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'It was so incredible to get back my strength' - how a fitness class helped this woman's cancer battle

After her cancer battle, Jennifer Hogan found vital support at a unique fitness class for patients


Cancer survivor Jennifer Hogan runs in The Memorial Gardens in Kilmainham, Dublin. Photo: Tony Gavin

Cancer survivor Jennifer Hogan runs in The Memorial Gardens in Kilmainham, Dublin. Photo: Tony Gavin

Cancer survivor Jennifer Hogan runs in The Memorial Gardens in Kilmainham, Dublin. Photo: Tony Gavin

Exercise is medicine and should be prescribed to all cancer patients as part of their ongoing recovery, according to an Irish expert.

Research, conducted by clinical exercise physiologist, Mairéad Cantwell and sponsored by the Irish Cancer Society, shows that exercise is in fact a key weapon in boosting recovery.

For the past three years, Mairéad has worked with participants on a 12-week exercise programme for cancer survivors, called 'Move On.'

This is part of the MedEx wellness programme at Dublin City University, which runs medically supervised exercise classes for people with a range of chronic illnesses, including cancer. At the end of their cancer treatment, participants take part in an hour-long medically supervised exercise class twice a week.

Dr Jennifer Hogan took part in the programme last year following treatment for breast cancer. An obstetrician and gynaecologist by profession and a keen athlete in her leisure time, she had completed a triathlon the day she found a lump on her breast. She recalls it as a moment that changed her life overnight. Aged 36 when she received her diagnosis, her subsequent treatment included a gruelling 14-month regime of chemotherapy, surgeries, radiation therapy and infusions.

Having gone from an exceptionally fit and active woman, by the time her treatment ended, she was weakened to the point of exhaustion. Even the simple act of getting out of bed in the morning required major effort. She enrolled on the 'Move On' programme in a bid to regain some of the strength and fitness she'd enjoyed before her cancer diagnosis.

"It was amazing," she says. "This was a springboard that helped me go from incapacitated to being able to exercise again.

"I wasn't comfortable exercising with my triathlon mates, because I couldn't keep up with them and felt I was holding them back. To be in an environment where everybody had been through cancer treatment was ideal. The group spanned all levels of fitness. I saw one person who couldn't climb a few steps at the beginning of the programme bounce up the stairs at the end.

"The exercises were tailored to each participant's abilities. We had talks on nutrition, healthy eating, and setting ourselves goals. I pushed myself as hard as I could and as time went on, it was incredibly heartening to see myself achieving those goals, and feeling my strength return. It was a long, slow process, but I'm now training for the Dublin half-marathon in September."

N0w 38, Jennifer is also back at work in the Coombe Hospital, where she says her own ordeal has given her a new insight into the suffering of her patients, many of whom have lost babies due to miscarriage.

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"During my cancer journey I lost my job, temporarily, my sport, and even my identity for a while," she says. "It opened my eyes to understand things from a patient's perspective. The road to recovery has been challenging, and I was fortunate to have the support of family, friends, colleagues and, not least, my partner, who's also very sporty and encouraged me all the way. Would he exercise with me? He'd push me out the door!"

One of the first milestones Jennifer achieved was completing the 5km ARC Cancer Support Centre walk in Phoenix Park earlier this year, a challenge she relished. Not too surprisingly, however, her mum was protective about seeing her daughter, who'd already been through so much, push herself to the limits of physical endurance.

"There is a tendency for people to say, 'Relax, put your feet up,' when you're diagnosed with cancer, but you do enough of that during treatment," she says. "The last thing I needed was to sit around thinking about my cancer.

"Thankfully, things are changing in the healthcare system. There's a growing recognition of the need to be physically active. I felt desperately weak after my cancer treatment, and sport and exercise helped me feel normal again."

