Cancer Wellness Magazine: The Fitness Issue with Ethan Zohn (Winter 2023)

WINTER 2023

ETHAN ZOHN PUTS A NEW SPIN ON “SURVIVOR”

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THE PSYCHEDELIC SERIES A COMPLEMENTARY THERAPY EMBRACES THE MAGIC MUSHROOM

BEAT THE BLUES SELF-CARE FOR WINTER DESPAIR

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Happy New Year!

s we head into 2023, I am so excited to feature Ethan Zohn as our issue 17 cover star. Ethan puts a new spin on the word “survivor,” as he’s a twotime cancer thriver as well as the winner of one of the toughest seasons of the reality TV show of that name. On page 40, he shares his captivating and, at times, heart-wrenching story with a sincerity and grace that both encourages and motivates. And his past as a professional athlete is the perfect backdrop for issue 17 — the Fitness Issue.

The Fitness Issue is rife with inspiring stories from other cancer warriors, like bodybuilder Erica Langley (p. 48), a Chicago native and hometown hero; as well as information about amazing organizations such as the Aunt Sister Project, a nonprofit providing free or low-cost exercise classes for cancer thrivers (p. 36); the rise of cannabis use for post-workout recovery (p. 50); and delicious recipes to keep you warm through the winter season (p. 16). I’m also excited for you to learn about how psychedelic drugs are being used as treatment for people with

cancer — issue 17 features the first in a new, four-part installment on the rise of psychedelic therapy (p. 24), detailing the history of psychedelic drug research in the United States and how they can help alleviate some of the emotional effects of cancer and its treatment.

Our subtheme for the winter issue is artificial intelligence, and we’ve rounded up some cutting-edge technologies used in hospitals and other care settings that are changing the way cancer is diagnosed and treated (p. 53).

As I make plans for the year ahead, I hope to continue being able to serve our amazing cancer community, and my wish for you all is to enjoy another year filled with good health and happiness.

Natalia Espinosa Editor-in-Chief

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CAYLEI VOGELZANG Founder NATALIA ESPINOSA Editor-in-Chief + Creative Director CATHERINE EVES

Editorial Director

FEATURES Editor-at-Large MIRELA KOPIER Editorial Associate FRANCESCA HALIKIAS CONTRIBUTING WRITERS ELYCE NEUHAUSER, AMBER SULLIVAN, SUSAN HERNDON, SAMANTHA DEVICTOR, LINDA FORSTER, LEA GUCCIONE, SARAH DIMURO, MEGHAN MCCALLUM COVER PHOTOGRAPHER RICARDO BEAS EDITORIAL ADVISORY BOARD GAIL PRINS, PHD GLEN STEVENS, DO, PHD OPERATIONS MANAGER ISABEL GARCIA SYSTEMS ADMINISTRATOR JACK SAXE-STARAL EXECUTIVE ASSISTANT ANTONIJA ROGIC

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ALL RIGHTS RESERVED. NO PART OF THIS PUBLICATION MAY BE REPRODUCED IN WHOLE OR PART WITHOUT PERMISSION FROM THE PUBLISHER. THE VIEWS EXPRESSED IN CANCER WELLNESS ARE THOSE OF THE RESPECTIVE CONTRIBUTORS AND ARE NOT NECESSARILY SHARED BY CANCER WELLNESS AND ITS STAFF.

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Cancer Wellness

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COVER STAR: ETHAN ZOHN

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WINTER 2023

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STRETCH IT OUT Cancer fighters use yoga to help soothe emotions, improve sleep and reduce stress.

AN AI ASSEMBLY Artificial intelligence and a new kind of cancer care

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CLEANING UP THE CALUMET Recent efforts aim to restore the natural beauty of the Great Calumet Industrial Region

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WARM & SAVORY Warm up cool winter nights with these hearty and healthy dishes.

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CW & BRIGHT PINK PRESENT: THE BRIGHTENED & ENLIGHTENED SERIES The first installment of our new series in partnership with Bright Pink features FORCE — the preeminent nonprofit focused on the hereditary cancer community.

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@S.L.C.AMERON

cW Online Over on our Instagram, @cancerwellmag, we asked cW readers a question: What is the first thing you did when you were declared cancer-free?

Read on for their responses.

@MMPACK

“My husband and I went on a weekend getaway right before the Christmas holidays to celebrate! We drank wine, slept, shopped, got massages, ate fine food and simply celebrated each other… Going forward, I simply want to live every moment being grateful.”

— Marti Phillips Pack, multiple myeloma

“I’m not sure my medical team will ever use [‘cancer-free’] because they can’t guarantee that the cancer won’t come back; they say “no evidence of disease” at this time. I’m very grateful for that and my response is to say ‘yes’ to every opportunity that comes my way.”

— Sandra Cameron

@SSDACQUISTO

“I will likely never get to [be] cancer-free, so I live every moment of every day and I never say ‘I’ll do that next year.’ Be present, live fully, love hard!”

— Shannon Snow DAcquisto, breast and brain cancer

@CANCERTINES

@JOANNEEE.U

“After my last round of chemo, I went to Bermuda before getting my post-scan. It wasn’t clear, but after six months of chemo, I had to celebrate getting through it! The plus side was getting away from Chicago winter for a week.”

— Joanne Ulanday, stage IVB Hodgkin’s lymphoma 6

Cancer Wellness

@ TAMMYBERTUCCI

“I won’t hear those words for at least four years, so I plan on living my life now to the fullest! I want to plan a trip to Europe and go to a meditation retreat. I am grateful and thankful every day and have learned so many lessons on this journey.”

— Tammy Bertucci, leukemia

“I wear a new pair of socks to each of my appointments; it’s what has gotten me through. I wear socks with encouraging messages or fun designs.

I’m nowhere near the end of my treatment, but it’d be so great to add a pair to my collection that said ‘cancer-free!’”

— Araceli Lopez, breast cancer

@TAMRONLITTLE

“I let out a huge wail!”

— Tamron Little, mesothelioma

@ITSROSA.LINA

“Since I was told I had breast cancer at 28, I paused dance and remained focused on getting well for the next 10 months. During those awful months, the one thing I told myself was I would get back to dance because it’s always been my happy place…

After completing radiation, I returned two months later and joined a dance team.

Was it hard? Of course, but I pushed through because dance always brought me joy and fulfillment.”

— Rosalina Felipe, breast cancer

The cW Agenda ALL THE NEWS YOU NEED TO KNOW

FUNGUS AMONG US

Research from the Weizmann Institute of Science in Israel and the University of California, San Diego have found fungi in all 35 types of cancer studied. Other studies found people with certain species of fungi in their cancerous tumors had worse health outcomes. These findings can help researchers better understand the role of fungi in cancer cells.

DIVERSIFYING MEDICINE

The Harper Cancer Research Institute partnered with the Pokagon Band of Potawatomi Indians to raise awareness about early detection in Native American communities. This will address disparities in treatment outcomes and help researchers diversify cancer tissue samples to create more personalized medicine for people of all races and ethnicities.

EMBRACE YOUR CURLS

Be careful of chemical hair-straightening products. A study by the National Institute of Environmental Health Sciences followed almost 35,000 women between ages 35 and 74 to monitor risk factors for breast cancer and other conditions, and found that women who frequently used hair-straightening products were more than twice as likely to develop uterine cancer.

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GOOD GENES

In a Swedish preclinical study of patients with clear-cell kidney cancer, researchers found the activity of four specific genes in the patients’ cancer cells may be able to predict the risk of tumors spreading to the skeleton, occurring in one-third of cases. The research will help scientists better understand the interaction between tumors and their microenvironment.

PUT TO THE TEST

A molecular test that distinguishes between benign and malignant cysts shows promising results for pancreatic cancer. Funded by the U.S. National Cancer Institute, the Pancreatic Cancer Action Network and others, PancreaSeq will help improve early detection of pancreatic cancer and avoid overtreatment.

HAND IN HAND

Moderna and Merck have announced that together they will develop and sell a cancer vaccine that is personalized for individual patients. Moderna’s messenger RNA vaccine technology will be studied along with Merck’s Keytruda to treat patients with high-risk melanoma.

Researchers at Johns Hopkins University are developing a vaccine to train T-cells to recognize and kill cells that have one of the six gene mutations that causes pancreatic cancer. The first clinical trial included 12 patients with pancreatic cancer who were treated with surgery. Two years later, these patients are still cancer-free!

SEEK A SCREEN

Doctors and oncologists have noted a rise in breast cancer diagnoses in younger people.

According to the CDC, most breast cancer diagnoses occur in women over 50, but one in 10 women diagnosed are under the age of 45. Every person with breasts, not just those over age 50, should pay attention to their bodies and get screened.

MEDITERRANEA-YUM!

Researchers concluded that a Mediterranean diet rich in fiber, mono-unsaturated fatty acids (found in oils, nuts and fish) and polyphenols (found in vegetables, fruit and whole grains) has been associated with a major improved response to immunotherapy drugs, called immune checkpoint inhibitors, in melanoma patients. This diet was also associated with progression-free survival at 12 months.

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THE WARRIOR Asha Miller

AS TOLD TO CATHERINE EVES 8

Cancer Wellness

Photo provided by Asha Miller

@dearcancer_ itsme

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henever I tell my cancer story I always go

It was so unassuming and so tiny; my mom and from the year before. The year before I was husband could barely feel it. diagnosed was 2016, and I was going in for When I went to our family doctor for my daughter’s preroutine surgery. They were just supposed to school appointment, I asked the doctor, “Hey, can you look at take a cyst off my uterus and do it laparothis tiny bump under my armpit?” I always say I hijacked my scopically, but it did not go as planned. I woke up with one daughter’s appointment. The doctor looked at it, and she said, less ovary, and that sent me into one of the darkest months “If I did a breast exam on you, I never would have noticed this, of my life, honestly. Which sounds crazy, because I had it’s so unassuming.” And I thought, OK, great. Then she said, cancer the year after, but [this surgery] really wrecked my “But since you found it, if you want, I can send you for an ultramental health. My hormones were just up and down with the sound.” And because of what happened during my surgery removal of my ovary. The doctors never told me that would the year before, I [wanted to] take every precaution. affect my mental health, so I was so confused. I was like, why

[My] doctor’s office called [and] said, “Everything am I feeling this way? What’s going on with me? looks great; you can’t be 100 percent sure, but there’s

I was sent into a depression with lots of anxiety. nothing worrisome.” It was the one thing she said, that Coming out of that months later, I decided, OK, I need you can’t be 100 percent sure, and that changed everyto get out of this house. I’m normally a very active person. thing. I told her I don’t want to have to do anything else in I like to be with my kids outside, and I wasn’t leaving my six months, so what can I do now? house. So my husband and I went to a local fitness center, She said we could do a biopsy. I didn’t know what a and I thought, maybe if I get into these classes I can stand biopsy was; I didn’t know it involved needles. If I did, maybe at the back and do a little something and feel better. And I wouldn’t have done it. My husband and I were driving that’s how I found fitness. It was through some of the to the doctor’s office, and I kept thinking to myself, you’re darkest and scariest times of my life. being ridiculous, this is so dramatic — this bump no one

As I continued, I realized could even feel, and everyone has it wasn’t just physically that I said is fine — why are you getting a started to change, but mentally needle stuck into your body? I’m a and emotionally. I started seeing woman of faith, and I truly felt like “While I agree that we these little changes in my body, God kept putting this on my heart have to feel the loss and and I felt like the endorphins and wouldn’t let it go. helped my mental health. I would

[ My doctor] did an ultragrieve, I think there is leave the gym happier than I had sound-guided biopsy and I asked a point, too, of finding been before. I got super addicted. him, “I know you probably can’t I wanted to learn all I could about tell me now, but what do you think the beauty intentionally, fitness, and within a couple of it is?” He said, “I think it’s a cyst; I months [...] I was the fittest I had think it’s nothing to be afraid of.” finding the beauty in been in my life. I felt so strong at

[But then] on Sept. 28, 2017, those broken and hardthat point. I felt like I knew my at 8 o’clock in the morning, that body better than ever. same doctor himself called me to-love spaces.”

Then the managers at the and told me it was cancer. gym asked if I would become He was as shocked as I was. I got a fitness instructor. I was so to the hospital, and it went bad fast. nervous my first class; I didn’t have a lot of confidence. I A one-and-a-half-hour appointment turned into six hours knew I loved it, but I didn’t know if other people would, doing four or five different tests. It was one of the scariest but [then] I realized my passion for fitness really did transdays. That one tiny bump ended up being just the tip of my fer over to others, and it encouraged others in the class. cancer iceberg. I had malignant calcifications across my [About] two months after I became a fitness instrucchest wall. It had already spread to my lymph node undertor, that’s when I found the bump. neath my armpit, so I was already at stage III when we found That’s why I start my cancer story from the year before, it. This was the most shocking, because I found it when no because I don’t think I would have noticed the bump if I one else saw it, because I continued to keep pursuing it. hadn’t gone through [that surgery], because I was so in tune I ended up with six months of chemo, the “Red Devil,” with my body. I knew it better than I’d ever known it. I found the AC double chemo, as well as Taxol. After that I did this tiny, little bump under my right arm. It felt like a mosmy double mastectomy. I wanted to do reconstruction, so quito bite. It was just so tiny, so I wasn’t worried at all. I felt I had expanders put in. I also had 36 rounds of radiation. strong, I wasn’t sick, it didn’t hurt, it wasn’t growing, so when For me, radiation was harder than the chemo, because I found it, I thought I just hadn’t felt this before, it feels like a it’s so unknown. In Hollywood and the movies, you see lymph node. I thought maybe I was working out too hard. enough images of bald women going through chemo. You I’m very passionate about doing self-checks in a certain see the sickness, the tiredness, all of that, so even the way: I rotate my arm back and forth, because it feels differently general public knows at least a little about it. But radiation, backward and forward. [About one month after first feeling who films radiation? Who films the third-degree burns? the bump], I did my self-check, and I couldn’t feel it. I thought As a woman of color, my skin didn’t turn red, it turned everything was fine. A couple weeks later, I was in the exact black, and my skin reacted differently than white skin. And same position, and I felt it again. It was more to the side of my my doctors were honestly ignorant to that fact, unfortubreast by my armpit, so I never thought breast cancer. nately. They couldn’t help me the way they should have, Cancer Wellness

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because they weren’t prepared and didn’t want to acknowledge that black skin is different than white skin. I would search images on Google for radiation and come up with hundreds of pictures, but only two — maybe two — were of a brown-skinned person, so it was very isolating and scary.

All through my chemo, my radiation, I still taught my fitness classes. I came into the gym as much as possible.

After my surgeries, I would sit in the back of the gym and sometimes just tap my feet. Sometimes I would just sit there knowing I was surrounded by positive people. It was like my sanctuary. I always say the gym is my church, my sanctuary; it’s where I have praised, where I have screamed, where I’ve cursed, cried, sweated. The endorphins would connect me with feelings that I didn’t even realize I had.

I have so many videos of me working out bald, working out barely moving after surgery. A couple months later, I’m moving a little more, then all of a sudden, I’m jumping around, then all of a sudden, I’m back down again. I think that’s the hardest part of cancer in general — those waves. They come so fast, and I don’t think anyone realizes until you’re in it. One minute I was strong and the next I’m looking at myself with a moon-shaped steroid face, and I had gained weight. So you have this sudden body dysmorphia; this sudden shock to your brain of your body changing so quickly. I was thinking, how do I get back to that place where I’m proud of this new body?

Then after the radiation, my body just crashed.

I told my doctor, “I don’t think the cancer’s going to kill me, I think it’s the treatments.” I’m just tired, I was just so tired, so I opted to do a more naturopathic way of suppressing hormones. I went into an intense detox naturopathically, which was so hard but so necessary. I came out of that feeling like [I could] finally move my body again and step forward into reclaiming some parts of me.

After that, I did my second-stage reconstruction, got my implants, and I was so happy. But four months later, I had a uterine ablation, because I had been bleeding excessively since chemo, and while I was recovering from that, I saw there was a recall of implants, including mine. They were recalled for causing another type of cancer.

I ended up having to explant at the beginning of 2020, and that was the toughest surgery yet. I was terrified, because I had three weeks to wrap my mind around looking down and seeing a deflated chest — not a flat closure or a small reconstruction or a botched reconstruction — but a deflated chest. I was finally falling back in love with this body, and now I would have to do it again; in a new way, in a scary way.

It was about three weeks after my surgery before I could look at my chest. I did it in my own bathroom, privately, because I couldn’t even show my husband. I knew I had to love that part of me before I [could] allow anyone else to love that part of me.

I ended up walking in New York Fashion Week for AnaOno three weeks after my explant surgery, which was insane. I had never even worn a two-piece swimsuit in my life, and here I was walking down the runway with other breast cancer veterans, in just a bra and underwear with no breasts. It was life changing, honestly, for me. After that I was also asked to introduce the mastectomy swimwear line for Target. It was so weird, because it felt like it was opportunity after opportunity saying, girl, you’ve got to start loving this body, because if other people love it, shouldn’t you also?

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A huge part of that was my daughter. I would look at her and think, how can I say out loud around her that I don’t love my flat chest, when she’s standing there with a flat chest? Does that make her less of a girl, does that make her less beautiful to me? Of course not, I would never say that.

And yet I would look at myself and feel those things. While I agree that we have to feel the loss and grieve, I think there is a point, too, of finding the beauty intentionally, finding the beauty in those broken and hard-to-love spaces.

I started doing what I call “mirror moments,” where I stand in front of my mirror — sometimes I’m completely naked and sometimes I have clothes on — but I look at my scars. I have 27 scars on my body from my neck to my hips, back and front, from 12 surgeries. I touch each scar; I just feel them and look at them and love them. I send so much love to those parts of my body. That is something I try to do daily, even if I can’t stand in front of the mirror for long, it’s to just look at myself and say, “Thank you, body. No matter what, you’ve shown up. No matter what has happened, you’re still here; you’re still kicking it.”

Each scar holds painful memories, but they also hold the memories of the times that I was resilient, and I survived.

So that has held such power to stand there, and there are times when I’ve had my son and daughter with me in those moments, and I’ve lifted my shirt and been able to tell them the stories of these scars. [I] want them to realize whenever they get scars, they’re beautiful no matter what. That’s what body love is really about. It’s a daily decision; to say, “I’m going to show up, and I’m going to love this ever-changing body.”

This year is my first year in six that I don’t have a surgery.

It has been a very revolutionary year, putting it mildly, of trying to figure out how to not just survive, but thrive. This year has really been about trying new things and facing fears and slowing down when I need to.

Learning when to rest is hard for those of us who are cancer veterans. There’s a reason I say veteran over survivor: When you’re a car crash survivor, a fire survivor, you typically don’t have to go back into those traumatic spaces, but us cancer veterans do. We have to keep going back and doing scans and touching our bodies in the same places that they found cancer. That brings up mental health and PTSD — things that aren’t as accessible as I feel like they should be.

So we have to figure it out, just like so many war veterans have to. We have to honor people who experience cancer and say, “I know you’re back, but [I know] there are things that are still hard.” And I think that’s the mentality we should have for cancer veterans. I know that just because your hair grew back doesn’t mean you’re done with treatment, that you’re done with the aftereffects of cancer. So today, I’m trying to figure out ways that I can thrive and not just survive. Honestly, it’s been terrifying, but it’s also been the best.

I have run faster than I’ve ever run in my life. I have broken personal records at the gym. I feel stronger. It’s so wild to look at my body some days and see those scars and those stretch marks and those wounds. I embrace the power of “and” — I see those things and I also see that I have biceps and I have this muscle. To me, that’s exciting, because that shows that there’s hope. There’s always going to be hope. No matter if you’re in the beginning of treatment, or you’re in this veteran status, there is hope that we can continue to do small steps to love our bodies, to be intentional each day, to look in the mirror and thank our bodies. Because no matter what we think, it’s still here, and it’s still showing up.

