you can continue doing. Not everybody loves Zumba or the pool, but we try to introduce you to lots of different types of activities as well, kind of after you've built that base, so that you can find things that you can continue to do in your everyday life.

Kristin Leung: Yeah. Absolutely. That's something I know that we really focus on at my YMCA. During our intake process, not only are we getting that medical background, and the history, and your physical fitness history, but talking to people about things that they enjoy. And it doesn't necessarily have to be something "fitnessy." Do you like to take walks with your dog? Do you like to play with your grandkids? And focus our activities around what you're going to be doing in your life.

So like my mother, she does a lot of dog stuff. So she wants to do agility with her dogs, but she's going to have to run a little bit. So I'm trying to get her into water walking. Just start low and slow. And make sure you're feeling good and you're feeling confident. And I want all survivors, anyone who's coming into this program should know that they can trust in their instructors until they build up enough confidence to really trust in their bodies again.

So like you said, you're lapping everybody who's on the couch. So just getting up and coming to the Y, coming to class sometimes is a great achievement. I've always encouraged our participants, even if you're not sure if you're going to be able to do a workout that day, just come and hang out with us. Listen and learn a little bit. You never know, you can get up and do a minute of walking and then take a break again just because it's better than having sat at home by yourself. You've done something, and you have something that you can feel proud of.

Rachel Dudasik: Right. And 1 thing that—I don't believe we've mentioned yet, but we use the term survivor from point of diagnosis onward. So we've got some folks that have just finished treatment. And then we might have somebody that's 2 years out but has just been unable to take that next step. And so I think people sharing that journey together, different outcomes, young and old—I think adding those different life stories and those different experiences, but having the common ground of we've all made it through this crazy, terrible, wonderful, weird thing called cancer. And we've done it and here's what next. And we can all be a support system for each other. I think we don't call it a support group because there's a lot of wonderful support groups out there already, but that kind of happens naturally. I think having, again, just these shared experiences really build a tight bond that helps when taking those next steps after the cancer journey.

Kristin Leung: Right. Yeah, it's funny you just said that because I've had so many survivors say the same words to me, that this is not a support group, but it really likens itself to one. Yeah. Just having that camaraderie and having folks who understand the journey that you've been through. And we're all there to support whatever your individual goals are. So your instructor is going to talk to you about whether or not your goal is just to walk to the end of the block and back without getting winded, or if you want to run that 5K, or whatever it might be, and we'll work toward that so that you can feel proud of yourself and feel accomplished.

Rachel Dudasik: Yeah. And I think as we learn more and more about kind of the effects of physical activity, I hope that programs like this will continue to grow. There was a lot of research studies around the program recently, the past couple years, with Yale University and Dana Farber Cancer Center. And they conducted research to study the impact of the program on participants. And what was found that participants across the board experienced significant increases in physical activity, overall quality of life, and fitness performance kind of in general. And so I feel like we all kind of felt like that about the program, but now we've got research behind it. I think that makes the medical community a little bit more at ease. I think they've seen the value, and now there's kind of the proof in the pudding, so to speak. So I'm excited that, as we continue this program, we're just going to learn more and more about how to navigate these next steps.

Kristin Leung: Absolutely. And as a science teacher, having those hard facts definitely puts me at ease. And hopefully anyone who's looking at maybe trying to bring the program to their facility, or any doctors' offices who are unsure about whether or not they should recommend this to their patients, knowing that there is significant data and statistics that really support the benefits of the program, that'll put them at ease. And we'll be able to continue to grow, as you said.

And at the very least, just get up and put on a song that motivates you and gets you going. Go for a little bit of a walk. And try to get some movement back. And see how you feel.

Rachel Dudasik: Yeah, that's what I would say. I think for me, unfortunately, sometimes it's hard to find that time in the day. And I think I used to have this notion that it had to be in the form of an intense however-long workout at a gym. And what this program helped remind me is that, again, just getting moving. So that might mean at lunch, I take a couple laps around the building, or maybe I park a little further away, or maybe sometimes just in the building I do a couple laps, talk to lots of members here at the Y, do a couple extra stair steps. But yeah, just getting moving is going to make us all feel better, so I think that's a great place to start.

Kristin Leung: Yeah. And actually, that just reminded me. I think one other really great aspect of this is that I'd say, people in general, we take care of others. We put our attention on others but very rarely give ourselves any attention and time. And I think that this program does not only give you an excuse to carve out a little bit of time for yourself, but gets you used to the idea. So self-care is just so important. We don't do it enough, but we need to start getting into the habit of making sure that we're doing what we need to so that we're feeling good mentally and physically throughout our lives.

Rachel Dudasik: Yeah. Couldn't agree more.

Kristin Leung: So that's about all I have. But I do encourage everyone to go to livestrong dot O-R-G. Check out LIVESTRONG at the YMCA program. Rachel, do you have anything to add?

Rachel Dudasik: I think that I would just—yeah, I would say get out there, take a couple extra steps, take care of yourself. And this is 1 great way to do that. So thank you for your time.

Kristin Leung: Thanks, everybody.

ASCO: Thank you, Ms. Leung and Ms. Dudasik. Find more tips on remaining physically active during and after cancer treatment at www.cancer.net/healthyliving, and on the Cancer.Net Blog at www.cancer.net/blog.

Cancer.Net is supported by the Conquer Cancer Foundation, which is working to create a world free from the fear of cancer by funding breakthrough research, sharing knowledge with physicians and patients worldwide, and supporting initiatives to ensure that all people have access to high-quality cancer care. Thank you for listening to this Cancer.Net Podcast.

[music]