On 16 October I was lucky enough to be invited to share the stage with Prue Cormie at the Monash Partners Comprehensive Cancer Consortium Forum Dinner, to talk all things exercise and cancer. I wanted to share my speech with everyone, which talks about the outstanding impact my medical team had in introducing exercise to my treatment journey – a complete game changer for me. Here’s to exercise, and the difference a truly ‘teaming’ team can have on a patient!
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It is my absolute honour to be speaking here tonight – thank you to the MPCCC for this opportunity.
Now, it is almost exactly a year since I shared the stage with Associate Professor Prue Cormie to launch the ExMed Cancer Program, in October 2017. There seems to be a certain poetry, then, to be able to do so again tonight – a night when I am struck by just how much of an impact exercise has had on my cancer journey. And also – how much the collaboration between my medical team served to save my life.
But allow me to start at the start.
I was diagnosed with stage iv bowel cancer in March of last year. I was a 32-year-old brand new mum. My beautiful baby boy was 8 months old – and I was tired. Not a sleepiness. More like a heavy, draining, uninspiring tired. A fatigue that took my life and energy and focus away. I knew it didn’t feel right, so I went to my GP for answers. To his credit, he took me seriously. He told me that nobody knew my body like I do, meaning that if I felt like something was wrong, we needed to pursue it. It only took a fortnight, via a full blood examination, abdominal ultrasound, referral to a gastroenterologist and an MRI, to find my cancer. And at the time that we found it, my cancer had already metastasised to my liver and my lungs.
I went through the pure hell that is an advanced cancer diagnosis – a path that I am sure this room is all too familiar with. Being told I had somewhere between 18 months and 3 years to live. Being told my liver was inoperable. Being told my chemotherapy was essentially palliative. I had no family history and no reason to get cancer and really – no hope. But I sought another opinion. And another. And another.
The oncologist I chose to work with was a breath of fresh air. He was pragmatic, direct, but unquestionably understood me as a person. As an individual. He gave me the same diagnosis everyone else had, confirmed my prognosis was scary, but told me there was a tiny opportunity to fight the statistics. Particularly, as I didn’t actually fit any of the statistics. He told me my treatment program would consist of two things: an aggressive chemotherapy regime, and exercise. This struck me as strange at the time. After being told so many times that I was dying and it was hopeless, now I was being told to exercise. I asked him for the thinking and justification behind my entire treatment program and he shared this with me. I headed off to get my port fitted and commence my chemotherapy and do my exercise and attempt to beat the statistics.
But I needed to know more about the exercise. I needed to understand the science. The why. The how. And so, I did my reading and found the incomparable Prue Cormie and dropped her a line. She agreed to meet me and shared the research with me, as well as the incredible program that she was just about to launch: Ex-Med Cancer. A best practice exercise medicine program. A path to deliver exercise medicine to the cancer patients who needed it most.
Well, I was an immediate convert. It was March in Melbourne and the weather was getting cooler. I was on a regime of fortnightly folfirinox, which made me so incredibly sensitive to cold. I couldn’t drink tap water or hold a fork or walk outside without my face contorting. But at least four times a week, I trekked out to the park outside my home with my brother, with gloves and beanie and coat on, to complete a half hour body weight workout. As I got stronger, and less nervous about the germs around me, I transitioned to a gym.
I worked and worked and worked and did all the chemo, with not a single dosage reduction, despite the peripheral neuropathy and shakes and chemo brain. This was my only chance.
Now to be fair, I have had a love-hate relationship with exercise over my life. I was the student who was guaranteed to forget their sports uniform in high school. Team sports scared me. I couldn’t catch. Running hurt. But as I got older I started to work out more. By the time I was pregnant, I was in the gym every week. But that didn’t really make the transition to exercising as a cancer patient any easier.
Cancer is a different beast. My body was so drastically unfamiliar. My mental health so unstable. Nothing was normal. The habits that I had pre-cancer were not guaranteed to translate to my cancer fight.
So what did make the difference?
My medical team.
- My oncologist asking me about exercise. Every. Single. Appointment. Legitimising it as a treatment. In one breath he was recounting my neutrophil count, and in the next, he was checking my squat count. He made me feel like I was in control of this aspect of my treatment and confirmed that it could only be making a positive difference to my outcomes. And of course, once I started to receive positive results from my treatment, our partnership in my cancer battle was crystalized. He would do the drugs, I would do the exercise, and together, we would get that surgery.
- Once I established a pattern of treatment, and established relationships with all of the key players across my treatment landscape, my nurses then went on to play a huge part in my uptake of exercise. I did workouts in day oncology. They were incredibly flexible, clearing space for me and making sure I was mobile enough to walk laps of the floor. They took me seriously and shared my progress with other patients and made me feel like I was at the centre of my treatment.
- Who else made a difference? My exercise physiologist. Exercise is a medicine that demands a personalised prescription, and mine required massive adjustments. To deal with my debilitating side effects, and recovery from my bowel, liver and lung surgery.
Because we did get to my surgery. On 1 November last year, the day after we launched Ex-Med Cancer, I had my impossible, game changing, lifesaving liver surgery.
We continue to remove dead and dormant lesions for my body. My cancer battle will certainly be a lifelong one. But I am officially in remission. And I am also officially a member of the Ex-Med Cancer team. Not only has my medical team dramatically altered my prognosis – steering me far away from my dire cancer fate – but they have also enabled a wonderfully exciting career for me.
I needed the chemotherapy and surgery. But I got there via the exercise. The mental, physical and emotional benefits of exercise have delivered me right here, right now – and I am now physically fitter than I have ever been in my life. I cannot overstate the role that exercise has played in my treatment – as well as in my prehabilitation and rehabilitation. But it is far more important to me to call out the committed, expert and simply wonderful people who enabled exercise for me – just as they did every other part of my treatment. My medical team put me in charge of my body, and that body will continue to be mine for decades to come. I am sure of it.
Never underestimate the power you have to give someone their own body. Their own mind. And the beautiful control that is using both, for their own good.
Thank you for the opportunity to speak tonight.
<pause for applause ;)>