Stretch It Out Yoga, a popular form of exercise focusing on breathwork through a series of postures or stretches, is gaining acceptance in western medicine as a way to relieve the mental, emotional and physical side effects of cancer treatment.

BY ELYCE NEUHAUSER

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ant some relief from the fatigue, nausea and insomnia of cancer treatment? Some ease from the stress and anxiety? Look no further than your yoga mat. Yoga offers more than just a way to stretch muscles and firm up legs — it can also soothe emotions, improve sleep and reduce stress.

The World Health Organization defines yoga as exercise, while the National Health Institute considers yoga a healing, full-body practice that extends beyond the physical realm.

And through scientific studies and research protocols, yoga continues to gain acceptance in western medicine as a way to mitigate side effects of cancer and its myriad treatments.

Kimberly Carson, MPH, C-IAYT, E-RYT, a mindfulness and yoga therapist at Oregon Health & Science University in Portland, has been developing research protocols for people with chronic conditions through the study of classical yoga since 1999. Classical yoga refers to a system of practices that includes postures, breathwork, meditation and philosophical teachings based on foundational and historical texts. Along with Carson’s husband, Jim, a clinical health psychologist and former swami (a spiritual teacher in the Hindu tradition), Carson created the first behavioral intervention protocol to demonstrate a decrease in pain in women with metastatic breast cancer.

“In metastatic disease, pain is progressive and gets worse 12

Cancer Wellness

as the disease advances,” Carson says. “Using the tools of a yogic trajectory, a combination of gentle asana (postures), pranayama (breath practices), meditation and mindfulness practices, we actually could reduce the baseline level.” Carson’s research in mindfulness and yoga therapies has been part of national professional trainings at Duke Integrative Medicine Center in Durham, North Carolina; Kripalu Center for Yoga & Health in Stockbridge, Massachusetts; and Veterans Affairs centers across the country.

Most people facing cancer practice yoga to help manage their emotions while keeping the body mobile through gentle exercise. “Cancer patients and survivors are looking for some kind of grounding,” says Nancy Wang Gaeden, C-IAYT, a California-based certified yoga therapist specializing in gentle yoga for chronic pain and cancer. “Even though they may come for the gentle stretching, they stay because of the impact it has for them on the mental and emotional level, as well as for the feeling of being in community.”

Indeed, getting on the mat has enormous healing implications. The day Michelle Stravitz received her diagnosis, she went straight to a yoga class before her mammogram. “That’s what I needed to do to settle my mind and get through it,” she says. Stravitz is a seven-year, triple-negative breast cancer survivor and the cofounder of 2Unstoppable, a nonprofit whose mission is to help

women improve their cancer outcomes through exercise.

Stravitz says yoga helped her feel normal, strong and present. “In a class, every minute I’m given instructions for the next 30 seconds, so I don’t have to think ahead, I don’t have to think behind, I’m right in the moment,” she says. Using the techniques of yoga while going through treatments and surgeries can significantly decrease the ensuing pain and negative emotional effects. “So much of our experience in difficulties has to do with our perspective — how the mind is reifying the dynamic energy,” says Carson. “When we can help patients work with that aspect of their experience, the suffering reduces dramatically.”

For Steve Pinkiert, a Long Island accountant, water ski enthusiast and seven-time cancer survivor, yoga is daily medicine. After his first bout with testicular cancer in 1986, he explored chiropractic care, physical therapy and acupuncture, but he didn’t find relief until he got on a yoga mat. “Yoga is a neutralizer,” Pinkiert says. “It helps me with all of the issues of my life; it keeps me balanced with work and family — yoga puts me at rest and keeps me in place.”

How can you go about finding that peace and calm?

Is it really accessible for all? Yes, with practice and mindfulness, says Wang Gaeden, who invites students into a gentle loving presence, offering a complete loving embrace for where they are. Her classes at Providence Medical Group in Santa Rosa, California, focus on moving with the breath, which more deeply connects students with their senses in the moment. “Yoga helped me feel more normal and in control during an out-of-control time of my life,” Stravitz recalls. Focusing on her breath continues to quell her anxiety. “It always reminds me that I’m here right now,” she says. “As far as I know, at this moment, I’m OK. Every lump is innocent until proven guilty.”

Yoga can help cancer patients stay limber and at ease with their bodies. “Yoga is a great tool to regain and maintain mobility and stability and also to help people return to function,” says Diana Tjaden, clinical director and founder of Full Circle Physical Therapy – Ivy Rehab, an exclusive breast cancer recovery center in Garden City, New York.

She endorses gentle stretching as a great way to begin rehabilitation, post-surgery and treatment. “Once a patient gets their range of motion, they can slowly add weight-bearing movements,” she says. She recommends starting slowly, breaking up physical activity into shorter durations, alternating muscle groups, modifying postures and holding them for shorter periods of time to build endurance.

Carson recommends slow transitions, especially when starting out, and Wang Gaeden suggests beginning with a three-part breath — bring breath into the belly, ribs and chest — and gentle warmups, with movement following the breath. Both Carson and Wang Gaeden (who was a student of Carson’s Therapeutic Yoga for Seniors at Duke Integrative Medicine), believe in finding the lowest common denominator to make the yoga practice accessible to everyone, no matter what phase of cancer they are facing. “The training really informed me in meeting students where they’re at,” says Wang Gaeden. “We want them to not only be able to do the class, but [to also] feel really good during and after.” The two give options and modifications, as well as permission to simply rest or opt out at any time. “Professional athletes use visualization when they are in recuperation because it lights up the same part of

the brain,” Wang Gaeden says. “So there are many ways to participate, and we welcome the whole spectrum.”

Although yoga and exercise are an excellent prescription during a cancer journey, patients need to remember that their internal reserves may be lower than their norm, and could persist in that way for decades after treatment. “We recommend that those going through treatment maintain 25 percent in their proverbial gas tank,” Carson says. “You don’t want to work so hard that at the end of class you are tanked. You want to keep that reserve of energy in your system.”

Ultimately, yoga is the connection between you and yourself. “Even if you are doing shoulder shrugs, it’s the inner asana, the inner movement that is the most important part,” Wang Gaeden says. “Coming into class with a self-kindness presence is the biggest opening into that relationship with the self.”

Take heart in a cancer diagnosis: it offers an opportunity for a new relationship with the body and with the self, and does not mean that you have to live with excessive restraint. “Things might be different,” says Tjaden, “but the quality of life after a diagnosis might actually be enhanced in some ways, with new understandings, new activities. Live your life with no limitations.”

Carson offers this simple sequence to incorporate during any part of a cancer journey. Speak with your healthcare practitioner first regarding any personal recommendations for your practice, and modify if your range of motion is compromised.

1. Begin supine, lying on your back, with your knees bent.

2. Inhale; stretch your arms over your head, resting by your ears. Exhale; bring your arms down by your hips.

Repeat five times.

3. Inhale; bring your arms over your head while tilting the pelvis forward, creating an arch in your lower back. Exhale your arms down, nestling low back into the ground. Repeat five times.

4. Bend your right leg and hold your knee close toward the belly. Inhale, moving your knee away from the belly, and extend your arms. Exhale, coaxing the knee toward the belly again. Repeat five times on your right side, then five times on your left.

5. Inhale; extend your right leg straight up toward the ceiling. Exhale, bending the knee. Repeat five times on your right side, then five times on your left.

6. Bring your right leg up toward the ceiling. Inhale, slowly lowering the extended leg to hover above the ground. Exhale to lift. Repeat five times on your right side, then five times on your left. On the last round, stay with the release of the leg to ground. Receive the depth of release.

7. Conclude with Shavasana, or supine relaxation pose, lying on your back with arms and legs comfortably extended, resting on the ground.

To learn more about incorporating yoga into your life, reach out to our sources: Kimberly Carson: www.MindfulYogaWorks.com Nancy Wang Gaeden: www.LoveGentleYoga.com Diana Tjaden: www.FullCircleBreastCancerPT.com Michelle Stravitz: www.2Unstoppable.org Cancer Wellness

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Self-Care for Winter Despair Cooling temperatures got you down? Warm up this winter with self-care tips from “happiness expert” Peggy Sullivan.

BY CATHERINE EVES

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he luster of autumn has faded and the harsh reality she notes that most of the crowds she speaks to consider of winter has set in. And so has your seasonal depresthemselves extremely busy — “But being busy doesn’t necsion. How cruel it is! to trade memories of the pumpkin essarily mean they’re happy and fulfilled,” she says. patch, watercolor forests, sunset bonfires in cozy sweat That’s why Sullivan is such a steadfast proponent of ers, for mountains of dirt-blackened snow piled up outside your self-care. She notes that improved mood and sustainable window, neighbors turning to strangers under heavy winter happiness can reduce anxiety while actually increasing wear and a mere eight hours of weak sunlight per day. energy and productivity. It all comes back to the “science” During the winter months in most of the U.S., it can of happiness — “One of the easiest ways to release endorbe hard to fight off depressive episodes, negative feelphins is through self-care,” Sullivan says. And this is ings and cold-weather malaise, but it’s not just the frigid where those microsteps come into play. “Those tiny little temperatures and social isolation that result in declining happiness rituals, those small things you can do that mental health, there’s a science behind it, too. According bring joy to you, even if it’s for a fleeting second, [will get] to Psychology Today, shorter days and limited sunshine the endorphins going,” Sullivan says. interrupt our circadian rhythm, which results in meta Self-care looks different for everyone. Sullivan bolic changes that affect well-being. Two neurotransmitbelieves the art of self-care is found in our understandters are at the center of your lousy mood: decreased seroing of why we don’t take care of ourselves — why we tonin and increased melatonin in the body cause feelings might trade sleep for early morning business meetings, or of sleepiness, irritability and sadness. putting someone else’s happiness before your own. “You

Left unchecked, the dead of winter could see you give yourself such a disadvantage by not taking care of isolated, depressed and without an ounce of strength or yourself,” Sullivan says. “Many people take care of everymotivation to fight through the dark. But it is possible to body else first […] self-care is about taking a moment and stay on top of these dark feelings. “A lot of people don’t putting yourself first on the list.” realize there are baby steps and small little things we can According to Sullivan, there are three parts to self-care. do to get those neurotransmitters […] going that starts to The first is to let go of perfectionism — “Sometimes good is change all of our body chemistry,” says good enough, sometimes shortcuts are Peggy Sullivan, leadership speaker, just fine,” she says, as it can help save “happiness expert” and founder of the time, resources and energy. Next is to nonprofit for women SheCAN!. “And “claim your non-negotiables” — things “Happiness is a that, to me, is all about self-care.” like making sure to always get enough muscle, and the Sullivan refers to “microsteps” that sleep, or any other acts required to keep anyone can take to increase feelings you functioning at your best. Finally, more you flex it, of well-being and happiness, which she mentions the importance of leading the stronger it becomes especially important during a “values-driven life,” meaning you winter months. “Happiness is a muscle, label your values — decide what is most gets, the more and the more you flex it, the stronger it important to you — and make choices to capable it gets.” gets, the more capable it gets,” Sullivan focus on those things. “For me, looking says, noting that even small changes back at my past helps me understand in daily life — these microsteps — that what nourishes me and what makes me bring joy compound to enforce overall well-being. “We tend happy,” Sullivan says. to think that happiness is something that happens to us,

Sullivan spends her workdays helping other women [that] we crash into it, but happiness is a choice,” she says. find happiness through SheCAN!. She didn’t realize at the Sullivan didn’t come to this realization easily — when time, but her experience with her mother’s cancer diagnosis she was very young, her mother was diagnosed with pancrewould go on to inspire what has become her life’s work. “If atic cancer. “She was in a state of depression and sadness and we can help people find time for what’s important to them frustration and anger that was pretty intense,” Sullivan says. […] their quality of life will improve greatly,” Sullivan says.

But one day, Sullivan walked into the hospital room and her “In life there are things we […] can’t control, [like] cancer, mother was smiling while enjoying a hot fudge sundae and illness; some situations are just out of our control,” Sullivan listening to music — acting in a way she hadn’t for a very says. “Our job is how to figure out how to settle in and how to long time. “I thought, my god, what a big change […] and she find something good out of something really hard.” Sullivan’s said, ‘You know, I just got the big secret to life: Happiness is mother’s passing was incredibly difficult, but Sullivan was my responsibility,’” Sullivan remembers. In her final weeks, able to glean invaluable lessons from it. “[A] hard challenge her mother made every attempt to trade anger for joy. “Life is not happening for a good reason, necessarily, but there’s is hard, life is challenging; we need to acknowledge the chal[…] something you can move forward with, some purpose that lenges,” Sullivan says. “But attitude is so contagious, and you can take away from something that’s really hard.” happiness is contagious. If you watch somebody who’s happy Microsteps in the greater scheme of practicing selfenter the room, the whole room lights up.” care are available to anyone and everyone — it can be as Of course, maintaining a happy mood can be easier simple as listening to a favorite song, or taking your dog said than done, especially during the colder months. Busy for a walk, or eating a square of dark chocolate. If you’re schedules juggling responsibilities related to work, friends capable, take a page out of Sullivan’s book and practice her and family, and the home also don’t leave much room to cold-weather morning ritual: Wake up, list three things to focus on yourself and your happiness. Through SheCAN!, be grateful for, then slip your feet into some warm, fuzzy Sullivan hosts more than 80 speaking events every year; slippers and do a little dance.

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Warm up on cold, winter nights with these warm and savory dishes.

BY AMBER SULLIVAN

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Photography by Amber Sullivan

Warm and Savory

CELERY ROOT SOUP Yield: 6­– 8 servings

Ingredients

1 tbsp avocado oil 4 celery roots (celeriac), peeled and chopped into small cubes, (approximately 6 cups) 1 large leek, dark green ends removed, cleaned and sliced 1 yellow onion, diced 4 cloves garlic, crushed 3 ½ tbsp butter 8 cups water, vegetable or chicken stock 2 tsp salt + more to taste 1/2 tsp ground nutmeg Optional toppings: crumbled bacon, sliced

chives, scallion, parsley, cracked pepper, crispy shallots, olive oil and toasted bread

Directions 1. In a large pot, add 1 tbsp avocado oil over medium heat; once shimmering, add leek, onion and garlic 2. Saute for 5 to 7 minutes until soft 3. Add celery root and butter, and cook for 3 minutes, stirring often 4. Add water or stock and 2 tsps salt; stir and bring to a boil 5. Once boiling, lower heat and simmer for 15 to 20 minutes, until celery root is very soft 6. Turn off heat and stir in nutmeg 7. In batches, move soup to a high-powered blender, and blend until creamy and smooth 8. Season with salt to taste and add optional toppings

ONE-POT SPICED CHICKEN WITH SQUASH AND WHITE BEAN HUMMUS Yield: 3–4 servings

Ingredients

1 pound boneless skinless chicken thighs 1 tbsp avocado oil 1 ½ tbsp Lebanese 7 spice 1 tsp salt 1 red onion, cut into 1/2-inch wedges

1 acorn or delicata squash, sliced into half moons, 1/4-inch thick 1/2 cup dried apricots, halved 3 cloves garlic, crushed 4 tbsp butter 1 tbsp sherry vinegar 1/4 cup maple syrup 5 sage leaves 1 preserved lemon, chopped Optional toppings: pomegranate seeds or parsley Hummus 1 15-ounce can of cannellini beans, drained and rinsed 1/3 cup tahini 1 clove garlic 1/2 cup cold water 1/4 cup olive oil Juice from 1/2 lemon 1 tsp salt

Directions 1. Preheat oven to 400 degrees F; toss chicken thighs in a bowl with the 7 spice, salt and pepper 2. Heat avocado oil in a large cast iron oven-proof pan over medium heat; once shimmering, add chicken thighs 3. Sear chicken thighs for 3 minutes on each side, pressing with tongs or spatula to encourage browning; remove from heat and set aside 4. In the same pan, add another glug of avocado oil, then and add squash, red onion, garlic and dried apricots; saute for 5 minutes, then add butter 5. Once butter is melted, add sage leaves, sherry vinegar, maple syrup, optional preserved lemon and a pinch of salt 6. Saute for another 8 minutes until sauce has slightly reduced 7. Nestle the chicken thighs back into the pot, making sure they are sitting in the sauce; place pan in oven and cook for 20 to 25 minutes Prepare the hummus 1. In a blender, add cold water with tahini, garlic, salt, lemon juice and olive oil; blend until smooth 2. Add beans and blend again until smooth; if it’s too thick, add another splash of cold water 3. Add salt to taste

To serve Sprinkle the pan of chicken with pomegranate seeds and parsley leaves; serve with hummus

SAVORY OATMEAL BREAKFAST BOWL Yield: 2 servings

Ingredients

1 shallot, sliced 1 tbsp avocado oil 1 cup oats 1 cup chopped kale 1/2 tsp chili flake, or to taste 2 cups water + 1 cup water 1/4 cup shredded cheddar cheese 1 tbsp butter 2 eggs 1 tsp salt + more to taste 1/2 an avocado 2 slices of bacon Optional toppings: extra virgin olive oil, pepper, flakey sea salt, chili oil

Directions 1. In a pan over medium heat, add avocado oil 2. Once shimmering, add sliced shallot and cook for 2 to 3 minutes, until browned 3. Move shallot to a paper-towellined plate, and sprinkle with a pinch of salt 4. Bring a small pot of water to boil; carefully add eggs to boiling water, and let sit for 6 minutes 5. Move eggs to a bowl of ice water to stop cooking 6. In the same pan used for the shallots, add a glug of avocado oil 7. Add kale and sauté over medium heat for 3 to 4 minutes 8. Add oats and mix thoroughly, then add 2 cups of water and bring to a simmer, cooking for 10 to 15 minutes 9. Continue to stir, adding water as needed, 1/4 cup at a time 10. Add optional chili flake, a generous pinch of salt and pepper to taste 11. Add shredded cheese and butter; turn off heat and stir to combine until creamy

To serve Divide savory oatmeal into two bowls, peel the eggs carefully, and serve one egg per bowl. Add sliced avocado, bacon and crispy shallots, topping with a drizzle of olive oil, sea salt and cracked pepper Cancer Wellness

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SWEET POTATO MUFFINS WITH BROWN BUTTER CRUMBLE Yield: 12 muffins

Ingredients

1/2 cup unsalted butter 1 ¼ cup granulated sugar 2 eggs 2 sweet potatoes, or 1 can of mashed sweet potatoes 1 ½ cup all-purpose flour 2 tsp baking powder 1/4 tsp salt 1 tsp ground cinnamon 1/4 tsp nutmeg Brown butter crumble topping 1 cup all-purpose flour 1/4 cup chopped pecans 3 tbsp light brown sugar 2 tbsp granulated sugar 1 tsp baking powder 1/2 tsp ground cinnamon 1/4 tsp salt 6 tbsp unsalted butter

Directions 1. Preheat oven to 400 degrees F; spray a muffin pan with cooking spray, or place paper liners in each cup; set pan aside 2. If using fresh sweet potatoes, pierce the skin with a fork and cook them in a microwave for 5 to 10 minutes, or bake in the oven until soft, then peel 3. In a bowl, cream the butter and sugar until light and smooth; add eggs and mix well 4. Add cooked or canned sweet potatoes and milk; mix well 5. Sift in flour with baking powder, salt, cinnamon and nutmeg, and stir until just combined, being careful not to overmix 6. Chill muffin batter for 1 hour in fridge For crumble topping 1. In a pan, cook butter until foamy and browned (it will smell aromatic and nutty); move to a bowl and place in the fridge to cool 2. In a medium bowl, add the rest of the crumble topping ingredients, then add the cooled brown butter 3. Stir with a fork until the mixture forms pea-sized clumps 18

Cancer Wellness

Bake the muffins 1. Fill muffin tins with batter until four-fifths of the way full 2. Top with a spoonful of crumble mixture 3. Bake for 16 to 20 minutes; turning the pan halfway through; muffins are done when a toothpick inserted into the center comes out clean 4. Let cool in the pan for 10 minutes, then serve and enjoy This recipe was handed down by Amber’s grandmother, who has been baking these muffins for 50 years. Amber’s spin on this treasured family recipe is the crumble topping, which she says is a nod to her grandmother’s love of coffee cake.

