At the time of her breast cancer diagnosis, Teresa Serbia knew she was overweight.
“After I was fortunate enough to become a survivor, I realized I needed to change my lifestyle,” says Teresa, who weighed more than 200 pounds at her heaviest. MD Anderson’s Active Living After Cancer program not only helped her trim down to 170 pounds, but also provided community support and taught her how to work through common challenges faced by cancer survivors and anyone trying to move from a sedentary to an active lifestyle.
The free 12-week program, now offered online via Zoom, introduces cancer survivors to simple, but effective physical exercises and behavior-based techniques that make lifestyle changes stick through 90-minute classes once a week. Each week a different guest speaker helps participants navigate survivorship topics, including nutrition, fatigue, fear of cancer recurrence and how to talk to your doctor.
“The program made a big difference in my life,” Teresa says. “It helped me be part of a group of people who were all doing the same things I was doing.”
Tools and support to help cancer survivors make healthy changes
The Active Living After Cancer program gives cancer survivors like Teresa the tools and support they need to make healthy changes at a pivotal time in their lives.
“A lot of people finish treatment, and they don't feel as well as they felt before. They may not have the same energy, or they're feeling a little lost,” says Karen Basen-Engquist, Ph.D., director of Active Living After Cancer. “Most people who join the program are pretty sedentary and find themselves asking, ‘OK, I've finished treatment – now what? What should I do to optimize my health?’”
The period after cancer treatment is an important time to begin – or return to – an active lifestyle. A number of observational studies show – particularly in breast, colorectal and prostate cancers – that survivors who are more physically active live longer, Basen-Engquist says. Multiple randomized clinical trials have also shown that exercise can help cancer survivors manage fatigue, depression and anxiety, and improve their overall quality of life.
COVID-19 brings a new, virtual format for Active Living After Cancer
The program is offered in English and Spanish. Initially, the program was limited to breast cancer survivors in the Greater Houston area. In 2017, it was expanded to survivors of any cancer type, and to residents of both Houston and El Paso, with the help of partner organizations, such as the Kelsey Research Foundation and the Cancer and Chronic Disease Consortium. Participants do not need to be MD Anderson patients, and they cannot be in active treatment.
By early 2020, CPRIT had funded the program with another grant to expand to rural and medically underserved communities in Texas, including the Beaumont and Tyler areas.
Then the coronavirus (COVID-19) pandemic hit, and it became clear that face-to-face meetings couldn’t continue safely. The team quickly transitioned to a virtual format.
“We had been thinking about developing virtual options for a while to help us reach survivors who live in more rural areas, so the need for social distancing gave us a chance to try it out,” Basen-Engquist says. “Participants have been very positive about the change. Many appreciate the chance to connect with other survivors and take positive steps for their health even during social distancing.”
Active Living After Cancer is currently enrolling for online classes, with new cohorts opening on a rolling basis. The program’s staff is working with Gift of Life in Beaumont and UTHealth in Tyler to offer virtual classes for cancer survivors in those areas this fall.
Participants see fitness improvements
Since 2014, more than 900 survivors have participated in Active Living After Cancer. Nearly 80% have completed the program. Participants consistently report improved quality of life and show measurable progress in their physical fitness. For example, the sit-to-stand test counts how many times a person can stand up from a chair and sit back down in 30 seconds. When the program expanded to all types of cancer survivors, only 30% of participants measured above the 50th percentile for their gender and age. By the time they completed the program, nearly 50% measured above the 50th percentile.
The team relies on community health educators to lead Active Living After Cancer, and each educator brings their own pizazz to the program. During weekly telementoring sessions, the educators share ideas that have worked well for their classes, such as starting a group text thread for participants to motivate each other or creating vision boards during the behavioral lesson on goal setting. Successful ideas are incorporated into the program as enhancements so they can be tracked, measured and used in future classes.
Giving cancer survivors new skills to stay active
Since graduating from Active Living After Cancer in January, Teresa misses the community of her class. But she continues walking three times a week and is determined to hit her goal weight of 150 pounds.
She, like other participants, is enjoying an improved quality of life and making progress in reaching her physical fitness goals.
“As a behavioral scientist, I think behavior change is not something that just happens in 12 weeks,” Basen-Engquist says. “But I hope we give cancer survivors new skills and the ability to keep looking for resources to keep themselves physically active.”
Teresa says one of the most important things she learned was how to work through challenges and keep moving toward her goals.
“They taught me that even though you might backslide a bit, it’s OK,” she says. “Don’t beat yourself up. The more you do for yourself, the better you feel.”