This week we’re sharing some of the main features in Issue 2 of Happy Magazine here on our website, starting with our cover star interview with Beacon Hospital Cancer Survivor Sarah Ní Riain.
Sarah spoke to us about the Hospital’s Fit for Life exercise programme and how it helped her get the confidence to return to the gym.
Sarah Ní Riain is 38 and from Clonlara in Co. Clare. In January 2018 she got the news we all hope to never hear – she had breast cancer. Luckily, she had found it early.
“It was actually Christmas Day when I first noticed something,” Sarah told us when we met her at the Beacon Hospital recently. “We were visiting family friends and they were big buff lads – one of them gave me a tight hug and it really hurt my breast! Then a second friend also hugged me and it hurt even more. A few days later, the pain was still there and it didn’t seem right.”
Fast forward a few weeks and Sarah was facing a journey that would include chemotherapy, a lumpectomy surgery, radiotherapy and Tamoxifen. Her cancer was Stage 1 and although chemotherapy could perhaps have been forgone, she decided, on the advice of her team at the Beacon, to get through four sessions.
“My oncologist was Dr Jenny Westrup. She is just incredible. I can’t speak highly enough of her and the rest of the team at the Beacon Hospital. I was very grateful to be able to have my treatment here.”
We met Sarah on a cold day in early April this year, to talk to her all about her participation in the Beacon’s Fit For Life exercise programme. The programme was set up and designed by the Beacon Physiotherapy Department to align with the evidence base and best practise in the area of exercise during cancer. It is now run by Senior Physiotherapist Sarah Wright and championed by Dr Jenny Westrup and her Chief Oncology Liaison Nurse, Jennifer Nestor. The programme is a 6 week course suitable for all cancer patients during and after cancer treatment.
The aim of the programme is to promote the importance of the role of exercise for cancer patients. The latest medical research in this area suggests that not only does a higher level of physical activity reduce risk and recurrence of many cancers, in particular, colon, breast, prostate and endometrial cancers, but the benefits for improved outcomes in progression and survival are so significant that the team at the Beacon Hospital are now even prescribing exercise as part of treatment plans.
“At first I was surprised when Dr Westrup prescribed exercise as part of my treatment,” Sarah said. “But she explained to me that if I exercised both during treatment and afterwards, my chances of recurrence would be markedly reduced.”
Guidelines suggest 30 minutes a day, 5 times per week. “I was just shuffling around the park, but, I was going out most days,” Sarah said.
“In the weeks before my surgery, Dr Westrup recommended I get out for at least an hour every day, to get my heart and lungs working that little bit harder, to help with my recovery time after surgery.”
“My surgeon, Ms Reem Salman, and Dr Westrup were both so encouraging about getting out and getting moving. They kept motivating me about how exercise would help me with the ‘fatigue circle’ – where if you don’t get out and move, you lose muscle tone, you lose energy, you feel fatigued and then you don’t go out because you feel tired – that vicious cycle.”
“From the early days of my treatment at the Beacon, both Ms Salman and Dr Westrup mentioned the Fit for Life programme and that I should get started with it.”
“After my surgery, I had radiotherapy for four weeks. It was fine, although I was quite tired once I had completed it. I went back to work part-time and then I started the programme here in January of this year.”
The Fit for Life programme is run once a week at the Beacon in the hospital’s physiotherapy studio. Groups are kept small with a maximum of six participants to ensure each person receives dedicated attention. Each week includes one hour of circuit exercise and 30 minutes of education.
“I have loved it. It’s a gentle approach which takes into account what you are capable of at whatever stage you are at – and builds on that,” Sarah said.
On week one, the lead physiotherapist meets with each patient and discusses their diagnosis, current problems and goals. Exercises are then tailored to each individual.
“I was a very sedentary person and I’d tried a few times to get more active, however, I found gyms really off-putting. I felt like everyone was looking at me and judging me, but that’s probably not even what they were thinking. This programme removed a lot of those obstacles I felt were in my way and gave me the reassurance that I wasn’t going to be doing anything I shouldn’t, given what I had just been through.”