SWEET AND SPICY ROSEMARY NUTS Yield: 6–8 servings

Ingredients

1 cup cashews 1/2 cup pumpkin seeds 1 ¼ cup walnuts, halved 1 cup pecans, halved 1 tbsp olive oil 1 tbsp melted butter 1 tbsp brown sugar 1 tsp salt 1/2 tsp ground cinnamon 1 tbsp chopped rosemary 1/2 tsp cayenne 1/4 tsp nutmeg 1 tbsp maple syrup

Directions 1. Preheat oven to 350; add all ingredients to a bowl, toss until coated and combined 2. Spread mixture on a sheet pan lined with parchment paper 3. Bake for 16 to 20 minutes, turning the sheet pan halfway through

To serve These will be a hit at your next holiday party! Serve the roasted nuts in decorative ramekins alongside fresh rosemary sprigs and seasonal cocktails. Better yet, add these to a charcuterie platter, with olives, crackers, cheeses, cured meats and other small bites.

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Chef Amber Sullivan moved to Los Angeles six years ago and discovered her love for farmers’ market-driven California cuisine. Since then, she has worked her way up through the local culinary scene. Beyond the restaurant industry, Amber has worked as a private chef, developed menus and recipes as a consultant, taught cooking classes, catered events and promoted food pop-ups out of her home in Silverlake.

She is most inspired when walking through a farmers’ market, finding unique seasonal ingredients for innovative and healthy but flavorful dishes.

Amber loves the act of cooking for others; seeing people happy and enjoying their food feeds her soul. If you’d like to view some of chef Amber’s work, visit her food Instagram, @eatbyhand.

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Moving Beyond Cancer LIVESTRONG at the YMCA is a free program, operating in 42 states, that helps cancer survivors find and maintain an active lifestyle.

BY MEGHAN MCCALLUM

W

e all know the importance of regular exercise for overall physical and even mental health, but fully adopting an active lifestyle can be easier said than done. And for those who have experienced a cancer diagnosis, the stakes and challenges are even higher. Cancer treatment can leave individuals with post-surgery restrictions and long-term side effects impacting energy levels, strength and mobility. Exercise can provide a multitude of benefits in managing side effects and decreasing risk of recurrence, but these very side effects and restrictions can make it even harder to get the recommended levels of activity.

Personalized training and support can help connect the dots for individuals wanting to redefine their approach to wellness in cancer survivorship, and LIVESTRONG at the YMCA offers just that. A free, 12-week exercise program for cancer survivors, LIVESTRONG at the YMCA teaches exercise as a key component of post-cancer recovery.

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and weight training. An end-of-program assessment meaThe evidence-based program “helps adult cancer survivors sures each participant’s individual improvements compared reclaim their health and well-being after a cancer diagnosis,” to their original baseline measurement. And although this says Phillip Jiménez, president and CEO of the West Cook data helps each individual see their progress in a concrete YMCA in Oak Park, Illinois. Sessions take place twice per way, Jiménez emphasizes that some of the most significant week, with 90-minute classes focusing on cardiovascular and growth is a kind that cannot be measured or quantified. strength training as well as healthy lifestyle education.

“We have the pragmatic approach, where the program

Jiménez describes the LIVESTRONG program as goals are met, we have good enrollment, participants com“part of the YMCA’s commitment to the community — in plete the program and survey responses show that it was addition to traditional programming, we wanted to tap into helpful. Those are the quantifiable, measurable results,” risk management [and] preventative and tertiary care,” with he says. However, he personally thinks that “the best meaa focus on lifestyle changes to address chronic disease. surement is whether the participants create a community.”

Jiménez says that the program helps cancer survivors “go

Jiménez acknowledges that cancer is a very lonely from ‘I can’t’ to ‘I can’,” helping them establish understandexperience, and one of the most valuable outcomes of the ings of various types of cardiovascular and strength training LIVESTRONG program is the interpersonal bonds formed exercises and how to build a routine for an active lifestyle. between participants. “To have someone right there with

Although LIVESTRONG is a group program, paryou who understands, that’s a community,” he says. ticipants progress through individualized training plans Jiménez emphasizes that while an individual’s internal under the direction of the program instructors. The healing can’t be measured, this component is critical to the program starts with baseline measurements of cardioprogram’s success. “You can’t underestimate the emotional vascular fitness, range of motion and resistance training. healing that happens when someone is scared about the From there, participants receive their custom plans to suit reality of not being themselves ever again, and then seeing their particular needs and goals. that this doesn’t necessarily need to be true,” he says.

This customization is so important because of

In a typical year, the West Cook YMCA offers four, the incredible diversity of participants, Jiménez says.

12-week sessions of the Although all participants LIVESTRONG program, have cancer in common, with approximately eight each person’s experience to 12 participants in each. can be vastly different from “You can’t underestimate the Like most facilities over the the next. The program is emotional healing that happens past couple of years, the open to all cancer types, LIVESTRONG program ages and genders. Within when someone is scared about and the YMCA more broadly any one LIVESTRONG the reality of not being themhas faced challenges with cohort, there are likely staffing as they re-emerge many different diagnoselves ever again, and then from pandemic-related setses, treatment plans and backs. Staff shortages have post-treatment challenges. seeing that this doesn’t necesimpacted the availability of LIVESTRONG instructors sarily need to be true.” the LIVESTRONG program take all these factors into at the West Cook YMCA in account when working with recent years, though Jiménez each participant. “The idea notes the branch is keeping a participant waitlist, aiming to is to understand that each individual is there for a differoffer the next session of the program in early 2023. And if ent reason,” Jiménez explains. you’re not local to West Cook, there are 388 other YMCAs in While the technical skills a participant learns in the the U.S., across 42 states, offering the program.

LIVESTRONG program can help them overcome can Participants are encouraged to join the LIVESTRONG cer-related physical changes and restrictions, Jiménez program no matter what their baseline may be in terms of adds that cancer survivors face significant emotional physical and emotional recovery from cancer. Instructors challenges as well. The LIVESTRONG program aims are trained to meet each individual where they’re at, and to provide the requisite empathy and individualized the welcoming, supportive environment allows particiattention to help participants establish a whole-person pants to safely develop an active lifestyle. Participants are approach to long-term wellness after cancer. also welcome to meet one-on-one with LIVESTRONG

Through LIVESTRONG, participants adopt health instructors ahead of time to cover any individual questions. and wellness “as a larger concept,” Jiménez says. “It’s not just

To anyone considering joining the LIVESTRONG about getting on a treadmill, losing weight or lowering BMI. program and seeking support as they navigate cancer surIt’s a full commitment to a person being as whole as possible.” vivorship, Jiménez offers some words of encouragement: Beyond the requirements of fitness instruction, it takes “Anyone going through this journey doesn’t have to be specific skills from the program instructors for this approach alone. Reach out; explore this program with your commuto be successful, Jiménez says. In addition to having the technity. We’re here to help you.” nical knowledge and completing LIVESTRONG-specific training, instructors leading the program need to be compasTo learn more about LIVESTRONG at the West Cook YMCA, sionate and understanding of each participant’s situation. and to register for the program waitlist, visit westcookymca.org/ Over the course of the 12-week program, participants LIVESTRONG. learn specific skills and track their progress in flexibility Cancer Wellness

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The Psychedelic Series Part one of cW’s Psychedelic Series examines the history of research into psychedelic drugs in the United States and considers why psychedelic therapy may be an ideal option to help relieve some cancer patients’ end-of-life depression and anxiety.

“A

BY CATHERINE EVES

nxiety makes my head a busier place than an airport with delayed flights,” says Thomas Hartle. “Most of those thoughts are things I can’t do anything about, and the degree of their interference in my life varies from stealing moments [to] holding me hostage [because] I can’t handle even a little more sensory input. It feels like being alive but not living, and, at its worst, it feels like actively dying.”

In 2016, Hartle was diagnosed with stage IV colon cancer. He experienced debilitating anxiety following his life-threatening diagnosis and saw little success with most treatment methods. But when Hartle became the first Canadian to legally access psilocybin therapy, life became exponentially more bearable. “Psilocybin therapy turns the volume down on all that noise and truly makes it possible for me to live in the moment,” he says. “I can actually be present to do the things that are important to me.”

Psilocybin is a chemical compound found in certain species of mushrooms that produces variable mind-altering effects, including mild euphoria, changes in perception, increased empathy and visual and auditory hallucinations. While “magic mushrooms” are a popular yet illegal recreational drug, growing scientific research into psilocybin and other psychedelic drugs is proving that they can provide more than just a fun — albeit perplexing — night between friends, but could help relieve some of the severe, negative emotional effects of cancer.

Research into psychedelic drugs isn’t new. Pioneered in the U.S. in 1950, research continued through the 60s and produced promising results about the potential for psychedelics, like LSD, MDMA and psilocybin, to treat things like substance addiction, anxiety and depression. However, in 1970, the U.S. government passed the Controlled Substances Act, thereby banning the use and research into psychedelics, for 24

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any purpose. Fortunately, psychedelic research was revived in the 1990s, and in the year 2000, researchers at Johns Hopkins University were the first to obtain federal approval in the U.S. to resume studies in healthy volunteers.

In 2019, Johns Hopkins launched a research center dedicated exclusively to the study of psychedelic drugs. The researchers at the Center for Psychedelic and Consciousness Research primarily study psilocybin to help treat a wide range of health issues, from smoking cessation to anorexia to Alzheimer’s disease, according to a 2020 article in Scientific American.

Post-1970, these were the first researchers to revive psychedelic therapy studies for cancer patients, specifically, in 2016. This study involved people with aggressive cancer and found that psilocybin was able to significantly decrease the patients’ rates of depression and anxiety, with 80 percent of trial participants reporting reduced depression and anxiety six months later.

Since then, research into psychedelics and the cancer community has only grown, and more oncologists are introducing their patients to psychedelic therapy as a way to treat the negative mental and emotional aspects of a cancer diagnosis.

Dr. Manish Agrawal is at the forefront of this type of work. He is the founder and CEO of Sunstone Therapies, whose mission is to address the emotional effects of cancer. Agrawal has been practicing oncology for more than 20 years, and during that time, he realized treating the mental and emotional side of a diagnosis is just as important as the physical.

“A growing realization as an oncologist was this was a huge unmet need that [emotional effects are] impacting the quality of life more than the cancer treatment,” Agrawal says. As a principal investigator for one of the more than 90 active clinical trials involving psilocybin, he believes psychedelic therapies can help reduce the death-anxiety felt by many cancer patients, especially given the current lack of relevant resources.

Agrawal offers a real-life example of how psychedelic and understanding, without overwhelming grief and tension. therapy helped one of his patients: a patient was having “[For] many of our patients […] they’re able to talk about trouble managing the emotional weight of knowing his four their cancer, their diagnosis, about their fears amongst their children may have to grow up without a father. The patient’s friends and family, [which] leads to more awareness around relationship with his mother was also strained, as they were this and it not being such a taboo subject,” Agrawal says. “You no longer able to enjoy spending time together because they get a sense from [the patient that] they don’t want to die, but were so focused on how it might be cut short. they’re not so fearful about it.”

For these reasons, Agrawal’s patient was a good can As far as negative side effects of Agrawal’s psychedelic didate for psychedelic therapy. Agrawal’s sessions include therapy sessions — there usually aren’t any, as long as patients administering a single dose of psilocybin with accompanying have sufficient support and understanding of what to expect. therapy before and after the experience — the talk therapy Agrawal says that a little anxiety before the session is peroffers emotional support to help wrestle with the big feelings fectly normal: “Taking a high-dose medication that’s going to that come from the drug’s effects. “[Psilocybin] enters people allow you to explore your unconscious and deal with things into this altered state of consciousness, and they’re able to see that you’ve been trying to avoid would cause some anxiety.” material or step outside of themselves,” Agrawal says. The first The drug itself is safe — even exceedingly high doses, which step, which Agrawal calls preparation, prepares the patient for would never be used in a therapeutic setting, don’t negatively what the experience may feel like and helps build the patient’s affect organs like the liver and kidneys, according to Agrawal. trust in the therapist, the process and themselves. Difficult “Compared to most of the drugs that we use in oncology, it’s a emotions will rise and can be worked through with proper relatively safe drug on the body,” he says. emotional support, he says.

Doctors still aren’t entirely sure what is happening in the During the session, the patient will first talk with this mind during a psilocybin therapy session. The sense of unity therapist about an intention — what do they hope to get out and mystical significance people experience can lead to lasting of this? — then they are given eyechange in ways of thinking, according shades and typically lie down on a to Scientific American, which says the comfortable sofa, with light music drug may “alter communication in “Psilocybin therapy playing in the background. The whole brain networks.” But such overwhelmsession lasts about eight hours, but the ingly positive results should allow this turns the volume patient will start feeling the effects of type of therapy to become more widedown on all that psilocybin about 30 minutes after it is spread and easily available for cancer administered, with peak effects occurpatients, especially with the help of noise and truly makes ring between three and four hours in, people like Hartle. He advocates for says Agrawal. The therapist is with the psychedelic therapy because of how it possible for me to patient the whole time, and once the it improved his life, despite his struglive in the moment.” effects have totally worn off, the patient gle to access it in his home country of will have a little food and talk with the Canada. “All [the] difficulty I had to go therapist about the experience. Once through to get access is specifically the they’re feeling grounded, they go home. The last step, called reason why I advocate so hard to get the therapy legalized,” he integration, takes place one or a few days later and helps the says. “It has not always been easy, so I am trying very hard to patient make sense of the experience. “[This step helps] make make the access simple for everyone else who needs it.” meaning of what they saw, what they experienced and how Agrawal says that sooner rather than later, psilocybin they [can] integrate it into their life so they feel more fulfilled and other psychedelic drugs could be FDA approved in the and can make the changes they need to,” Agrawal says.

U.S. for clinical use. Already, in March of 2019, the FDA Agrawal says the case of the father mentioned above was approved a nasal spray called esketamine (derived from successful. During his session, the patient envisioned himself the ketamine) for treatment of major depression. MDMA, as a tree — “Even though he was a tree that was dying or had commonly known as a party drug, could be FDA approved died, there were still branches, and the kids were still playing to treat post-traumatic stress disorder as early as 2024. on it,” Agrawal says. “He got the sense that even though he

For cancer patients who think psychedelic therapy wouldn’t be there physically, [he] would always be part of their could offer a solvent to the emotional torment of a cancer life.” Agrawal says the patient went home after his session, diagnosis, things are looking up — Agrawal says he and almost immediately had the opportunity to talk with his expects psilocybin to be FDA approved to treat anxiety seven-year-old son about his cancer and mortality. and depression, in patients where conventional treat “Before, he may not have engaged in that conversation,” ments have been ineffective, in the next two to five years.

Agrawal says. “They were really able to talk about it, that he Agrawal insists that grief is a normal part of the human might die [and] what it would be like if he was gone.” The experience, especially for those with limited time left, but that patient was also able to share the therapeutic experience with time does not have to be spent shrouded in darkness and emohis mother, and they were able to reestablish what cancer tional turmoil. Psychedelic therapy can help cancer patients had taken away. Agrawal says that the patient was able to tell find the light. “[Psychedelic therapy] allows me to make my his mother, “Yes, the cancer is there, it’s unfortunate, but time matter with my loved ones by focusing on the things I now we’re not enjoying our time together, [because] you’re so can do something about, instead of all the things that are out worried about me dying.” The psilocybin session didn’t change of my control,” Hartle says. “It also makes it easier for me to the patient’s physical condition, but allowed him to initiate look for the lessons in this experience instead of focusing only painful, necessary conversations that come from a place of love on the adversity of it.”

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What C omes Next

cW’s resident cancer coach delves deep on a relatively new modality for the western world: Qigong.

BY MIRELA KOPIER

I

was so excited when I learned that this issue was the Fitness Issue. My educational background is in health and wellness promotion, and I am a certified personal trainer and 200-hour registered yoga teacher. Yes, I am one of those people who loves to work out. While my career path did not direct me toward a gym or yoga studio, I’m thankful for this opportunity to share my knowledge with the cancer community.

My curriculum and degree followed the American College of Sports Medicine (ACSM) guidelines and, according to the ACSM, exercising during and after cancer treatment improves fatigue, anxiety, depression, physical function and quality of life, and it does not exacerbate lymphedema. I have heard from some cancer patients that there is no way they can do any type of physical activity during treatment due to being exhausted, in pain or mentally drained. But with that I say, let me show you!

All the side effects of chemo and radiation can be lessened if you are able to find the activity that is right for you. According to Nathan Crane, award-winning author, director and producer of the documentary film, “Cancer; The Integrative Perspective,” the human body is designed to move. Exercise is the pump that pumps the lymphatic system, which moves the toxins out of your body and helps produce antibodies and killer T-cells.

With that in mind, I would like to share the practice of Qigong. Qigong has been around for more than 4,000 years, but it is a new practice for me and most of the western world. America’s first exposure to Qigong was in 1993 during the PBS series, “Healing and the Mind with Bill Moyers.” Qigong literally means “life-energy cultivation,” and is a Chinese system of physical exercises and breathing control related to Tai Chi. In reference, Tai Chi is the martial arts practice and Qigong is the medicinal practice.

I offer this modality to those going through treatment or those who may have just finished treatment, as I have found it both beneficial and gentle. According to Master Mingtong Gu, founder of the Chi Center, a Qigong healing center in New Mexico — it’s not an exercise only available to people who are in perfect physical health. Master Gu speaks about working with people “truly depleted and very weak,” as well as those who are disabled and may be in wheelchairs or hardly

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able to move at all. As you start to practice and move — even just one finger — more movement will become available to you. One arm, then two arms, then you may gradually be more capable; moving the spine, a hip, one leg and so on.

In the short time I have experienced this modality, I have noted similarities with yoga, but Qigong moves at a much slower inner pace. A practitioner of Qigong may experience more of an energetic movement during a practice, which, if you read my column from last issue, is heavily involved with the mind-body connection. As Master Gu mentioned, you can start off with a finger movement which can spark the energetic flow to build on that first movement, until the energy moves you to the second movement, and so on.

To build a better picture of Qigong, I’ll share a bit of the techniques and principles. Qigong is built on the concept of the five elements: wood, fire, earth, metal and water. These are the energetic archetypes whose cycles affect the flow of energy in the body, according to Chinese medicine. Techniques include slow, long and deep breathing; gentle and smooth movement; mind regulation; and visualization. In some practices, chanting is used, which transfers the energy from within. There is a large component of meditation through all these techniques, which allows the body a deeper connection to movement and the breath.

As a child of curiosity and discovery, I hope you can share in my excitement for a new modality, and I would like to thank my readers for allowing me to learn along with you.

Stay well and enlightened until next time!

On the Way to Wellness Robb Leone, president and cofounder of BIÂN, follows up with Cancer Wellness about his journey with leukemia and the many things for which he’s grateful.

Photos provided by Anthony Thalier

BY FRANCESCA HALIKIAS

Cancer Wellness

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HOW HAS YOUR CANCER JOURNEY BEEN GOING?

Things have been going fine. I think my body is becoming acclimated to the chemo treatment that I’m taking daily. I feel like my energy has improved, and I’ve been optimistic about future outcomes being positive.

