Fighting back with fitness
Glenda walks into the gym, drops her bags and rolls out an exercise mat while cheerily chatting with a few personal trainers.
Just over a year ago Glenda had a double mastectomy, and had lost nearly all movement in her upper body.
“You don’t realise it but they don’t just take your boobies out. They take everything. Muscle, nerves. It was like my arms and shoulders just froze,” she says.
‘But now I can do this,” she says laughing as she lifts both of her arms over her head.
“I can finally hang out the washing … and lift 20 kilos.”
Glenda, with 11 other women in various stages of breast cancer treatment or recovery, is celebrating the last day of the Fighting Back with Fitness Program with a workout, of course, and a lot of laughing and chatting.
The pilot program is an Australian first in a community setting. The women have been training together for 90 minutes, three times a week for 12 weeks, under the observation and guidance of exercise physiologists and personal trainers at Fit Lab’s High Performance and Rehabilitation Centre.
Exercise physiologist Henry Elliot can be seen co-ordinating personal trainers, popping in and out of his office and helping the women into their warm-up stretches.
Over his career, Henry says, he has worked with several people across all stages of cancer and treatment, including in the acute chemotherapy phase, and has seen the positive effects of physical activity. His passion for the program is evident. “Cancer sucks, but the treatments are worse,” he says.
“Chemo, radiotherapy, surgery, hormone treatments and the additional drugs to improve the effectiveness of these treatments are incredible. They save lives. But they are seriously unpleasant and remorseless in their collateral damage to quality of life.”
The physical toll treatment takes on the body is immense. As in Glenda’s case, after surgery, cording or a hardening of the tissue under the arm can feel like a cable binding the ribcage to the upper arm. Also, both surgery and chemotherapy can damage the lymphatic system, causing painful volumes of fluid in the arms or abdomen.
“Early-onset menopause, infertility,
hot flushes, frailty, sarcopenia, osteopenia, psoriasis, problems with balance, falls risk, the list is very, very long.”
Henry also says fatigue is a near-ubiquitous side-effect and it often exacerbates the biggest challenge many women face: maintaining their mental health.
“Even if we completely ignore the biomedical impact of treatment, it is the other side-effects that people never think about. The change in social identity – these are caregivers, mothers, doctors and students, suddenly turned into clinical patients and receivers of care,” he says.
“The disease and its treatments completely change how people see you, how you see yourself, what is important to you and how much of your day is your own choice.
“To have to think about things like the Registry of Deaths, cost of treatment, loss or change of career, concern that your own children might get cancer too.
“Stress and fear are endemic in this experience. Then you consider the fatigue burden and the cognitive decline – mental health is a big factor here.”
As I sit and watch the women joking and smiling, while moving their bodies in ways they couldn’t think possible 12 weeks ago, it occurs to me that this program really is invaluable. There is no talk of cancer, just a group of women doing their cardio and lifting weights.
“This certainly wasn’t some dream-team of ex-athletes rolling up for gym session,” Henry says.
“Some of the women genuinely believed they couldn’t make it through one day at a gym. We had five ladies who were unable to stand from the floor and whose mental health scores were considered extreme for measures of stress and anxiety.
‘‘During the program there were surgeries, births, deaths, illness. There was some seriously tough sh-going around the gym some days, but it only brought everyone closer together.
“Now everyone can drop and rise from the floor and their mental health and fatigue scores are significantly better.”
Henry says that while the clinical results have been outstanding, the most rewarding outcome has been on a personal level.
“When I hear things like ‘my friends told me I’m glowing’, or ‘I skipped down a set of stairs on the weekend without thinking about it – and then remembered only a few months ago I had hobbled down them’, that is what matters.”
“The true value of this program is that it worked. This kind of thing should be standard care for most cancers – the evidence is so rich and profound.”