But while things are changing, Mairéad Cantwell suggests that healthcare professionals often don't recommend sufficient exercise to benefit their patients following cancer treatment. In a study of 43 medical oncologists, radiation therapists, clinical nurse specialists, GPs and surgeons, she found that while recognising the importance of exercise in their patients' lives, many didn't propose enough to meet the recommended physical activity guidelines for cancer survivors.

"Evidence shows that a minimum of 150 minutes of moderate intensity aerobic exercise combined with two to three resistance [weights] workouts a week aids cancer recovery. Yet many people are not active enough to reap the benefits of this simple but powerful treatment," says Mairéad.

It's not a one-size-fits-all kind of therapy, however, as exercise programmes have to be tailored to suit the abilities of each individual, and in a hard-pressed health system, doctors' time is already under pressure. Added to that is a chronic lack of community-based exercise programmes to rehabilitate cancer survivors, despite the proven benefits that physical activity brings.

"Exercise boosts fitness levels, physical function, mental well-being, quality of life, and helps people manage the side effects of treatment," says Mairéad.

"If a doctor were to prescribe a pill that could do all that, patients would be sure to take it regularly. But exercise is a powerful medicine, and cancer survivors need to take a daily dose to maintain their health."

As part of her research, Mairéad conducted a series of focus groups in which people were asked to share their experiences of cancer treatment. While everyone's cancer journey is different, one commonly expressed feeling was one of loneliness at the end of treatment.

"People spoke of a period of isolation when they were discharged from the hospital system," says Mairéad. "Having spent months or years going from one appointment to another, suddenly they were on their own, and they described that as being a very lonely place. It's not easy to go back to work and pick your life up where you left off when you've been through such a long, difficult and life-changing experience.

"There's a gap in the cancer care pathway when people have finished treatment, and as a vehicle for recovery, exercise is very empowering. After passively going through the rigours of treatment, this is something positive that people can do for themselves. They're in charge, setting their own goals and finding ways to achieve them."

Enlisting friends and family to join in activities will boost your chances of sticking to an exercise regime, she says. Evidence shows that people are more likely to follow through if they've committed to meeting others for a walk or a workout, and exercising in a group is more social than hitting the trail alone.

And with a recent upsurge in jive, céilí and step dancing sweeping the nation, keeping fit and cancer-free has never been more fun.

Another activity to have hit the popularity jackpot in the past decade is dragon boat racing, a Chinese-inspired activity that's been shown to help breast cancer survivors build muscle strength and recover from lymphoedema and other side effects of surgery. Since the first club, Dublin's Plurabelle Paddlers, was set up in 2010, a network of similar clubs continues to spread across the country, providing a platform for breast cancer survivors to paddle their way to recovery.

Bríd O'Connell, who set up the Shannon Dragons in Limerick last year, says it's been a life-saver in more ways than one.

"We bring the best version of ourselves to the water," she says. "There's a kindness afloat. We carry each other and laugh with each other, and that's more life-giving than you can imagine."

Mairéad Cantwell says the dragon boat racers are an inspiration to other cancer survivors.

"Our focus groups have shown that cancer survivors enjoy exercising with people who've been through a similar experience," she says. "Through that shared experience, they don't feel self-conscious and it gives them a safe, encouraging and supportive environment to regain their physical and emotional strength."

Using the information from MedEx studies with both healthcare professionals and focus groups, Mairéad and the research team set about designing a programme that could increase cancer survivors' physical and mental well-being, optimise their quality of life and support them to make physical activity part of everyday life.

"In addition to the twice weekly exercise classes, participants received additional resources, including a home exercise guide and information sessions on how to incorporate activity into their lives," says Mairéad.

"We're now in the final stages of this study and hope to have the results ready in early 2019."

* The Irish Cancer Society is holding a 'Decoding Cancer' public talk on the effects of exercise on cancer and how physical activity can help a person going through cancer treatment. 'Keeping Fit, Stopping Cancer' takes place this Wednesday at 1pm in the Wisdom Centre, Cork Street, D8.


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