LIFESTYLE CHANGES AND THERAPIES YOU RECEIVED FROM BIÂN ALLOWED YOU TO REDUCE YOUR DAILY CHEMO PILL; IS THIS STILL TRUE?

Yes, I got it reduced to 50 milligrams from 100 milligrams. And then I had a metabolic reading, and I got my levels to a good spot. [The cancer] in my blood is getting close to becoming already untraceable, which is wonderful. I will stay on the treatment plan for at least two years to make sure that the mutations don’t come back, but I’m hopeful.

The intention is to get off the medication at some point.

DID YOU IMAGINE YOU WOULD RESPOND SO POSITIVELY TO TREATMENT? DID YOU PREPARE YOURSELF FOR THE BEST? THE WORST?

I think the first reaction was just that utter shock. I wasn’t even thinking about the outcomes, and then there was the initial panic of, oh my gosh, I have cancer, what the heck, and what does that mean, exactly? Then there was a period where I did my own research, and it was really frightening to see what was going on with leukemia and cancer in general. But then as I started getting more comfortable with the diagnosis, talking with my doctors and seeing how effective specific targeted treatments are in leukemia, I became more optimistic. I had guarded, cautious optimism.

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Cancer Wellness

CAN YOU TELL US MORE ABOUT THE MEDICAL CONCIERGE ASPECT OF BIÂN, AND HOW USING THESE SERVICES HELPED DETECT YOUR CANCER?

The medical concierge at BIÂN is structured in a way to be preventative with medicine and healthcare. I went in for a typical extensive annual physical, and within that, there were some levels of my white blood cells that were elevated.

I think in many normal circumstances, the levels were not elevated enough to cause alarm, and my condition might not have been diagnosed right away. At the insistence of my doctor, she recommended I get further testing, which I actually didn’t follow up on right away, but she stayed on top of me. I think the personalized care of the doctor that I received at BIÂN is what put me over the edge of like, OK, I’m going to do this, and it’s because of that early diagnosis that my outcome is better. My treatment plan has changed so fast; I feel like I really caught this within the first three to six months of inception, and that gives such a greater probability of a healthier outcome and a healthier life.

WHAT DOES A WEEK IN YOUR LIFE LOOK LIKE WHEN IT COMES TO HOLISTIC HEALING?

I do weekly acupuncture and monthly energy healing specific to me. I try to follow clean eating habits 80 percent of the time — BIÂN has great food, so that helps a lot. I try to meditate every day and do active exercise five times a week. I’m doing yoga, or light strength stuff, and a lot of the time, I feel like it’s making me feel stronger than I was before my diagnosis, and many times I often even forget about my diagnosis.

WHAT’S YOUR FAVORITE ACTIVITY AT BIÂN?

I’m partial to our steam room with our cold plunge pool — that is a very consistent part of my routine. I feel like there is a meditative component to the cold plunge that really relaxes and calms my whole body, along with reducing inflammation. It expedites recovery and gets my mind and body in a healthy spot. The steam helps sweat [everything] out. The combination of the two gets my blood, which I’m trying to heal, moving through my body faster and opens and constricts my blood vessels, and I think [that] expedites the healing process.

I feel very fortunate and blessed for [access to BIÂN], but I also feel it’s part of my overall mission. We built this place before any diagnosis, and I feel like there’s a reason that I got this diagnosis, maybe, to spread awareness on preventative measures and new alternative and reactive ways to treat cancer.

WHAT IS YOUR FAVORITE AND LEAST FAVORITE PART OF YOUR WEEKDAY? I love talking with all the BIÂN members. This community is super positive and supportive — not just of my journey, [but] there’s just a great energy here that I really love and enjoy. The toughest part of my day is the challenges of building a brand-new business, and in a COVID and post-COVID world, there are endless challenges. And it could certainly add up, but I have to keep a positive attitude and just keep on trying to build the best possible experience we can.

HOW DOES BIÂN SUPPORT THE CANCER COMMUNITY?

We’ve sponsored and donated a number of things to various cancer organizations and continue to do that. I think that I’ll be more active and involved specifically in leukemia foundations, and I think this has opened my eyes to the importance of continued cancer research. I know that 25 years ago, my cancer diagnosis was very severe, and it was not as bright of an outcome as we currently have. I think taking this and hopefully finding cures for all the other cancers out there and diseases, you get a lot of hope. There are many people that don’t realize how impactful donating can be, and how powerful science and medicine are getting at addressing these specific diseases.

ANY NEW ADVICE THAT YOU’D GIVE TO CANCER WARRIORS?

I think that it’s healthy to take in all the love and support that you feel from others and thank people for sending that energy out into the universe. It helps me get better, I think, so it’s powerful. I think it’s also healthy to know that every day is not great, and there are going to be moments where it’s frustrating, and it’s OK to have breakdowns. It’s healthy to accept the ups and downs of this journey and hopefully just fall back on all the support, or any support people have, and to know that it starts with the right kind of attitude. Hopefully people can feed off the positive energy that the world sends them.

WHAT ANIMAL PERSONALITY?

BIÂN’s founders (L to R): Kevin Boehm, Joseph Fisher and Robb Leone

BEST

EMBODIES

YOUR

A dolphin. They are super playful. I love the ocean; I feel the power of the ocean — I think it’s very healing. I feel like they love interacting and are incredibly intuitive and can communicate with all different types of life forms. And they’re just so beautiful to watch, jumping through the ocean waves.

Cancer Wellness

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Super Clean 1

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5 ONCOLOGY BODY LOTION This plant-packed lotion can be used daily to restore moisture and renew healthy skin cells. The anti-inflammatory botanical formula glides on silky smooth with a pleasantly clean scent providing instant relief to red, itchy skin.

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6

HAND FOOT CALMING CREAM Twelve all-natural, skin-nourishing ingredients combine to comfort painful, swollen hands and feet, while maintaining soft healthy skin all over the body during treatment.

Powerful and pleasant, the silky, lightweight formula has an uplifting citrusy scent from hints of bergamot and lemon oil.

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Disclaimer: This is not medical advice. The products and their descriptions are written from the perspective of their author, who makes no claim other than their opinion.

The section is meant for entertainment purposes only and reflects the sole opinion of its author.

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Cancer Wellness

Photos and product samples provided by Dermavitality

ORGANIC SOOTHING LIP BALM Featuring all-organic oils and waxes, this plant-rich lip balm is multifunctional — it can be applied to dry patches anywhere on the skin, including cuticles, hands, feet, chins, cheeks and, of course, lips. A base of olive fruit oil, candelilla wax, coconut oil and shea butter deliver fatty acids to aid in preventing damage from environmental factors while softening the lips and providing anti-aging benefits, like reducing lip lines and pigmentation.

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Hello, MBC thriver.

We see you.

We honor you.

We support you.

Everyday.

“What cannot be cured, must be endured.”

This quote by Salman Rushdie perfectly reflects our mission at ROOTS & WINGS—to support integrative & wellness programs that increase emotional, physical & spiritual well-being during the continuous oncology treatment for Metastatic Breast Cancer. Visit our site to donate and learn more. And mark your calendar for our annual event, Move IV MBC, coming August 6, 2023.

rootswingsfoundation.org

FORCE

Cancer Wellness is proud to present the first installment of our new series in partnership with Bright Pink. FORCE is the first (and largest) nonprofit focused on providing education and resources to the hereditary cancer community, while championing efforts to widen access to genetic testing, cancer screenings and lifesaving treatments and procedures — regardless of income or insurance status.

BY CATHERINE EVES 32

Cancer Wellness

Photos provided by FORCE

The Brightened & Enlightened Series Presents

“H

ereditary cancer is a lifelong struggle,” says Verinda Hobbs. “It’s like a time bomb, and [you] don’t know when something might happen, if you’re carrying that gene.” Hobbs is the partnerships and diversity manager at FORCE, AKA Facing Our Risk of Cancer Empowered — a nonprofit whose mission is to improve the lives of all individuals and families with hereditary predispositions to cancer, regardless of income or insurance status, by providing access to education, genetic counseling, testing, screening and preventative services.

Hobbs, like most of FORCE’s staff, has a family history of hereditary cancer.

When her sister was just 28 years old, she was diagnosed with breast cancer. Only four years after that, she was gone. “At that time [in 1998], we didn’t know much about genetic connections to cancer [and] we couldn’t find a lot of support, so that became a difficult time in my life,” says Hobbs.

With little support from medical professionals, Hobbs’ family had no idea that one of their own passed from a cancer foretold in her very DNA — a genetic mutation that had been there since birth. They had no idea that there were most likely other family members that also carried this mutation, or that, once made aware, there were steps they could take to decrease their risk of contracting hereditary cancer. It sounds alarming, but this is a fact for many families across the world, which is exactly what Sue Friedman aimed to address when she founded FORCE more than 20 years ago, on the cusp of the new millennium. (Story continues on next page.)

Since 2007, Bright Pink has been a national leader in educating, equipping and empowering millions of women to be proactive with their breast and ovarian health. Today, Bright Pink operates as a nonprofit venture philanthropy fund, building on their proven success and deep expertise to find and fund the next generation of groundbreaking breast and ovarian health initiatives. Laser focused on moving the needle on young women’s breast and ovarian health outcomes, Bright Pink has continued to deepen its focus on health equity and finding solutions that remove barriers to care and help save lives. Why? Because despite advancements, millions of women continue to needlessly die of breast and ovarian cancer every year.

Cancer Wellness is partnering with Bright Pink to highlight their Mission Partners — nonprofits that embrace evidence-based practices, make steadfast commitments to ensure health equity and are working toward a common goal. Together, Bright Pink and their Mission Partners have the power to develop systemic change.

That’s why Cancer Wellness and Bright Pink are pleased to announce the “Brightened & Enlightened Series.” Each issue, Cancer Wellness will sit down with officers and executives from one of Bright Pink’s Mission Partners to highlight their triumphs in the cancer prevention space.

The Winter 2022 issue features the faces behind FORCE — Facing Hereditary Cancer Empowered. As a Bright Pink Mission Partner, FORCE aims to deliver greater coverage of preventative care for underserved high-risk women by improving state legislation. Bright Pink will support FORCE in recruiting, training and equipping a diverse cohort of patient advocates to break down barriers to preventative care at the state level.

Cancer Wellness

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Friedman, who today acts as FORCE’s executive director, was 29 when she was diagnosed with breast cancer. She had a one-year-old baby and was preparing to get pregnant again, when she found a lump. It was 1996, and the BRCA1 and 2 mutations had just been isolated as breast cancer susceptibility genes, and the screening for this mutation had just become the first available genetic test for cancer risk. But despite Friedman’s medical training as a veterinarian and her experience going through cancer treatment and surgery, the first time she heard about the BRCA mutation was while she was waiting for a fitting at a local mastectomy boutique.

After her fitting, she went home and started researching, and realized that she matched many of the descriptors of individuals with the BRCA mutation — the most eye-opening being that her Ashkenazi Jewish heritage meant that she was at increased risk. According to the CDC, one in 40 Ashkenazi Jewish women have the BRCA mutation, but in the general population, it’s only about one in 500 women.

Then Friedman’s cancer came back. Following this recurrence, she knew she had to be proactive about her own health, so she underwent a full hysterectomy following the birth of her second child. “I was newly menopausal; I had all these other issues about risk, about my family, about menopause, and they were different than the other breast cancer survivors I was meeting,” Friedman says. It was 1998, and Friedman was active on a message board for breast cancer survivors. “I’d post I have this mutation, and people were like ‘What’s that?’ because it was still new, and I started meeting these other people who said, ‘I probably don’t belong here, I don’t have cancer, but I have this gene,’” Friedman remembers. She found a lot of likeminded individuals, who hadn’t had cancer themselves but were caregivers of people who did, or who were also searching for answers about what is today known as hereditary cancer.

Friedman found that many of them felt either unwelcome or uncomfortable taking up space in a corner of the internet devoted to people going through treatment.

“It was really those people who didn’t feel welcomed anywhere that I thought needed a home. That’s why I started FORCE,” she says. “We were really grassroots, but it grew quickly because there was a need and a gap.”

Growth was so exponential because FORCE was the only organization at the time serving the hereditary cancer community, which is linked to breast, ovarian, pancreatic, prostate, colorectal and endometrial cancers. FORCE was founded during a time when significant strides in cancer research were being made, especially regarding these mutations, or cancer susceptibility genes. As well, improving technology meant that screenings were becoming less cost-prohibitive and therefore more accessible, to an extent. But with better access came more questions, and FORCE wanted to be able to provide those answers.

That’s why Verinda Hobbs, like many before her, was recommended to reach out to FORCE. Their resources provided the clarity and calm Hobbs needed while her family was grieving the loss of Hobbs’ sister. Hobbs found FORCE’s community support resources especially welcoming. “They had support groups that could help me understand what was going on, deal with the grief of my sister, and understand what the future held,” Hobbs says.

“The support and encouragement I got from the women and some men […] really struck a chord in me and made me feel understood in a way that I had not been before.”

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That’s why Hobbs jumped at the opportunity to join FORCE’s staff. “I don’t want to see anyone else’s family go through that type of struggle — looking for information, being turned away,” she says. “People of color, particularly with breast cancer, when it’s diagnosed it’s at an aggressive stage, so timing is of the essence, [and] not knowing what to do next is a terrifying position to be in. […] FORCE is able [to] bring comfort, information, resources [that] help people like me, that didn’t have those resources at a time we really could have benefited from them. That’s why I’m here and why I do what I do.”

FORCE’s senior vice president of volunteer programs, Sandy Cohen, has a similar story. She originally connected with the organization after finding out she was a carrier of the BRCA mutation. Cohen’s grandmother passed away from breast cancer when she was only 38, and Cohen’s mother expressed worries that she herself would also get cancer. “This was all before the genetic mutations were found, so she didn’t know there was a real link, but she felt something inside of her and it stayed with me,” Cohen says. After her mother passed away at the age of 54, also from breast cancer, the fear of a hereditary link was cemented in Cohen herself. “I became obsessed with thinking about it right after my twins were born. I thought, ‘I can’t leave these babies,’ so I had the testing, it came back positive, and my genetic counselor pointed me in the direction of FORCE,” she says.

From her start running FORCE support meetings in the Philadelphia area to assuming her current role at the organization, Cohen has found the experience to be invaluable. “[FORCE] empowered me with information. They comforted me because they understood what I was about to face,” she says.

“It was so nice to be validated and to be amongst peers who understood and shared some of their decision making, [so] I too felt comfortable with how I wanted to manage my own risk.”

FORCE has 12 different support groups available to the hereditary cancer community — there are so many, because a major facet of their overall mission is to address the unique needs of everyone who makes up the hereditary cancer community. Following the pandemic, FORCE pivoted to a virtual format for all their support groups, meaning location no longer inhibits access to support. They have a group that is conducted in American Sign Language, one for caregivers and parents, one for the LGBTQIA community, one for young cancer survivors, and eight other types that are each tailored to serve a unique corner of the community.

FORCE knows they can only measure their success by how they support those who are most underserved, meaning their advocacy and public policy efforts are a vital part of the organization. Currently, most health insurers don’t provide adequate coverage of screening and prevention services for those considered high risk. Friedman, FORCE’s founder and executive director, notes that specific communities are affected by hereditary cancers at higher rates than the general population (such as the rates of BRCA 1 and 2 mutations in Ashkenazi Jews), which FORCE addresses by mobilizing volunteers to become Patient Advocate Leaders, or PALs. PALs put in the work to actually influence national legislation in order to widen access to these services for all communities facing hereditary cancer. “A lot of people don’t have adequate insurance coverage, or the insurance companies in their states don’t cover the surgery that’s required to help them stay alive or prevent cancer from becoming overwhelming in their family and their own lives,” says Hobbs.

FORCE’s PALs also work to advocate for more diversity in scientific research. “We see a lot of the ways that lack of inclusion and diversity in research can lead to gaps in guidelines,” Friedman says. “We did an XRAY review, looking at [how] some research studies are designed in a way that who’s excluded from the research can add to disparities,” she says, noting that certain comorbidities may be more prevalent in people of color, for example. “If that’s the case, if that’s an exclusion, then when you get results [they] may not [apply to] diverse populations.”

FORCE’s website features many tools available to people seeking insight about hereditary cancer — along with details about their public policy and advocacy efforts the site also features information about clinical trials, how to find financial assistance and how to connect with a Peer Navigator volunteer — someone who shares a similar situation and can offer support. The site also provides access to the XRAY program. “[We’re] trying to address online digital health literacy, and really trying to help people understand where to find reliable information online,” Freidman says, noting how easy it is for people to spread misinformation. FORCE’s XRAY program offers an extensive database of research that is delivered in language anyone can understand, bridging the gap between the science as it’s reported in peer-reviewed journal articles and the general population.

The hereditary cancer community is only growing, and FORCE adapts to that by continuing to expand their coverage to include information and resources for new mutations and communities as they become known. They’ve just recently added Lynch syndrome to the roster, for example, which comes with an increased risk for colorectal, endometrial and other cancers. This commitment to serve the ever-widening hereditary cancer community is how FORCE has made itself such a powerful… well, force… in the hereditary cancer community. “We have to stop making it such a burden on people to be able to take care of themselves and their families,” says Hobbs. “Our main goal is to make sure no one has to face heredity cancer alone,” adds Cohen.

To learn more about FORCE or to join their volunteer program, visit FacingOurRisk.org

Cancer Wellness

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The Aunt Sister Project founding Board of Directors (from L to R): Denise Standard, Rachel Howard, Ashley Lentz, Dianna Van Voorhis and Carri Farrand-Clemens.

Meaningful Movement with Aunt Sister

Maintaining good physical fitness can lead to more positive outcomes for people with cancer, but the dearth of resources can be a significant roadblock for some — the Aunt Sister Project is looking to change that. Whether you’re new to fitness or a seasoned athlete, this nonprofit provides free or low-cost exercise classes, for all fitness levels, for cancer thrivers and survivors everywhere.

t’s well documented that regular exercise can help reduce the risk of cancer, but people going through or recently finished with cancer treatment can also greatly benefit from regular physical activity. About a decade ago, Macmillan Cancer Support, a leading British cancer charity, published the Move More report, which was a review of more than 60 studies of cancer and exercise. One of the biggest takeaways from the report is that approximately 150 minutes of exercise each week could lower a breast cancer patient’s risk of death or recurrence by as much as 40 percent.

The problem, however, is that cancer care teams don’t typically provide resources or guidance about the benefits of exercise post-treatment, even today. In fact, Macmillan polled more than 400 doctors and nurses and found that the majority had limited knowledge about how exercise 36

Cancer Wellness

and physical activity can both prevent cancer recurrence and help manage the long-term physical effects of cancer.

But for cancer survivors, regular exercise can be so much more than a way to help maintain a healthy body. In a group setting, exercise classes can be community-building, acting as a support group for those who have finished cancer treatment and may suddenly feel lost without the daily rigmarole of doctor’s visits, managing treatment symptoms, updating friends and family and everything else that goes along with active treatment.

“Everything goes from 100 miles an hour to ‘What’s next?’” says Ashley Lentz, founder of the 501c3 nonprofit the Aunt Sister Project. “And we really want to be the what’s next.” The Aunt Sister Project provides free or low-cost exercise programs and classes to cancer warriors, thrivers and survivors. Lentz wants the Aunt Sister

Photo by Martin Howard

I

BY CATHERINE EVES

Project to be the “what’s next” as a way to promote whole This is one of the reasons Lentz has made a career out of body wellness following cancer treatment. “Medical prohelping cancer survivors remain active. She was also inspired fessionals say you should work out and get physical activby how this group seemed to be more dedicated than any she ity, but they don’t necessarily give a direct referral to a had worked with before. “I really fell in love with working program,” Lentz says. “I wish that more doctors would with this part of the population,” Lentz says. “They worked actually prescribe it [as] part of the care continuum.” harder; they showed up every single time. […] Seeing how This lack of knowledge and resources is something quickly and drastically they can make changes mentally and that Lentz directly addresses with the Aunt Sister Project. physically [was] like nothing I’d ever seen before.”