Evidence suggests cancer survivors are keen to receive information and advice about exercise, but they would like a health professional to deliver that advice and support.
“With a dedicated physiotherapist by your side, checking in every week about any concerns you may have or new symptoms you might have been experiencing – was a great comfort,” Sarah said.
“I would come in and push myself – for me it was a tough workout every week and something I looked forward to. Each session is determined by you and what you are able for on the day, and I liked to give it my all.”
“Sarah, the Physiotherapist, would help each of us to find the right level of exercise for us. For example, we might be doing push-ups, and someone might have been doing theirs pushing off the wall, whereas I would have been doing mine pushing off the bench – you were assisted to find the right level that challenged you and then encouraged to do that.”
Patients keep track of their activity on a weekly basis and aim to progress towards a set of goals.
“Each week then, we were encouraged to move it up a level, and challenge ourselves – see what we could do.”
Once the six weeks are complete, follow-up sessions are provided at 3 months, 6 months and 1 year to record each participant’s progress and help them stay on track with their fitness goals.
“My goal now is to sign up with a personal trainer and do regular one-on-one fitness sessions. I know it will continue to help me with the fatigue that I feel, a common side effect of the treatment I’ve been through, and help keep me motivated.”
“The programme has definitely helped me with my general energy levels – I have definitely noticed a difference.” And the benefits have not just been physical. “It has also helped my mental health. I know that the regular exercise I’ve been getting has triggered other positive changes in my life, physically and mentally. This programme was really good at gently encouraging me to get moving more, not just here in the gym but every day, in my life.”
Also part of the Fit for Life programme are education sessions, provided by the physiotherapy team, hospital oncology dietician, occupational therapist and psychologist, and topics include exercise pacing, healthy eating, relaxation strategies and more. “The talks were really nice and I enjoyed the group setting of them,” Sarah said. “We would learn from the expert but also from each other as we had the time and space to share our experiences. The group was small enough to allow this to happen, without it feeling like therapy, although it was therapeutic!”
Another participant of the programme spoke to us on the day we met Sarah. While she did not want to share her name, she talked to us about how she felt the programme really helped her regain her confidence when it came to simple things, like going out for a walk again on her own. She also found the information sessions really beneficial and a way to share her feelings with others that understood what she had been through.
Any oncology patient can be screened to join the programme, including patients from other hospitals. Participants to date were encouraged to join the programme by their physiotherapist, consultant, specialist nurse or other healthcare professional including GPs. Patients can also join without input from a healthcare professional, often hearing about it through word of mouth.
The programme costs €180 for the 6 weeks and this includes the follow-up appointments at 3 months, 6 months and 1 year.
To date, over 100 patients have completed the programme at the Beacon Hospital – men and women of all ages and all different cancer types. One thing they all had in common though? They all rated the course as 100% satisfied and every single one of them had improved levels of physical activity and quality of life.
“Quality of life. That was something I was surprised my oncology team cared about,” Sarah said to us. “When you think about cancer treatment and your treatment plan, all you’re concerned about is getting it done. But my team cared about my quality of life, during treatment and afterwards. That meant a lot to me.”
“Since participating in this programme, I’ve actually gone to the gym. This might not sound like much to the average person, but it was a big step for me. This programme has helped me learn that once I am moving, I enjoy it, I just need to make the effort. Now, my focus is to make sure exercise is a part of my life going forward. As I get busier with work, I’m finding it harder to prioritise exercise, but I know the importance of it now.”
“I think everyone knows the importance of exercise, but it’s not until you start it yourself and you feel the benefits and you get that positivity from just moving more, that you realise how important it really is. This programme helped me discover that.”
For more information on the Fit for Life programme or to sign up on the next available course, contact Physiotherapist Sarah Wright at the Beacon Hospital on (01) 293 6692.
Written by Holly Kennedy. Photos by Michael Grubka.