Each cancer journey is unique, and each survivor has Lentz hasn’t had cancer herself, but, like most Americans, different strengths and weaknesses regarding physical she has been affected by cancer. In 2012, when Lentz was first health. Lentz is a certified “cancer exercise specialist,” taking steps to become certified in this specialty, her aunt, meaning she’s trained on how to create exercise programs Sister Helene Lentz, was diagnosed with ovarian cancer. Four that accommodate the unique needs of this population. To months later, she was gone. “We lost her very quickly,” Lentz receive this certification, according to Lentz, trainers take says. “A week later I started working with [my first] group of courses that explain what can happen to a person mensurvivors.” It was purely coincidental that Lentz would lose tally and physically from diagnosis to the start of treatsomeone to cancer while becoming certified, but this experiment — which can include chemotherapy, radiation and ence is what would inspire her to create the Aunt Sister Project. surgery. “It takes you through that timeline and what the In Lentz’s words, her aunt was a “very charitable woman,” side effects of the different modes of treatment would be, founding multiple nonprofit organizations during the 50 years and then it helps you develop [proper] exercises,” she says. she was active in the church. “She’s the epitome of a human There’s a lot to unpack and explore through these trainitarian,” Lentz remembers, and that’s why the Aunt Sister ing courses, but that’s to Project exists, named in be expected. Cancer exerher honor. Lentz wants cise specialists know how to make post-cancer exerto adjust exercise classes cise options available to “It was a support group without “on the spot” to accommoeveryone — regardless of being a support group. [...] date any symptoms a client their location or financial might be experiencing situation. As of right now, There were relationships that that day. “Symptoms pop all classes are provided were built, lifelong friendships. […] up on a daily basis, and in a virtual format. “Even they’re not really predictwithout COVID, I know a Everybody had a different story, able,” Lentz says. The Aunt lot of people are hesitant Sister Project offers classes to go into a gym,” says but they all had that one thing in catered to a wide variety of Lentz, citing the potential common that really connected them.” abilities — from low impact for cancer treatment to to high intensity, there’s weaken immune systems. something for everyone.

She says that the Aunt While having an instructor who is understanding and Sister Project will always provide virtual classes, but hopes to accommodating of an incredibly wide range of symptoms add a brick-and-mortar location. “I’d love to have facilities just related to cancer and its treatment is both comforting and for people with a cancer diagnosis, so they know when they refreshing, this is not the only reason cancer survivors walk in the door, there are specialists there that will help them flock to her classes — Lentz emphasizes that classmates are the way they need to be helped,” Lentz says. quick to bond over their shared experience, broadening the Most of the Aunt Sister Project’s classes are just $5 each, scope of the fitness class into a support resource, as well. which covers the cost of the instructors, but Lentz recog This wasn’t something that Lentz expected, but it soon nizes this fee may be exclusionary to some. “We can provide became clear that her fitness classes were more than just scholarships, so that if cost is the issue, talk to me and we’ll that. Before founding and becoming an instructor for the give you a scholarship,” Lentz says. The Aunt Sister Project Aunt Sister Project, Lentz led classes for cancer survivors fundraises through donors and events hosted throughout at her local YMCA. After one of these first sessions, she the year to offer these scholarships. “Nobody gets turned noticed how quickly classmates bonded with each other. away regardless of ability to pay,” she says.

She picked up on this bond when teaching one of her

This January, the Aunt Sister Project is hosting free first classes with the Aunt Sister Project, as well. “It was classes all month long. “I think a lot of people are hesitant to a support group without being a support group,” she says. try virtual training because it’s the opposite of what you’ve ever “There were relationships that were built, lifelong friendthought exercise could be,” Lentz says. She compares virtual ships […] Everybody had a different story, but they all had classes with the in-person classes she used to teach, explainthat one thing in common that really connected them.” ing that the student experience is much the same. “Once we

This connection is something that helps Lentz’s get people into the program, I’ve seen that the relationships clients stay on track with their fitness goals, while provid[between students] are just as strong, the changes that I see ing a community to lean on during the good times and the mentally and physically are just as good. Once they’re in, bad. “It’s really heartwarming to see how supportive they [they’re] devoted and they work hard.” But, most importantly are for each other, [and how] they celebrate getting better of all, Lentz knows this to be true: “We have a good time.” and the progress they’re making,” Lentz says.

To learn more, visit AuntSister.org Cancer Wellness

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One in a

Actress Miranda McKeon uses her social media platform to encourage open and honest discussions about the mental and physical aspects of cancer, breaking stigmas about cancer and demystifying a diagnosis to her loyal followers, which number more than a million.

BY LINDA FORSTER

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Cancer Wellness

Photo provided by Miranda McKeon

Million

M

iranda McKeon was fixing her top at a party by pointing out “gratitude moments” by speaking up to when she felt a lump on her right breast. At only friends and family during moments that “felt really present, 19 years old, the “Anne with an E” actress’s grounded, happy or exciting,” she says. She notes it is a chance of being diagnosed with breast cancer simple way to pause and reflect while practicing presence. was one in a million, yet she knew something was wrong.

“Hence, #GratitudeMMoment was born,” she explains.

“I just immediately had a gut instinct and reported the lump The hashtag, which includes the double “M” taken from to my primary care doctor,” McKeon recalls. After an ultrasound, McKeon’s initials, was launched on social media earlier mammogram and biopsy, her test results came back positive for this year. McKeon uses this hashtag as a way to inspire her cancer, marking the beginning of an unconventional journey of followers to share their moments of “casual magic” — the hope, perseverance and unwavering gratitude. little wins and bright moments of everyday life. “I wanted McKeon is a lifelong storyteller; whether in her personal to share this joy with others and am so happy to see people journals or on screen, she says that stories help her shape and having #GratitudeMMoments of their own,” she says about express her identity. “It’s a primal trait that works magic — it’s the trend, which has quickly caught on amongst her fans. human connection that causes change,” she says. When she Even with gratitude as a steady pillar, grief and hardreceived her diagnosis, she says that writing felt as natural as ship are inevitable. It takes grace to honor not only the breathing, so she started a blog almost instinctually, paying good, but the dark and difficult and to give yourself permishomage to her diagnosis by calling it “One In a Million.” sion to feel the entire spectrum of being human. McKeon “During treatment, writing was an outlet for survival,” says she felt this way throughout her treatment, and that McKeon says. “I truly felt like I had no choice but to be her body and mind felt utterly incongruent. During these writing at the time.” Her blog evolved into a vessel for times, her family and friends helped her regain a sense exploring and processing uncharted emotional territory, of balance, becoming irreplaceable healing forces. “They from isolation to grief, stemming from her diagnosis. “It showed up with listening ears and ready hearts to share is a form for me to heal, explore, imagine, grieve and commy pain with me. It was the most incredible thing I’ve municate,” she says. “It’s a lifeline witnessed in life,” she says. for me when I feel isolated, even While she may not have had when I am surrounded by people.” the support of a group of people Garnering over a million folwho had felt and known what it was “[Writing] is a form for lowers on Instagram, McKeon like to go through cancer, she found me to heal, explore, knew making her journey public comfort in knowing that pain is both would result in an irreversible loss universal and natural. “We’re all imagine, grieve and of privacy. But she also knew she made up of the same stuff, and an communicate. [...] It’s a held the power to break stigmas understanding of this concept can surrounding breast cancer. bring us a lot closer and make us feel lifeline for me when I feel “Cancer is not something to be less alone in our struggles,” she says. ashamed of,” she says. “I’m glad

By her fifth round of cheisolated, even when I am we’re moving away from times motherapy, McKeon was forced surrounded by people.” where cancer was a taboo topic.” to re-evaluate her relationship

Spreading awareness and with her body. Despite the cold encouraging open and honest discapping trial she completed before cussions are essential in demystifying both the mental and each round of chemo, she watched as her hair fell out in physical effects of breast cancer and promoting early detecclumps and strands. “It has been really tough looking in the tion. On the video sharing app TikTok, McKeon has started a mirror at different points and not recognizing myself,” she series about “keeping it real,” focusing on topics she feels are says. McKeon believes hair can be a vital symbol of power, underrepresented in the media, especially for young adult beauty and identity, and alopecia may feel like an utter loss cancer warriors — from fertility to hair extensions and medof autonomy; it can feel like your own body betrays you. ically induced menopause. “I hope this series and my story

As her appearance changed, McKeon was comin general are spreading awareness to young women to start pelled to look inward. “Hair loss was pivotal in changing understanding and advocating for their bodies,” she says. the way I value certain qualities about myself,” she says.

Although McKeon reveals that it was, at times, painful “Everything superficial seems a lot less important now. I to be unapologetically candid in her battle with breast think that’s a common theme in my life right now — I cancer, she never regretted her decision to share her story don’t sweat the small stuff as much. I find I have a lot more publicly. “I want to live in harmony with everything hapinner peace when it comes to daily inconveniences. They pening in my life — the good, the bad and the ugly.” she says. just don’t bother me anymore.”

“It’s been unimaginably difficult, and of course, there are

Post-treatment, McKeon has relished the normalcy days where I wish I had kept it all to myself.” Nevertheless, of life while taking the time to heal both mentally and she acknowledges the role cancer has played in her growth physically. She has returned to the University of Southern with inspiring gratitude. “In the long run, it’s been one of California, where she is finishing a degree in communithe best things I could have done for my healing and intecations. McKeon is still avidly blogging, auditioning and gration of this experience into my larger life narrative.” writing. As for the future, she has several entrepreneur Gratitude is an undeniably powerful force. ial endeavors in the works, but most importantly: “[I’m] Understanding the profound impact it has on wellin a really, really good spot at the moment, and intensely being, McKeon began cultivating this practice in her life grateful,” she says. “The future is bright.”

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a new kind of “survivor” Ethan Zohn became a household name after winning season three of “Survivor,” one of America’s longest-running reality TV shows, but his million-dollar win pales in comparison to surviving cancer — not once, but twice.

BY CATHERINE EVES PHOTOGRAPHY BY RICARDO BEAS

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t was one of those perfect, early-fall days in New Zohn speaks fondly of his time on “Survivor,” despite York City, when the trees in Central Park have only criticism widely circulating about the notoriously extreme just started to relinquish their leaves, that Cancer conditions of the third season (contestants didn’t have Wellness met up with Ethan Zohn to take photos for access to clean water and they were constantly at risk of the issue 17 cover story. Zohn was totally at ease amongst being mauled by wildlife — season three was rife with the hubbub of his former hometown — this may come scenarios that were great for ratings, but horrific for the as a surprise, as he traded the chaos of city life for the contestants). But maybe that’s the result of a job well done. deep forest of New England about seven years ago. While Zohn won the game by developing loyal and trusting relathe desire to leave a cramped apartment in the city for a tionships with the other contestants; he calls it the “nicecozy cabin in the woods may be familiar to most of us in guy strategy.”

2023, Zohn’s decision to “do the off-the-grid thing” wasn’t “Survivor’s a game of relationships,” Zohn says. “It’s motivated by the general ennui of a post-pandemic world, how you can sell yourself and your ideas to other people but a fight for survival following cancer recurrence and that determines how far you’ll go in the game. I had every shattered mental health. But this change of scenery, along intention of being the evil-backstabbing-slimy pig to get with an exploration into alternative therapies and a focus ahead. However, when I got out there, they take away food, on philanthropy, is what most helped Zohn find peace they take away water, you’re tired, you’re hungry, your true post-cancer. colors come into focus.” Zohn was a loyal friend, which Zohn is best known for winning “Survivor: Africa,” meant the other competitors wanted to keep him around. the third season of one of the longest-running reality TV This is a great tactic for a game in which teammates vote shows in existence. However, his story of recovering from each other out of the game, but it doesn’t guarantee a win. aggressive Hodgkin’s lymphoma is just as remarkable and According to Zohn, this strategy has yet to be repeated inspiring as the one where successfully in the 40 or so he outlasts 15 strangers in seasons following “Survivor: the middle of the desert in Africa.” “I didn’t get one Kenya, with barely any water, vote against me, and no one “You never know what’s around food or shelter. “Survivor” [since has] been able to win came first, but cancer as the nice guy,” he says. the corner in ‘Survivor,’ just like changed everything.

A good heart and in cancer. [...] If you keep your “All of a sudden I had a kind soul will get you everychance to assess and reaswhere with other people, self alive long enough, somesess what I was doing in Zohn knew to be true. thing’s around the corner, like my life, who my friends are, Unfortunately, the same what my passions are,” Zohn cannot be said of cancer. new research, new drugs, new says. “[I] feel like if you’re not In 2009, after experiencing diagnosed, if you don’t go some itchy skin and disalternative therapies, […] just through a crisis like that, you covering a swollen lymph keep the momentum going as might not take the time to do node, Ethan was diagnosed that […] Then, if you survive, with a rare form of blood long as you can.” you actually get to do it.” cancer, called CD20-positive Zohn has been cancer-free Hodgkin’s lymphoma. “I was, for 10 years, but his haras you can imagine, comrowing journey continues to influence his life today. He’s pletely scared that I was going to die,” Zohn says. His only heavily involved in philanthropy, both within and beyond connection to cancer was through his father, who passed the cancer community, and has remained involved with the away of colon cancer when Zohn was 14 years old. “To me, HIV/AIDS organization he founded with his season-three cancer equaled death,” he says. “It was a really scary, conwinnings, Grassroots Soccer. He is also an outspoken advofusing situation for me. [I] was 35 years old; I was on top of cate for some of the alternative therapies and complementary the world [and] you just never think it could be you.” medicine that helped him through his two cancer diagnoses.

Treatment was aggressive. Initial rounds of chemoHe’s even got an app that addresses a gap he felt during treattherapy and radiation had little effect, so Zohn’s doctors ment: CancerBuddy connects cancer warriors to each other prescribed more intense treatment, including in-patient using geography and shared traits such as age, hobbies and ICE chemotherapy, followed by an autologous stem cell cancer type, among others. “Cancer is a team sport,” Zohn transplant — Zohn sums up his first stem cell transplant says. “You can’t do it yourself.” as “brutal,” but that’s an understatement. The transplant But let’s back up. In the early 2000s, when Zohn was required Zohn to be in a “hyper-sterile bubble,” because in his mid-20s, life felt sort of flat. His career playing prohis red and white blood cells would have to be obliterated fessional soccer had evolved into coaching, but it didn’t through chemotherapy before reintroducing healthy stem suit him. He attempted to go corporate and nail down a 9 cells that would, theoretically, rebuild his immune system. to 5, but he got laid off before his first day. “You’re never But with this potentially lifesaving treatment, came an unemployed, you’re always between life choices,” Zohn incredible amount of pain, social isolation and a body says with a laugh. Taking advantage of this in-between weakened beyond recognition. time, he decided to send in a video for a chance to compete About a year after his transplant, Zohn was “back in on “Survivor: Africa.” The rest is reality-TV history. working order.” He was happy and healthy once again.

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He ran the New York City Marathon. He even competed on another reality competition show — the 19th season of “The Amazing Race.” But less than two years after his transplant, Zohn’s cancer came back.

“Getting the news the cancer returned was deflating,” Zohn says. “It was exponentially more difficult than the first time around, because [now] I’m running out of options.” Zohn’s support system was noticeably smaller, but his fears had only grown. He’d already explored some of the most intense treatment options for his particular type of lymphoma; he’d already fought for his life. His depression and anxiety around a second diagnosis left him feeling totally isolated.

Looking back on his cancer recurrence a decade later, Zohn draws parallels between his experiences with cancer and “Survivor” — “You never know what’s around the corner in ‘Survivor,’ just like in cancer,” he says. “If you keep yourself alive long enough, something’s around the corner, like new research, new drugs, new alternative therapies […] just keep the momentum going as long as you can. I know it’s so cliché, but don’t give up, because you never know.”

The second time exploring treatment options, Zohn was fortunate to be a candidate for a clinical trial testing a brand-new targeted therapy called Adcetris. And it worked. As this new drug targeted cancer cells instead of indiscriminately destroying all cells, Zohn managed chemotherapy symptoms much better the second time around.

“I felt good, I looked good, I wasn’t losing my hair, I could sleep, I didn’t have nausea; I actually ran the New York City marathon again while undergoing chemotherapy,” he says. He would need a second stem cell transplant, but his brother Lee was an almost perfect match. “The only problem is I’m no longer my mom’s favorite son,” Zohn jokes.

And after a long recovery, Zohn was once again declared cancer-free.

“This is where the real challenges began for me,” he says. A familiar feeling came back to him — the feeling of listlessness during his 20s that led him to try out for “Survivor.” “You have your whole life to live in front of you, and there’s no roadmap on how to do that,” Zohn says. The lack of resources available for young adult cancer survivors, in particular, was noticeable, and Zohn felt powerless to stymie the overwhelming feelings of fear and anxiety. “I got to a point where I wasn’t living a life I was proud of, and I was plagued with these, what I call ‘What if?’ scenarios: What if I die? What if the chemo didn’t work? [I was] just on this hamster wheel of destructive decisions and thoughts.”

But then — relief. “That’s when cannabis came into my life,” Zohn says. He knew something needed to change, because his fears were keeping him from living, and the pills prescribed to address this weren’t working. He gravitated toward a “plant-based wellness regime,” and started to explore alternative therapies away from prescription medicine. He practiced yoga, meditation and visualization, started exercising, went to therapy, changed his diet and started taking CBD and THC. “Those types of things, I felt, helped me so much, because it made me feel like I was taking control back over my illness,” Zohn says. “[It] made me feel better about myself and more confident that I wasn’t destroying myself.”

Zohn takes CBD daily, like a multivitamin, and THC more sparingly. He says once he started taking cannabis, he felt like he could breathe again. “I could push the [dark] thoughts aside and focus on things that really mattered,” he says. Today, Zohn advocates for cannabis use during treatment and post-cancer. He says that when he was first diagnosed in 2009, there wasn’t one trained oncologist or nurse at the hospital who could educate him on cannabis and cancer. This translates into a lack of access, even today, for many cancer thrivers and survivors, despite the many reported benefits for this population. “Here I was in a mask, bald from chemo, gloves, with a cane, hitting the streets of New York City talking to a drug dealer,” Zohn remembers.

But due to advocacy efforts of people like Zohn, marijuana laws have relaxed in many areas of the country, which is widening access to regulated, clean and safe cannabis.

Zohn maintains two partnerships with cannabis companies. He’s the Chief Purpose Officer of MONTKUSH, a CBD-focused farm and dispensary in Vermont, and a brand ambassador for Momenta, the in-house brand for the CBD and THC dispensary Trulieve. In April 2022, Zohn partnered with Momenta for the Boston Marathon to celebrate 10 years in remission from cancer. This was a huge moment for Zohn, as he was following in his father’s footsteps by running the same marathon his father had run years before. Zohn also partnered with AKTIV Against Cancer, an organization working to ensure physical activity becomes an integral part of cancer treatment.

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It makes sense that physical fitness would come easily to someone made famous by surviving in some of the world’s harshest conditions. Even so, it may be hard to reconcile the person who won “Survivor” with the one Zohn describes during active treatment. This was especially hard for Zohn, as it all happened while he was very much in the public eye, just a few years after his big win.

“The media had built me up to be this person of strength, this role model,” Zohn remembers. “Then I got diagnosed with cancer, and I’m a shell of what I once was.” Zohn is quick to downplay his celebrity status, but fresh off the physically intense “Survivor,” one can only imagine how difficult it must have been to transition from being a beacon of health to someone who is very ill, with public interest only increasing as your health decreases.

“I won a reality-TV show in front of 27 million people on national TV, yet when I get diagnosed with cancer and may die, that’s when people started to take notice of me and my story,” Zohn says.

Despite how he may have felt about the matter, Zohn decided to make his battle public, openly speaking about his cancer journey and keeping his personal motto always at the back of mind: Never let a crisis go to waste.

But before taking charge of his cancer narrative, Zohn felt pulled in two different directions — almost like he was leading two different lives — and it was negatively affecting his mental health. “The dichotomy between what was really happening and what people thought was happening was very destructive in my life,” Zohn says. Publicly, Zohn was incredibly positive, but behind closed doors, he was sick, depressed and unable to leave the house for days at a time.

“I wanted to lead the narrative, and [focus] on if I could take this horrible nightmare that I’m going through and use that to help other people, then [that] is an opportunity to do really important things,” Zohn says. “Playing some role in helping other people get diagnosed earlier or helping them manage their cancer care made it worthwhile to share my story.” And the feedback was overwhelmingly positive.

“The second I started to share what it was really like to go through cancer, what I was really struggling with, from everything from fertility to girlfriend issues to mental health issues, that’s when [I] really felt like I could make an impact in this space and use my story to help others,” Zohn says.

This echoes what Cancer Wellness hears a lot from readers. Stories from other survivors sharing harsh truths about cancer — the stress, the malaise, the confusion, the need to put on a happy face for others — can help people manage their own journeys. It’s a reminder that you are not alone; there are others going through what you are going through. And these benefits can be felt on both sides: “There is research that shows that focusing on the plight of another human being helps you heal, so that was part of it as well, selfishly speaking, but being able to help others […] that was a part of my survival strategy,” Zohn says.

This mentality hearkens back to Zohn’s belief that cancer is a “team sport,” affecting not just the person diagnosed, but everyone else in their orbit. It is almost too easy to compare a game show like “Survivor” with the cancer experience, and Zohn is quick to agree: “[In “Survivor”], you want to be the last person standing, but you can’t [win] the game unless other people help you get there,” Zohn 44

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says. Unsurprisingly, he says he often gets asked the question: Which is harder — cancer or survivor? “Cancer is more difficult,” Zohn says. “Because you’re not playing for a million bucks, you’re playing for your life.”

Zohn’s cancer diagnoses occurred after his season three win (you could consider them the meat in his “Survivor” sandwich) but in 2019, he decided to go for it again. “Survivor: Winners at War” featured Zohn and a cast of other past winners, celebrating the show’s 20th anniversary. This time, Zohn was better prepared for the challenge. Having already competed, he was familiar with the ways “Survivor” would tax his body and mind — something that was useful when navigating cancer treatment. “I pushed my body to the absolute limit, and then I had to push it more to be able to win this show,” Zohn says.

“When I was diagnosed with cancer, it gave me a little bit of confidence on how strong the human body is.”

What Zohn wasn’t prepared for, however, was how he would feel mentally. “Playing the game [again] thrust me back to a time that I wasn’t really prepared for, because I was weak, I was tired, I was hungry but not hungry, I missed my family, my friends,” Zohn says. “The last time I looked that way, the last time I felt that way, the last time I was having all these experiences was when I was sick.”

But this time, Zohn was able to manage the mental strain through the tools he picked up to help him twice through cancer — he meditated and practiced chanting and visualization. “[They helped] get me out of my own head and back into the present,” Zohn says. Ultimately, Zohn had to put his health first — “I’m freezing, I’m not eating, I’m full of anxiety. [I’m thinking], the cancer’s going to start growing again,” he says — so he left after episode three.

“I’ve always kind of lived in extremes, [but] that didn’t lend well to my survivorship,” Zohn says, noting that finding balance is a big part of him living a good life today.

And how many of us are able to share that confidence?

Knowing when you can push the body, knowing what it’s capable of, and knowing when to take a step back, deciding something isn’t worth it. During a cancer fight, there are so many unknowns; so many difficult decisions to make with no positive outcomes guaranteed.

“I’m not going to say it’s a gift; it’s not,” Zohn says about his diagnosis. “It’s not even close to a gift, but it gives you the opportunity to assess your life.” For Zohn, this means focusing on philanthropy work, something he was engaged with even before his diagnosis. “There are complete strangers out there, running marathons, riding bikes, kicking a soccer ball to raise money that funded [a] drug that saved my life, and to me that’s inspiring,” Zohn says. “So now when I go out to fundraise for all these [organizations], I feel like I [can] really drive home the message that will get people to emotionally attach. […] Whether it was a blessing to have that experience or a nightmare, I don’t know, but it helped me do what I love doing better.”

For more on Ethan and his partnerships, visit them on Instagram: @EthanZohn @GrassrootSoccer @MyMomenta @CancerBuddyApp

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(Re) Building the Body

BY CATHERINE EVES

Erica Langley’s breast cancer diagnosis came just weeks before her first bodybuilding competition.

With no family history of cancer and a sparkling record of clean living, she was blindsided by her diagnosis. But she would soon find her physical and mental strength — honed during rigorous training — would be an asset during treatment and help her come back stronger than ever.

“P

eople are telling me, my case is treatable, I’ll be fine,” begins Erica Langley, “but what if I’m not?” After months of grueling training schedules and strict dieting in preparation for her first bodybuilding competition, Langley was diagnosed with breast cancer at just 38 years old. In five weeks, she was supposed to take the stage for the first time, but her plans were derailed to make room for a rigid treatment schedule.

Langley was afraid because she had seen firsthand what cancer can do to a body: When Langley was 25, her grandmother passed away from stomach cancer. “I was praying all the time. I knew God was going to heal my grandmother, she was going to be fine,” she remembers. “I was in denial until the day I found she had passed.” More than a decade later, her grandmother’s passing was top of mind after receiving her own cancer diagnosis. “I was terrified,” she says.

Today, Langley is cancer-free and back at the gym, training for an upcoming competition in which she’ll attempt to earn her Pro Card. But her journey was far from easy. “When I was first diagnosed, I couldn’t understand why I was going through this,” Langley says. “By all accounts I was living a healthy lifestyle. […] I was taking care of my body; I had a healthy diet.”

After her diagnosis in 2018, Langley stopped going to the gym. After the initial shock of her diagnosis wore off, she found it hard to accommodate work, visits from family, chemotherapy sessions and working out. “Before I knew it, I had gotten into the habit of not going,” she says.

But it was Langley’s long history of staying in shape, cultivated from an early age, that helped her thrive through cancer treatment. Before her diagnosis, and even before her bodybuilding training, she lived an active lifestyle. But she was lean, primarily due to a focus on cardio at the gym. An acquaintance pointed out that she had very little muscle tone, and she let this be her fire to switch things up in the gym and start strength training with weights. “Within 90 days, I was totally ripped,” Langley says. She realized she had a natural affinity for gaining muscle and strength, but she had reached a plateau, and couldn’t progress by herself. “That’s what put me on the path to preparing for my first bodybuilding competition,” she says.

Despite an abrupt end to her training, Langley was in the best shape of her life at the time she was diagnosed.

This would become all too important when she started receiving chemotherapy treatments.

“My doctors would all tell me that because I was in such good physical health that [would] be beneficial to me,” she says. She experienced many of the typically debilitating symptoms of chemotherapy, though less severely than if she wasn’t in such good shape. Langley and her friends even used to joke that her chemotherapy days were her “spa days,” because she was able to take the day off work and would often nap during sessions.

After treatment was over and she had recovered from double mastectomy surgery, she was 50 pounds heavier, and she didn’t recognize herself. “Right before chemo, I was in the best shape of my life,” Langley says. “[I] wasn’t sure if I was going to be able to get back to that state.” At least, she thought, not without help.

So she started training with Daniel “Bolo” Young at Chi-Town Fitness near her home in the Chicago suburbs. She tasked herself to accomplish a formidable goal — to be competition ready within six months. She asked Young if he thought she could do it. “I said, ‘Why wouldn’t I think you can do it?’” Young says. “You just battled cancer.

What is it that you can’t do?”

She worked closely with Young to create a program that would accommodate her goals as well as her unique experience with cancer. Langley is a “natural” athlete, meaning she doesn’t take steroids or performance-enhancing drugs.

Many natural athletes rely on the muscle-building qualities of certain supplements, but Langley found that most supplements would negatively interfere with medicines she was taking for her cancer. “[We] wanted to make sure it didn’t interfere with my medication, or it wasn’t promoting the growth of cancer cells,” Langley says.

But Young was ready. “I knew it would be a challenge, [but] I was really excited,” Young remembers. “Knowing that she just told me her story of what she went through with chemo, I was all for [it].” Young started with a physical

assessment to gauge Langley’s post-cancer strength, then got stuck into research about what supplements he could safely incorporate into her training plan. Young is also a certified nutritionist, and he created a meal plan that also reflected Langley’s unique needs.

“By being such a unique situation, working with Erica actually pushed me to be a better coach,” Young says. He learned that, post-cancer, strength and energy levels can change from day to day, and it’s not always a physical issue, but “it’s the mental hurdle that people have to get over” to perform their best and come back to the gym, day after day.

Because it wasn’t just about getting her body ready for competition — Langley would have to get her mind ready, too. Through her faith and tireless support from her fiancé, she was able to manage the emotional side of her diagnosis, without which she wouldn’t have been able to find the mental stamina required to train for — and win — her first competition. “I tried to tell myself, you can’t be fearful and trust in God at the same time,” she says.

In that first competition in May 2021, Langley placed first in one category and medaled in others, competing against women who did take performance-enhancing drugs, but hadn’t just been through cancer treatment.

Standing on that stage was a defining moment in Langley’s life.

“I’ve shown that I can stand next to somebody [who] is on steroids and look just as muscular and developed as they do,” she says. “I’ve done something that I know not everybody can do.”

But the pleasure of surpassing goals isn’t the only positive to come from Langley’s cancer journey. Before her diagnosis, Langley felt a little lost.

During commutes to work, she would listen to Steve Harvey’s radio show every morning, which often discussed finding your purpose in life. “I would get a little depressed, because at that point in my life, I didn’t know what my purpose was,” Langley says. “I’m here, but what am I supposed to do?”

After making it through cancer treatment and finding success in her first competition, the media began to reach out to Langley to share her story. “It started reaching more and more people, and they would tell me how my story had encouraged them,” she says. “It hit me […] Maybe I went through everything [to] tell my story to help somebody else, [because] I’m not the first to go through this, and I won’t be the last.”

It also helped Langley evaluate where her passions lie.

“Going through my ordeal with the cancer and continuing to maintain my health and a specific body image [has] prompted me to want to help others,” she says. She aspires to become a personal trainer and a certified nutritionist helping people like herself — those who want to regain their strength and a positive body image post-cancer. “I want to continue to be a voice or an advocate for them, and say, ‘Yes, you can. I’ll show you how.’”

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Cannabis Comeback?

More athletes have been turning to cannabis to support their recovery efforts post-game or post-workout, but what purpose do CBD and THC serve in a sports and exercise setting?

BY FRANCESCA HALIKIAS

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Photo provided by MacKenzie McClain Hill

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he popularity of cannabis (or marijuana) has increased significantly since becoming legalized for recreational and/or medical use in certain states, including California, Colorado and Illinois.

This powerful plant has been enjoyed recreationally for years, but it has also been used to ease symptoms of depression and anxiety while reducing nausea and physical pain, among other uses. Recently, even athletes — usually touted for being in exemplary physical health — have been turning to cannabis for a surprising reason: to aid in physical recovery.

After a tough workout or game, athletes are known to recover by taking ice baths or getting massages, but there has been a recent rise in the use of cannabis to receive similar physical and mental relief. In fact, in 2019 it was reported that cannabinoids were considered the second most commonly used substance among contact-sports athletes, replacing nicotine, according to the National Library of Medicine (NLM).

Marijuana consists of both CBD and THC. THC typically has a mind-altering effect — what is known as a “high.” CBD, which does not impair bodily functions and does not cause a high, is more commonly used in the worlds of sports, mental health and pain relief. Because CBD is also not addictive, the World Anti-Doping Agency (WADA) removed CBD from its prohibited list in 2018, meaning that athletes are allowed to use CBD, in or out of competition. However, the U.S. Anti-Doping Agency notes that “because it’s nearly impossible to extract only CBD from the cannabis plant, athletes should assume that CBD products are probably mixtures of CBD and other prohibited cannabinoids” and they should be cautious if using the substance while subject to anti-doping rules. THC remains on WADA’s prohibited list.

CBD can be applied topically or consumed through smoke inhalation or edible consumption.

According to Forbes Health, “CBD interacts with neuroreceptors in your endocannabinoid system, which sends signals between your cells to help regulate your movement, mood, homeostasis and immune system.”

CBD edibles are becoming more popular as a way to help with ailments such as sleep deprivation and anxiety, and CBD oils and tinctures have found their way into sports as an alternative to prescription medicine. Athletes who want mental and physical relief after subjecting their bodies to grueling exercises and competitions, without a mind-altering effect, turn to CBD for this relief.

MacKenzie McClain Hill, founder of a CBDpowered beauty and wellness brand called LumiBloom, has been a competitive elite athlete for most of her life.

“I first got into CBD [when I was] looking for natural solutions [for] inflammation and pain. It allowed me not to rely on Ibuprofen or Advil, which I was popping twice a day to try to deal with pain,” she says. Hill was on the track team while she attended the University of California in Los Angeles and continued to train and compete around the world after graduating. LumiBloom’s products include CBD tinctures, teas, vitamins and spa products, like bath bombs and body oils.

At the peak of her athletic career, a typical day for Hill started on the track for three hours, followed by two hours in the weight room. She then would have active recovery ranging from Pilates or physical therapy to massage therapy or chiropractic care.

“With CBD, after workouts I just felt more recovered, more relaxed and ready to perform,” Hill explains. She decided to create a CBD sports line for LumiBloom, so that athletes — or anyone who enjoys working out — could find relief for muscles and joints.

The line includes a CBD pain-relieving spray, CBD recovery bath salts, a CBD muscle relief stick and a CBD muscle soothe stick.

“Whatever the sport, whether you go hardcore in the gym, are a weekend warrior or just trying to stay active, CBD products can support your workout,” Hill says. She particularly credits LumiBloom’s soothe stick — made with MCT oil, menthol, camphor, peppermint and, of course, CBD — in helping mitigate her post-workout soreness.

CBD has also been attributed to alleviating mental stress. As stated by the American College of Sports Medicine in data from 2021, “Professional and elite athletes also face mental health challenges, and data indicate[s] that approximately 35 percent of elite athletes suffer from disordered eating, burnout, depression and/ or anxiety. Limited privacy, inadequate recovery time and limited control or independence may also add to the stress of a professional or elite athlete.” While CBD

should not be a substitute for consulting a doctor about symptoms such as mental health or physical pain, it can provide athletes with another option rather than conventional medicine when it comes to mental well-being.

“CBD is not addictive, and it is a natural product that can be used topically or orally without negative side effects associated with conventional remedies,” Hill adds. For athletes who have allergies to medications or can’t tolerate side effects that come from certain medications, CBD can act as a more natural replacement.

While CBD’s use among athletes is on the rise, its physiological, physical and cognitive effects are still not fully understood. According to the NLM, there is evidence that supports the potential use of CBD to improve the efficiency of recovery processes and sport-related fatigue, but not enough studies have been conducted to give proper recommendations for dosage and frequency of consumption. Though CBD appears to have some properties that may boost exercise recovery, more research must be done to find out why.

In terms of CBD’s counterpart, THC, the top reasons athletes use marijuana is to help them recover from tough workouts, reduce pain, improve sleep and alleviate anxiety, according to the New York Times (NYT) in a 2021 article. THC, however, especially when inhaled and smoked, can damage lungs, potentially leading to chronic bronchitis, according to the American Lung Association. Smoking can also cause an immune-compromised person to be more susceptible to lung infections.

However, according to the NYT article, a survey demonstrated that out of 600 cannabis users, 70 percent said that marijuana increased their enjoyment of exercise, and 80 percent of users said that it helped them recover better from exercise. The marijuana use ranged from smoking to edibles to vaping.

For cancer warriors and the multitude of side effects that come from chemotherapy and radiation, CBD can help with nausea, vomiting, depression and anxiety.

Because of the health risks associated with smoking and vaping, edibles may be a safer option for those wanting to try cannabis, but a doctor’s consult is the best way to determine what works best for each individual.

As a greater number of athletes use cannabis for athletic recovery, it may soon become normalized in society as another part of an athlete’s recovery routine.

“Currently, we are working on a post-workout [CBD] tincture you would take for overall recovery, so your body isn’t as sore the next day,” says Hill. “Some people like topical options to treat a specific area, while oral options help internally.” Whatever athletes choose, the cannabis industry will only continue to grow. As for Hill, she hopes “to get LumiBloom into the hands of as many people as possible to support them living their best, most authentic lives from the inside out.”

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Cancer Rights: Navigating Employment, Insurance, & Finances A Practical Guide to Cancer Rights for Caregivers A Practical Guide to Cancer Rights for Young Adults A Practical Guide to Cancer Rights for Seniors

TriageCancer.org/CancerRightsGuides Download in English or Spanish

An Artificial Intelligence Assembly The advancement of artificial intelligence in hospitals and other care settings has allowed for growth and improvement in both the diagnosis and treatment of cancer. Here are some of the cutting-edge technologies that we think you should know about.

BY FRANCESCA HALIKIAS

A

rtificial intelligence (AI) has integrated itself into many aspects of everyday life — from cybersecurity; to online shopping chatbots; to maps and navigation; to Siri, the iPhone’s tiny personal assistant that lives in your pocket. AI uses data to make decisions or predictions, and this concept is gaining popularity in cancer care, as oncologists and researchers explore the many ways AI can help diagnose and treat cancer.

According to the National Cancer Institute (NCI), AI has been on the rise in assisting doctors with cancer imaging, answering questions like: Is it cancer or a harmless lump? If it is cancer, how fast is it growing? How far has it spread? Is it growing back after treatment? The NCI also notes that AI can help “improve the speed, accuracy and reliability with which doctors answer those questions.”

With that, cW has rounded up some new and innovative AI technologies that are providing hope for patients, doctors and hospitals everywhere.

AVENDA HEALTH, IQUEST AND FOCALPOINT

Brittany Berry-Pusey, PhD, cofounder and chief operating officer of Avenda Health, started the health tech company to transform the standard of care for prostate cancer treatment by using AI. According to the American Cancer Society, about one in eight men will be diagnosed with prostate cancer during his lifetime. “Our mission is to personalize prostate cancer treatments to provide improved quality of life and longevity,” Berry-Pusey says.

Avenda Health developed iQuest, an AI-based software designed to help identify where the cancer is in an

individual’s prostate by using a patient’s clinical data to map the extent of the disease and simulate treatment options. “There hasn’t been much advancement in this space, because it is a challenging disease to identify with imaging alone,” explains Berry-Pusey. “iQuest gives providers a much clearer view of where the cancer is.”

Along with iQuest, Avenda Health also developed FocalPoint, which is a laser-based ablation system that is powered by iQuest.

“With the knowledge from iQuest on where the cancer is, we can use FocalPoint to fully ablate the localized tumor in an officebased setting with just local anesthesia,” says Berry-Pusey.

Essentially, iQuest combines patient-specific data and determines the probability of the cancer in patients. It then visualizes the location and extent of prostate cancer to aid patients and their doctors in making well-informed decisions about next steps. Then, FocalPoint delivers targeted focal ablation treatment to the affected area, which minimizes the impact to healthy tissue while also preserving the quality of life. Because this treatment option is less invasive than surgery — requiring only a laser needle and thermal optical sensor — patients experience minimal to no downtime.

“The traditional approach to prostate cancer treatment leads to urinary and sexual dysfunction in more than half of patients,” Berry-Pusey says. “This is because prostate cancer is typically treated as a whole-gland disease, removing or radiating the entire prostate and damaging critical structures, even though the tumor is usually quite localized.”

With AI, Avenda Health is able to provide more personalized care while preserving the patient’s quality of life.

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In August 2022, Avenda Health announced it received an investigational device exemption (IDE) from the FDA for its ablation system, FocalPoint. This will allow for Avenda Health to combine the two technologies in a randomized controlled trial. “We will begin recruiting patients for a large clinical study that will show FocalPoint powered by iQuest is a superior form of treatment for localized prostate cancer compared to the standard of care,” says Berry-Pusey.

Preston Sprenkle, MD, associate professor of urology at Yale University and director of Yale New Haven Hospital’s prostate cancer focal ablation program, believes this new software has the potential to dramatically change prostate cancer care.

“Currently, most men have whole prostate treatment because we are unable to reliably predict the extent of prostate cancer within the prostate,” says Sprenkle. Sprenkle notes that MRI-guided biopsies of the prostate have improved the ability to treat prostate cancer, but without the help of AI, physicians are still only estimating where the cancer is located.

“The iQuest software is the most accurate way I have seen to visualize where cancer is in the prostate and the extent of this disease. [U]sing this technology, we can design our treatment zones with more confidence and precision, likely resulting in preservation of a greater number of important structures,” Sprenkle says.

Berry-Pusey believes that Avenda Health’s AI platforms represent a major shift for prostate cancer care.

“Our AI algorithms will help physicians be the best they can be,” she says. “With AI, we finally have a path forward where patients will no longer have to sacrifice quality of life for length of life,” she says.

“With AI, we finally have a path forward where patients will no longer have to sacrifice quality of life for length of life.”

AZRA AI

Azra AI is an algorithm that analyzes, identifies and classifies oncology patients by cancer type in real time.

This technology helps medical teams identify suspicious findings in patients that could lead to an earlier diagnosis and, in turn, allows for earlier interventions that increase the probability of a patient’s cancer entering remission.

“Prior to using [Azra AI], we did not have the technology that assisted nurse navigators in cancer treatment, and our team relied on reviewing schedules and waiting on direct referrals to help diagnose patients,” says Kristina Rua, an oncology-certified nurse and former director of oncology navigation services in the East Florida division of HCA Healthcare. “There were many challenges because of this, including the [number] of patients that were missed and unable to be tracked, as well as the amount of time it took to treat patients and help them through the care continuum.”

Rua explains how Azra AI assisted her team with many facets of the patient-care system, including the ability to create a benchmark of how many patients were being diagnosed, where they were being diagnosed and who was coming through their system. As an oncology nurse and navigator, Rua says it’s her job to ensure patients are accessing care in a 54

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timely manner. The AI has let Rua and her team treat patients faster, without having to wait on referrals, and has given her quick access to the specific diagnoses of each person.

Azra AI also helped advance breast cancer detection and diagnosis, where sometimes biopsies are ordered by an OB-GYN or primary care physician instead of a breast surgeon.

“Without [AI], patient care can be delayed due to the infrastructure of care, such as scheduling conflicts and the number of experts that are notified first,” says Rua. “Within hours of testing and using the AI technology, a breast cancer navigator can identify a positive diagnosis and notify all parties so that care is not delayed and is taken care of sooner rather than later.”

While Rua acknowledges that using AI to help with cancer detection and prevention is nothing new, there is still much room for growth on how it can be used in other areas.“With the amount of growth in AI and cancer, we’ll start to see it be used in precision medicine in the future,” Rua says.

FUJITSU RESEARCH KNOWLEDGE DATABASE

Cancer genome therapy is another area that has been improving outcomes in cancer care, representing a new wave of treatment options for cancer warriors, such as immunotherapy, oncolytic therapy and gene transfer. As noted by the National Library of Medicine, the field of cancer gene therapy is rapidly maturing and will no doubt be a permanent part of cancer therapeutics.

In terms of AI, Fujitsu Laboratories is collaborating with the Institute of Medical Science at the University of Tokyo (IMSUT) to create a knowledge database using AI-powered language processing technology. Oftentimes, doctors will predict the physical makeup, disease stage, drug response and side effects of cancer treatment, but it takes them a considerable amount of time to analyze medical research papers.

Fujitsu and IMSUT’s knowledge database, filled with over 800,000 medical papers, cuts that time in half so doctors are able to treat patients faster and more effectively.

Fujitsu is also partnering with Aichi Cancer Center to explore how AI can make it faster to analyze cancer gene panel testing results, as well as analyze the connections between genetic mutations of cancer patients and diseases.

“In recent years, it has become possible to obtain large amounts of genomic information from patients, but only a small fraction of this information can be used for treatment,” says Dr. Masaru Fuji, a project manager for Fujitsu. “This makes research into the use of unknown genomic information in medicine an important priority for researchers.”

This is why Fujitsu wants to utilize AI to help scientists and physicians access medical information from one big database. “Since AI can [also] predict relevant information for unknown genomic information that is not directly described in the training data, it is expected that physicians may be able to consider treatment policies for patients for whom it has not been possible to predict treatment methods in the past,” Fuji explains.

Genome therapy is still a relatively new form of treatment, and Fuji predicts that once the number of genomic medicine use cases and resulting data increases, healthcare professionals will be able to spend less time finding relevant medical information and files, and will then be able to help more patients, more quickly.

“This ability to process large volumes of data coupled with explainable AI that outlines the reasons behind the

treatment decisions sets Fujitsu’s approach apart from others in the industry,” Fuji says. “[We] offer a possible solution to the so-called ‘black box phenomenon’ in AI and machine learning applications.” Most technology systems don’t allow you to see the processes, or inner workings, of their software. They only allow you to see the input and the output. Fujitsu wants to change this by revealing the why and how of the AI, so that it can be adopted to support healthcare professionals all over the world.

VARIAN ETHOS THERAPY SYSTEM

Karmanos Cancer Center in Detroit has a new AI system called the Varian Ethos Therapy System, which aims to increase the capability, flexibility and efficiency of radiation therapy, delivering treatments in a 15- to 30-minute patient timeslot.

“Historically, standard radiation treatments follow a rigid plan that is set in place at the beginning of treatment,” explains Dr. Adrian Nalichowski, PhD, DABR, lead medical physicist at Karmanos. “While we can account for changes in the location of the anatomy throughout the course of treatment, standard treatments do not allow us to account for changes in the shape of the target tumor.” Adaptive therapy, used to increase the efficiency of radiation therapy, monitors physiological changes in patients’ anatomy as well as tumor response between treatments, and can adjust the original plan to better target the cancer throughout the course of treatment. This is due to using AI to help create an updated outline of the tumor and the surrounding healthy organs to recompute a new treatment plan, says Nalichowski. And this all happens in a matter of minutes.

With Ethos therapy, the patient is imaged before each treatment session. Algorithms use data from real patients and anatomical structures outlined by human anatomy experts, and Ethos therapy is able to create a new treatment plan that integrates the patient’s current anatomy.

After careful evaluation of this new treatment plan by physicians and doctors, the plan can then be used to treat the patient more accurately, as it accounts for changes in the normal tissue and target structures of the patient.

Nalichowski says that Ethos therapy is best suited for patients with cancers in the pelvic area and lower abdomen, including prostate cancer, colorectal cancer, cervical and uterine cancers, but he also notes it “can be utilized for a variety of other cancer types for which we may anticipate changes in the shape of the target between treatments or over the course of radiation therapy.”

Nalichowski says some patients may feel apprehensive about participating in a treatment that is headed by AI instead of humans. However, physicians are there every step of the way. “Because this technology is driven by artificial intelligence, it requires strict oversight by the radiation therapy team,” says Nalichowski. “Each treatment and its associated new plan is evaluated in real time by a radiation oncologist and medical physicist immediately before the treatment.” Nalichowski says the goal of Ethos therapy is to better target the tumor, reduce the dose of radiation to healthy tissue and potentially improve the overall outcome.

How is this technology creating a better future for cancer patients?

Among other benefits, the difference in time is a big factor, Nalichowski says, as Ethos therapy is able to create a personalized treatment plan tailored to the patient in a fraction of the time it would take a human. “[This] enhances our ability to deliver the most personalized and accurate treatment,” says Nalichowski.

THE BIGGER PICTURE

AI isn’t just creating better treatment experiences for today’s cancer patients, it is also shaping the future of cancer.

“AI in oncology is still in its infancy, both in medicine and cancer care, though it is rapidly developing,” says Michael Chung, MD, medical director of IT at The Oncology Institute (TOI).

TOI uses technology in almost every facet of patient care, from accessing electronic medical records and having virtual visits with patients, to prescribing medications online and viewing patient scans and body imaging.

Electronic medical records allow oncologists to quickly determine the appropriate treatments and treatment dosages and evaluate for potential medication interactions.

A cancer diagnosis often indicates there is a genetic mutation in the body, and Chung notes that through blood and tissue sampling, it is possible to discover if a patient has potentially actionable mutations, which are “genetic aberrations in a patient’s tumor that are targetable with an available anticancer treatment or are the targets of novel therapeutics in development,” according to the Hematology/Oncology Pharmacy Association.

“In the future, we may seamlessly use AI to guide all our clinical choices throughout the patient’s entire cancer journey.”

Essentially, AI greatly aids personalized medicine. “Many next-generation sequencing studies already utilize computer algorithms that suggest FDA-approved therapies based on mutation presence,” Chung says. “They can also estimate how a patient will respond to the treatments, or even go as far as to suggest enrollment in a nearby clinical trial.” Instead of treatments that are universally based, with variations depending on age, gender or type of cancer, AI has made it possible for a more individualized and genetics-focused treatment approach.

“As oncologists and clinicians, we often refer to expert consensus and evidence-based medicine to guide our treatment choices,” explains Chung. “In the future, we may seamlessly use AI to guide all our clinical choices throughout the patient’s entire cancer journey. This could very well lead to overall improved patient outcomes and patient satisfaction.”

However, while there seems to be much innovation at the forefront of AI, Chung points out some challenges that we still face when relying on computers and algorithms, rather than humans.

“Physicians still document a patient encounter based on a narrative note,” says Chung. He mentions that much of physicians’ documentation is qualitative rather than quantitative. “A good note will still contain all relevant information, but a narrative makes it difficult for AI learning algorithms to analyze, as algorithms would prefer analyzing numbers over descriptive words.”

Chung also understands the challenge of accepting technology in medicine. There will always be differing opinions on whether integrating AI will make things easier for both the doctor and the patient. As well, less human interaction in a care setting could negatively affect treatment experiences, as algorithms and data are not able to express empathy, which is crucial for some patients. It is a dilemma for many, but such is the nature of this rapidly growing field. “In the end, technology will always advance faster than humans can evolve,” Chung says. “We will just have to adapt.”

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Your Brain on Joy Neuroplasticity is a tool powered by the “plastic” nature of the brain, and can help cancer thrivers and survivors neutralize the feelings of depression and anxiety may accompany a diagnosis — no products, programs or prescriptions required.

BY LEA GUCCIONE

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magine if you could train your brain like a muscle. If, through repeated strength training, you could mitigate any fear when you hear words like “cancer” or “chemotherapy.” It might sound impossible, but this is just one use case for neuroplasticity — a wellness tool growing in popularity that involves training our brain to form new ways of thinking.

As we dive into a new year, we encounter well-intentioned reminders of mindfulness and positive thinking. But behind all of these tools, there is the brain itself; that magnificent, complex machine perched atop our spines that can do all of that, and then some. Years of research in neurology have uncovered the reality that our brains are capable of adapting to new information and action at a tremendous capacity. As we age, we can continue adapting and strengthening our brain even more, creating new pathways 56

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for thinking through the “plastic” nature of this organ. The word itself is a clue: “neuro,” refers to the neurons, or nerve cells, inside our brain, and “plasticity” refers to its malleability. So, what is this phenomenon and how can it be used?

“Neuroplasticity is creating new synapses in the brain or strengthening ones that can be weak,” says Professor Selena Bartlett. “A synapse is that minimal unit of neural networks in the brain that can be trained. So, neuroplasticity, meaning the brain can change with training and effort, starts with our own belief system first. What do we believe about ourselves and what do we want to create in our life?”

Bartlett is a neuroscientist and professor of neurology at Queensland University of Technology in Brisbane, Australia. Her work has brought this wellness tool to a wide audience within and outside the medical community. She first became interested in the idea of neuroplasticity more

than a decade ago, while running a lab at the University “The brain, over millions of years of evolution, has been of California, San Francisco (UCSF). “Up until that point, designed for social cognition. When you find your tribe, most of us had been teaching everyone that the brain that gives you the oxytocin and supporting hormones you couldn’t be changed after the age of 25,” she says. need to say, ‘I’m not alone, and there’s a lot of people in Bartlett has been studying the brain since 1989, but my situation.’” Finding your community allows our brain in the last two decades, major advancements in technolto chemically calm down, according to Bartlett. ogy, including functional MRIs and neuroimaging, led “That’s neuroplasticity at work. And joining a group of to a breakthrough. After years of research at UCSF, “it people you don’t know can be very anxiety-provoking, but once became clear that our brains can change across our lifesyou take the leap, you’re tapping into neuroplasticity,” she says. pan, no matter what the situation is,” she says.

“You’re learning a new language around survivorship.”

Most notably, Bartlett’s research shows the brain has A key tactic Bartlett also recommends is a morning the ability to help the body recover from traumatic illness, routine. When you wake up in the morning, what’s the both mentally and physically. Neurology has revealed that first thing you do? Anticipate your to-do list? Scroll our health isn’t just a game of genetic-roulette, but rather through social media? Google a symptom? a mindset and outcome we can continuously nurture.

“That’s our natural vice,” Bartlett says. “Instead of Dr. “To heal and to evolve are intimately linked,” says Google, look out the window, take a panoramic view and Rudolph Tanzi, PhD, in his book “Super Brain.” “Your think of three things you’re grateful for. From a neurobrain is remodeling itself right now.” Tanzi is a professcience perspective, that taps into the autonomic nervous sor of Neurology at Harvard University and a renowned system to turn down your stress reactions,” she says. “If thought leader in neuroscience. In his seminal book on you can’t do it when you first wake up in the morning, the brain, he writes, “Neuroplasticity is better than mind you can do it throughout the day. You’re tapping into the over matter. It’s mind turning into matter as your thoughts brain’s capacity for handling stress.” create new neural growth.”

Laura Rubin is a fellow cancer survivor, creative coach Tanzi and Bartlett’s research shows that through conand founder of AllSwell Creative, a journaling brand tinual learning and repetitive action over the course of weeks and lifestyle community focused on empowering others and months, our brains form through creativity. Journaling these new synapses, or neural is Rubin’s expertise, and she networks, to communicate to the believes its neurological benefits “There are ways that we rest of our body that we are not are endless. She leads workshops stuck, but there are new ways out. around the country teaching can actually contribute to As we actively form new neural the benefits of daily journaling our base level of joy on a pathways, the old ones fade. This — one session is focused specifimay sound simple enough, but it cally on neuroplasticity. day-to-day basis. It isn’t takes work.

One of the greatest aspects

“There is no neuroplastiabout neuroplasticity, Rubin just about external factors.” city without training and effort says, is how accessible it is. She and practice,” Bartlett explains. cites simple acts such as reading, “It’s not a 10-week fix either. exploring a new place, dancing The older we get, the harder it gets to maintain it for long and learning something new as some key ways to practice enough to make a new habit.” Bartlett says the process can this mental exercise. “You don’t need a fancy spa treatbegin with small steps, as opposed to a dramatic shift in ment, you don’t need a co-pay, you don’t need a specialist,” lifestyle, as your synapses will have a more difficult time Rubin says. “[It’s] those things that we can do on a daily adjusting to these big changes. basis that foster an overall sense of joy, well-being, satis Because everyone in the cancer community is affected faction — the list is long.” by this disease in a myriad of ways, Bartlett has a few simple Rubin was 31 when she was diagnosed with stage II strategies to help anyone tap into neuroplasticity. These HER2-positive breast cancer. Throughout her years into strategies are particularly useful for situations as stressful as recovery, she began what she calls “a concerted study a cancer diagnosis and are easy enough to begin right away. around the science of happiness.”

“You can start right now by opening your eyes, looking “Brain health is hugely important for all aspects of life, out a window, or even in a room, and taking in a wide so that’s one of the reasons I personally got interested in view, rather than a narrow view, around you,” Bartlett the field,” she says. “There are ways that we can actually says. “Especially right now, we have our vision narrowed contribute to our base level of joy on a day-to-day basis. It down [by] looking at our phones, computers and devices. isn’t just about external factors.” Neuroplasticity is a tool And that ends up stressing out the brain, because the that she hopes to continue sharing with others. brain’s not used to it — it’s a whole new thing in evolution.”

Whether you are mid-diagnosis, post-recovery or Bartlett says this is called taking in a “panoramic view,” taking care of someone with cancer, there’s tremendous and that it does wonders for our brain. power within the brain just waiting to be tapped. The best Another pivotal strategy for brain health is deepenpart? It can start today. By exploring these strategies and ing your relationships. That includes finding a “tribe” — more, we can form the foundation for a strong, healthy friends, family and, if available, a community who can brain; one that is prepared to manage fears and anxieties relate to your circumstances and provide support. with ease. So, grab a pen, take a look outside and remind “That would be my biggest suggestion,” says Bartlett. yourself that you’ve got this. It’s all science.

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Cleaning Up the Calumet For decades, industrial and manufacturing waste was dumped into the Grand Calumet River, turning the natural wilderness of the Calumet region into a polluted wasteland. But recent cleanup efforts aim to restore the river and surrounding region to a place of beauty once again.

BY CATHERINE EVES

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he Great Calumet Industrial Region spreads Of course, the Grand Calumet River and surrounding across the South Side of Chicago, stretching along region hasn’t always looked like this. About 120 years ago, it Lake Michigan and into southern Cook County was a swampy, sandy wilderness. Then, in 1889, the Standard and northwest Indiana. The region has long been Oil Company moved in, closely followed by the behemoth considered one of the most heavily industrialized areas of that was the United States Steel Corporation. A 1939 historithe country, and today it is home to more than 1,500 comcal guide about the region explains that oil refining and steel panies in the industrial and manufacturing sectors, includmanufacturing were considered “nuisance industries,” and ing steel mills, chemical plants and oil refineries, according this area was chosen for its remoteness, as it would allow these to the Calumet Area Industrial Commission. companies to operate “without offense to the inhabitants of Prior to the 1972 Clean Water Act (CWA), the significant Chicago.” Typical of the time, this is the book’s only reference amount of waste and pollution created by these booming to any negative effects of these types of industries. industries was drained into the Grand Calumet River. The Not much clarity is offered regarding what part of oil CWA established a basic structure for regulating pollution refining was found “offensive,” and is described, at most, as and water quality standards for all U.S. waterways, making a problem of aesthetics. Offensive smells and great clouds of it illegal for industries to release pollutants into “navigable black smoke, sure, but what of the negative health effects? In waters, unless a permit was obtained,” according to the U.S. 1905, Gary, Indiana, recorded a population of 19,000, but Environmental Protection Agency’s (EPA) website. (Permits that number had grown to 260,000 by 1939, according to the are granted to parties who can “ensure that the discharge historical guide. Most of the pollutants listed above — those does not hurt water quality or people’s health,” per the EPA.) found in the river sediment in 1987 — are considered carcino The 1972 CWA was the first major U.S. law to address genic by the American Cancer Society, meaning the droves water pollution, but in the case of the Calumet River, the of blue-collar workers who moved their families to accommodamage had been done. The river originates on the east date the influx of jobs from the industrial boom were at risk side of Gary, Indiana, with the eastern branch flowing of exposing themselves to carcinogens and contracting illness directly into Lake Michigan. It was and disease, like cancer. designated an Area of Concern

Today, Gary records a popula(AOC) in 1987 due to “legacy polluttion of around 68,000 — a decline ants,” according to the EPA. These that began in the 1970s as a result The 1972 CWA was pollutants (which include PCBs; of worker layoffs brought on by the first major U.S. law PAHs; heavy metals like mercury, reduced steel demand, technologcadmium, chromium and lead; and ical advancements in the industry to address water poloil and grease) were found in the and an increase in foreign compelution, but in the case sediment at the bottom of the river, tition. The city is now a shell of its meaning the industrial waste that former bustling self, barely recogof the Grand Calumet had collected, unregulated, in the nizable to the Chicago daytrippers time between the area’s industrial taking I-90 across the Calumet River River, the damage boom and the enactment of the CWA toward popular tourist destinations had been done. had remained in the environment, like the Indiana Dunes State Park or almost two decades after these types New Buffalo, Michigan. of polluting practices were banned.

But along with efforts to clean up The state of the Grand Calumet River is such that it has been the Calumet River and surrounding area, lawmakers hope granted Beneficial Use Impairments (BUIs) by the International to also restore the city of Gary into a place worth visiting. In Joint Commission (IJC) — an organization created by the U.S. February 2022, the Chicago Tribune reported that federal and Canada to protect their waterways for future generations. The money had been allocated toward cleaning up the Grand IJC’s 14 BUIs are designations that identify “some of the most Calumet River for “reversing the legacy left by decades of severe examples of environmental degradation,” per the EPA, but industrial pollution” and that “a clean environment tied to they are not permanent. A BUI can be removed after cleanup clean air and water puts the region in its best position to efforts prove sufficient improvement in environmental health. grow.” Part of a $1 billion federal package aimed at cleanOnly two BUIs have been removed from the Calumet River so far: ing and restoring the Great Lakes, the river is included in “Restrictions on Drinking Water Consumption or Taste and Odor this EPA-lead effort as it empties into Lake Michigan. U.S. Problems” and “Added Costs to Agriculture or Industry.”

Representative Frank Mrvan is quoted as saying, “We are in The remaining 12 BUIs recognize water quality issues a position to create investment, jobs and allow our neighbors related to harmful effects on fish and wildlife, recreational and friends to recreate on a beautiful clean river.” In addition effects like beach closings, “degradation of aesthetics” and to the Calumet River, the federal package includes funding similar. According to the EPA, cleanup efforts began in 2010 for 10 other AOCs around the Great Lakes. and are still underway. These efforts include sediment remedi About 20 miles east of Gary you’ll find the natural specation and habitat restoration projects, and once the remaining tacle of the Indiana Dunes. This national park is known for 12 BUIs have been removed, the EPA and the state of Indiana its mammoth sand dunes situated along the sunny shorecan begin the process of delisting it as an AOC. “Restoration line of Lake Michigan — it’s a beautiful place to spend a and cleanup at this AOC will improve one of the most heavily summer afternoon with friends. And if federal money conpolluted areas in the Great Lakes watershed and allow the tinues to support cleanup efforts along the Grand Calumet surrounding communities to benefit more fully from the river River, the natural beauty of the Calumet region will conand surrounding ecosystems,” says the EPA’s website. tinue to be enjoyed by future generations of midwesterners.

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TAKING ACTION The creators of Instagram’s Hip Hop Happy Hour, Trish Michelle and Tiffany Dyba.

Cancer Wellness spoke with the founders of six wildly different initiatives — from a nonprofit, to a mobile app, to a virtual happy hour — that were all inspired by their individual cancer journeys.

BY SARAH DIMURO

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urviving a cancer diagnosis can inspire you in tremendous ways. Some desire to give back and use their survivorship to help others navigate the unknown territory of cancer. From helping others start a family, finding clean beauty products and building community for others starting their cancer journey, each of the founders introduced below have made it their vocation to use learned experiences to improve life for those maneuvering the complexities and unknowns of this terrifying disease.

exam room and delivered the news: “It’s cancer, kiddo.”

Sefair was in a daze. “I don’t recall hearing most of the things the doctor said during that appointment. I just remember looking at my son’s little face and thinking, ‘Am I going to see him grow up?’” Next came a steady stream of appointments, surgeries and radiation to treat her thyroid cancer.

Around the same time, her close friend Agnieszka Jank was diagnosed with breast cancer. The two supported each other through appointments and scans. When Jank’s cancer spread to her brain, Sefair continued to do everything she could for her friend — arranging meal deliverPAOOLA SEFAIR & AGNIESZKA JANK, ies and house cleaning services — but found it was hard COFOUNDERS OF THE MY CARECREW APP to coordinate everything around Jank’s appointment and In 2015, Paoola Sefair noticed she was having treatment schedule. The two wished there was an app that a hard time swallowing when she turned her head. She could help. wasn’t overly concerned, but her doctor ordered a few

That’s why, in 2020, Sefair and Jank created one. tests just to make sure all was well. With her one-and-aThe purpose of the My CareCrew app is to streamline half year old on her lap, Sefair’s physician walked into the the entire care process. “The My CareCrew app offers an all-in-one app for patients and caregivers to share health updates with Mission Driven Tech’s founders, Eve McDavid and Dr. Onyinye Balogun. friends and family, create a wish list [for things like gifts and meals] and coordinate support with chores, transportation, errands and more,” Sefair explains. This free app also includes a symptom and mood tracker, which allows patients to update their community in real time.

Jank succumbed to her disease, but her legacy will live on through this incredible resource she created with Sefair. “I am grateful that through My CareCrew, [Jank’s] love, smile, courage, empathy, humor, dedication and determination will always be with us,” Sefair says. “She was the inspiration for My CareCrew, and now she is our guardian angel.” www.MyCareCrew.co SARRAH BENTLEY, VICTORIA RAPHAEL AND ANN PALMER, FOUNDERS OF A DAMN GOOD LIFE Sarrah Bentley was 38 when breast cancer shook her world. She was diagnosed in September 2020, when the whole world was in lockdown due to the pandemic. She was excited to start a family with the love of her life, but everything was put on hold to prepare for the fight of her young life. Suddenly, she was not only dealing with a cancer diagnosis, but how treatment might affect her fertility.

She went through two rounds of IVF, which resulted in one viable embryo. After completing cancer treatment, Bentley was placed on hormone therapy to help prevent recurrence, and knew that surrogacy would be her only option to have a baby. She 62

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was fortunate that she was able to afford the estimated $150,000 cost of a surrogacy journey, but she knew this was not the case for many women in her situation.

Bentley joined forces with Ann Palmer (a fellow breast cancer survivor) and Victoria Raphael (who, like Bentley, was also in the process of a surrogacy journey following a breast cancer diagnosis) to found A Damn Good Life, a nonprofit dedicated to providing young breast cancer survivors with resources to help grow their families through surrogacy.

“We began A Damn Good Life when we all saw a giant hole in financial assistance offered to young breast cancer survivors surrounding surrogacy,” Bentley says.

As their mission statement asserts, “A Damn Good Life will provide a future family with access to the surrogacy journey, top to bottom, from day one. From helping to match the recipient with an agency, to providing 100% financial support and acting as a support system in the process; we will give the gift of a family where one didn’t seem possible.”

To raise money, the trio host fundraising events, including a luau, a poolside soiree at a swanky New York hotel and exclusive yoga classes at Bloomingdales (led by Bentley, a professional yoga instructor). Their fundraising efforts have paid off, and A Damn Good Life will soon be offering their first full grant. As the founders say, “Having a baby should be every woman’s choice, and we want to create possibility where it was taken away by breast cancer.” www.ADamnGoodLife.org KELSEY BUCCI, FOUNDER AND CEO OF PARIS LAUNDRY In 2018, when Kelsey Bucci started her online beauty and wellness boutique, Paris Laundry, she was 30 years old and in the midst of intensive treatment for stage II breast cancer. “My skin reacted horribly to chemotherapy, and I wanted to use products that were as natural as possible,” Bucci says, “So I started making my own.”

In addition to her own products, Paris Laundry carries more than 50 clean beauty brands that “adhere to my strict ingredient restrictions, and that have similar beliefs about beauty and wellness,” Bucci says. She is a firm advocate that what you put on your body is as important as what you put in it. Beauty products that make it into both her online and her Savannah, Georgia brickand-mortar shop must follow her criteria: “Real products with plant-powered ingredients to help create an elevated lifestyle,” she says. “We only carry high quality natural products that perform.”

With a background in merchandising and styling, the mother of four always knew she wanted to one day run her own business, but it wasn’t until she was diagnosed with breast cancer that she figured out what that company would look like. “I just knew that if I was having a hard time finding truly clean, natural and safe products through cancer treatments, other women were probably looking for them, too,” Bucci says. And her product list is extensive, from bath and body, hair, skin and even home goods. Paris Laundry truly aims to “inspire wellness for every aspect of your life,” according to Bucci. www.ParisLaundry.com

TRISH MICHELLE & TIFFANY DYBA, FOUNDERS OF HIP HOP HAPPY HOUR

When Trish Michelle and Tiffany Dyba met at a Friendsgving party in 2018, they eagerly exchanged Instagram handles. They’d both been diagnosed with breast cancer in their mid-30s and were excited to keep in touch. When the pandemic hit in 2020, they saw social media as an opportunity to connect with fellow survivors, and they started the Hip Hop Happy Hour on Instagram Live, which they hosted every Friday. “Our weekly show supports and celebrates those in the cancer community through our shared love of community, advocacy and hip hop,” Michelle and Dyba told cW over email.

A handful of listeners quickly grew to thousands of engaged followers, because it’s not just about music and laughs — although there are lots of both — the duo also used their platform to promote a new initiative called Reclaim October, where the focus is on removing the “pinkwashing” of Breast Cancer Awareness Month, while raising awareness and funds for breast cancer organizations. During October, their Friday programming ends with an Instagram Live featuring breast cancer experts and community members, as well as a live fundraising event, where money raised goes directly to fund research or support those in treatment. In October 2021, they raised almost $20,000 through their Instagram efforts alone. According to Michelle and Dyba, the Hip Hop Happy Hour is “not your average cancer community providing a shoulder to cry on, it’s a group of dedicated, outspoken and often expletive-laced people who refuse to let cancer define us.”

Instagram: @hiphop_happyhour EVE MCDAVID & DR. ONYINYE BALOGUN, COFOUNDERS OF MISSION DRIVEN TECH

Eight months pregnant with her second child, former Google executive Eve McDavid was shocked to learn that she had stage IIB cervical cancer. Her medical team mobilized quickly to treat the aggressive cancer and ensure her baby was delivered safely. Luckily, McDavid was able to receive treatment at one of the world’s top cancer centers and responded incredibly well to treatment protocol, receiving “a statistically extraordinary outcome,” she says. But she soon discovered she was lucky, as most patients don’t have access to these treatments.

“When I learned that my outcome was the exception, and not the rule, I wanted to do everything in my power to make treatment both more accessible and more humane than the current state of care,” McDavid says. In May 2022, McDavid and Dr. Onyinye Balogun, a radiation oncologist who McDavid met during her treatment, founded Mission Driven Tech. McDavid describes the company as “a new women’s health venture, backed by Weill Cornell Medicine, dedicated to the transformation of gynecologic cancer care with modern technology.”

The organization’s goal is to provide all cervical cancer patients with access to the best tools and treatments. Mission Driven Tech won the Weill Cornell Medicine Business Plan Challenge, and it’s positioned to make great strides in cervical cancer care. “We’re very much a part of the global movement to improve women’s health, and now with the medical and investment communities at our backs, we’ll be successful,” McDavid says. www.MissionDrivenTech.com Cancer Wellness

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Physically Empowered Susan Herndon, BSN, RN shares the how and why of getting the body ready for cancer treatment.

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BY SUSAN HERNDON, BSN, RN

ancer treatments are often invasive and painful.

They may involve physical changes or discomfort in the bones, muscles, abdomen, hands or feet. Some patients may also experience mental and physical

Tridico notes that physical limitations may discourage fatigue, stress, anxiety or sleep disturbances. To counteract patients and slow their healing process. She educates them on these symptoms, some patients set physical activity goals to taking precautions that will help to enhance their recovery, such help improve their progression through the aches and pains of as practicing healthier eating, reducing sugar and salt intake, treatment. They accomplish this by gaining strength, building stretching, deep breathing exercises, monitoring blood pressure endurance and taking a more active role in physical fitness. and exercising under the supervision of their medical team.

This is one way a cancer warrior can be “physically empow Tridico also recommends enlisting an exercise buddy, as it ered.” A familiar emotion among cancer patients is the feeling promotes accountability. The opportunity to talk with friends they have lost control while knowing they could face a tough may also help reduce the emotional toll of cancer treatments. physical fight ahead. However, in the battle against cancer, it Tridico says being well-informed of potential physical limitameans so much more if you can feel empowered at the start of tions after treatments is essential, as providers can adjust or your journey, especially if it involves your physical health. modify specific routines for personalized treatment.

Exercise can provide many health benefits, including This mindset is in conjunction with Dr. Fadi Abuincreasing the oxygen and blood flow to the muscles, nourishShahin, MD, a medical oncologist and hematologist based ing the bones and improving mood. Raquel Quijano, a breast in Texas who is dedicated to treating cancer warrior from Texas, agrees. patients with a holistic, whole-body She knew exercise would be essential view. Abu-Shahin believes commuto her wellness through her cancer nication is essential during all treat“[It] is essential to partreatments, which left her feeling naument stages, from diagnosis to surseous and physically exhausted. ticipate in some type vivorship, to help reduce stress and Quijano began exercising weekly, minimize anxiety. of physical activity on and continues to maintain a regular

Good communication between schedule of walking and light weighta daily basis.

Even a patient and provider allows for a lifting. She believes this helped better understanding of treatment reduce pain and inflammation while 10-minute walk outside plans and how best to incorporate improving her flexibility, sleep and is beneficial.” specific physical fitness goals. Abuenergy levels. “I knew it would be Shahin says patients may face chalworth the extra work,” she says. lenges related to diet, weight and

Healthcare professionals are physical activity levels, and that maintaining a healthy lending their support by encouraging patients to stay physweight by eating nutritious foods can help. “Patients who ically active on a routine basis and invest in their general were previously healthy before their diagnosis would do health. Dr. Jamie Tridico, PT, DPT, a West Virginia-based better during their treatment,” he says. physical therapist specializing in cancer rehabilitation, Abu-Shahin recognizes that patients may have conbelieves in fostering an empowered mindset. “[It] is essencerns about their treatment side effects and physical tial to participate in some type of physical activity on a changes. He recommends keeping the lines of communidaily basis,” she says. “Even a 10-minute walk outside is cation open between the patient and physician. “Once we beneficial.” Even a short walk allows you to get some fresh know how the patient feels, we can make adjustments to air and enjoy the sunshine, which can help the mind relax. aid in their treatment process and promote ideal health Tridico has witnessed firsthand the physical challenges results,” he says. and limitations cancer patients face in their journey to recov Each patient should be encouraged to experience ery, which can include difficulty in reaching overhead, lifting healthy success in their cancer journey. From the guideveryday items or even getting dressed in the morning. As ance of their physicians and medical group, taking owna result, Tridico has made it her mission to educate and ership of their physical health is essential. With trust in provide the best physical therapy to her patients — includtheir team, support and perseverance, patients can gain ing passive and active range of motion with strengthening knowledge and prepare to be their physical best — optiand resistance exercises — to help produce what she says is a mistic, focused and physically empowered for treatment. “better quality of life after going through treatment.”

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have a big problem in society,” she says. “That was my light bulb moment that launched me into wanting to understand.”

Segar emphasizes how this discovery showed her the power of cultural norms when it comes to taking care of ourselves. “I thought, if people who had already faced a debiliMichelle Segar, a researcher and health coach, tating and potentially life-threatening illness had difficulty offers insight about sustainable behavior prioritizing their self-care after our study ended, [then] this changes in her latest book, “The Joy Choice.” speaks to our culture and the messages we get about what’s the most important thing we should be spending our time

BY FRANCESCA HALIKIAS on,” she says. “Clearly our culture is saying [that] it is not our self-care.” She wanted to create something that would ave you ever worked hard at eating healthier explore how to help people prioritize their self-care in a way and exercising more, but, after a week or two, that would embrace both success and failure. something happens that throws your plans out

Segar’s first book, “No Sweat,” compounds years of the window? research into a helpful guide explaining the science behind Michelle Segar, PhD, MPH, MS, a sustainable behavior motivation, so that exercise will become a mindset, not change scientist and director of the University of Michigan’s a chore. “No Sweat” led Segar into learning more about Sport, Health and Activity Research and Policy Center, in-the-moment decision making. “The Joy Choice” offers wanted to explore why this happens and what could be done readers insight into why society has made us feel as if healthy about it. Her new book, “The Joy Choice: How to Finally eating and exercise must be an all-or-nothing mentality.

Achieve Lasting Changes in Eating and Exercise,” challenges “I decided that we needed to reframe and rebrand the choices readers to adjust their way of thinking when it comes to creatthat most of us have to make to keep us ing sustainable and healthy change. on the path of lasting change,” says Segar.

“I’ve been studying why people She details a new way of thinking in her don’t sustain self-care behaviors like book, where there is always an “imper“I decided that we physical activity for almost 30 years,” fect-perfect choice” that lets us do someexplains Segar. The impetus behind thing instead of nothing. needed to reframe and Segar’s interest in this topic came

Segar wanted the book to be a from a study she conducted of cancer rebrand the choices program for readers to follow to help survivors approximately four years with decision making in a way that was that most of us have to past treatment. The study was to detereasy to understand. “The research supmine if exercise could reduce feelings make to keep us on the ports the whole premise of the book, of depression and anxiety. One group which is that the value of any choice to path of lasting change.” of survivors was randomized to exerexercise or eat in healthy ways is going cise, and the other was a control group. to be determined by the other choices

“What we found was that the and needs in the moment that we had group that exercised significantly improved in the meaplanned to make that choice,” Segar says. sures, compared to the group that didn’t exercise. But that She created a decision tool in her book, called POP, that really wasn’t the big ‘aha’ moment,” says Segar. “The big lets the readers “pop” their plans and choose to do something ‘aha’ moment came when we found that almost everyone had instead of nothing. Whether it’s going on a 30-minute walk or stopped exercising when our study had ended. I thought, wow, dancing in the kitchen for five minutes when you unexpectedly if people had felt comfortable committing to exercise [to] parhave to miss that morning workout class, Segar wants people ticipate for our research, but they didn’t feel comfortable prito know there is always an imperfect-perfect choice that can oritizing their own self-care once the study ended, then we keep you moving and healthy, even when plans change.

“In life, there’s all this unexpectedness, and that usually derails people from doing anything, because they go, ‘If I can’t do what I planned to do, it’s not worth doing at all.’ Well, that is the recipe for feeling bad about yourself, [having a] sense of failure, not being motivated — just a whole host of mostly very negative things,” Segar says. “The alternative to that, which science supports, is that if you do something instead of nothing when your plan is being derailed for circumstances that are outside of your control, you will actually feel better about it.”

Segar points out that in other areas of life outside of eating and exercise, such as schoolwork, parenting or relationships, we don’t expect it to be perfect all the time. But when it comes to eating healthily and exercising, we do.

“We know we could never live our lives in perfect ways,” says Segar. “We know we can’t be perfect parents [or] partners, because that’s not the nature of living,” she says. “It’s time for society to reframe. It’s time for us to give ourselves permission, and it’s time for society to follow suit.”

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