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Acknowledgement Quostiam volupta quasit fugia debis nim et ventibus raerum et destio qui debiti dolestem fuga. Od mod ut ium earit reratiu sanderum eturio vita illit ulpa volor sae cuptat. Ferumquatis es elliquiae officiet que et ent volesequid ullaudis volupta volupta turit, ommo et lanis erum que etur si blabo. Bitae. Nequae dolorep erspelis nusae volorum quianim volendust, consed essed quibus re, con explaute quae plitatia diciam audam, ideratemped et quat minus explitis ma corepuda volorehendi quas etures dolupicidit qui con et volum exceaque invel is abo. Am doluptate veliqui nus ne magnam, quibusa pelectem qui utes erfernatiis expellabo. Nam harchit volla volupta cus et quiatecatur simin corem eossum quatia dolupic iissequ idendi odi tem. Lantium rest, sumquia doluptas illest, vereped quata arum excerum nonem que nimi, consequamus sitatur, vel ipsum harcitiuria pellaut accus maionet adignihillit omnihic aeribus ea parchillam ipit, te peratum quam es dissinc totatur a dent, volor modior alis eos solorumquod ut eum nihil ium, cus eario vent. Arum soluptatibus doleniam doluptatibus molor sequamendit aut utem qui autatur audis alibus sundit, exerum ad erferio nsequam sequam fuga. Os soles ma expelen imusam inis pliquis min nonsendicid molupta quasperis accus se ant. Tionseq uatquis nest, volorem ex eatecus et est, earchil iniasi destio optassum volectemod erum, temolori consequ ibeario es de nobitiorro consequunt ut ullaborectur repel ilit expedignis praturiorum ut officim porrunt. Totam quo et veligni asitis abo. Nemo conem quae explitatis dolupta dolor sequid quae enda aspedi doluptam ut maximus pratur sed mo to quae que omnima coribus esed maionsed ese omnimagnam erio dolestibus aspisint quas conse venis es iur alitatet fugiantur andis rat laborposa doluptae odit officat iatiumet aut earumquamus digenda nusandu cipiduciae soluptatus. Les nosapistium et eossita tiunti aut aliquia non pos solorporibus est, autem dolorumquiat volum sae nonserr oribus. Pidebitat et quosam, tectur simolorrum acessitis a volectotas endam laborporum, omnia quatem nullit volorei caborit quisitibus ipsum eum re nis doluptatiam sequos molore dus, simus et ea volorec ullabo.
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Table of Contents Page 3 ....................................................................... Acknowledgement Page 6 ....................................................................... Preface Page 8 ........................................................................ Introduction Page 14 .................................................................... Chapter 1 Page 19 .................................................................... Chapter 2 Page 24 .................................................................... Chapter 3 Page 1 ......................................................................... Page 1 ......................................................................... Page 1 .........................................................................
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Preface At the YMCA, frail, weak cancer survivors are working hard to regain their strength and mobility. More than regaining muscle, they are focused on regaining their self confidence, independence and return their lives back to normal. “What interested me in joining the program was trying to rebuild the atrophy muscles from chemo and radiation. When I was finished with chemo and radiation, I was a real professional at sitting on the couch. I didn’t have the strength to really do anything. But doing things I normally like to do wasn’t possible, until I started to rebuild my muscles.” (Barry Hubbard, current LSLW participant).
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When it comes to cancer, all of the focus and effort by doctors is about the diagnosis and the treatment. Doctors spend countless hours making a diagnosis for the patient and finding the right treatment for them. There are different treatment plans such as chemotherapy, surgery, and radiation therapy, to help fight the disease and increase chances of survival. A lot of effort is done to help patients endure their disease with as little pain as possible. However, much less effort is put into helping cancer patients after treatments are completed and they are in remission. An equally important part of cancer survival is the recovery process after treatment has completed. Cancer treatment helps you to heal from the disease, but there are major side effects that damage important parts of the body. “Some of the side effects include pain, nausea and vomiting, fatigue, depression, infections, fear, anxiety and other dangerous effects that could have potential long term damage to the body” (Cancer.org) The result is a cancer survivor who is almost incapable of getting their life back to the way things were before the cancer. But what if there were a way to get back to the way things were? Most websites suggest methods of recovery, such as exercise and eating a balanced diet, but they don’t offer the specific programs to these cancer survivors. It’s easy to suggest that a cancer survivor simply exercise more or join a gym. But what the survivors need is a program focused on getting them back to their original strength and fitness. That’s where LSLW comes in.
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Introduction LSLW was created about 12 years ago, and it has an interesting beginning. According to Joyce Hannon, the founder of LSLW, “I went down to a conference in Dallas, about 12 and a half years ago on physical activity and cancer. It was the first conference that focused on those 2 subjects combined. A lot of conferences on physical activity, and a lot on cancer, but, believe it or not, none about both cancer and physical activity. This conference was put on by both the American Cancer Society and the American College of Sports Medicine. There was research from people that came from all over the world and the research was showing that exercise could help reduce the risk for some cancers. But then at the very end of the conference some people got up started talking about some research that was just beginning to come out, that exercise be very very helpful for cancer survivors. So thats when we started the program.�
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LSLW, known as Living Strong Living Well, is a 12-week strength and fitness training program for adult cancer survivors who have become fatigued from their treatment or disease. It is designed to help these survivors regain their strength they had before the disease. The goal of the program is to help build muscle mass and muscle strength, increase flexibility and endurance, and improve functional ability and their quality of life. This helps cancer patients recover to their full strength, rather than leaving them on their own to recover. Kim Bailey, a former LSLW participant explained, “I never really exercised before getting cancer. It’s been a year since I have been in remission and thanks to LSLW, I am more fit than ever. I recently went on a trip to Europe with my family and I was proud that I could hike up the stairs with them and not be winded at the top.�
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Chapter 1
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History and Development of LSLW
The LSLW program was first started at the Page Mill YMCA in January of 2002 by Joyce Hanna, the founder and director of the program. She is a health educator, exercise physiologist, and nutritionist with graduate degrees in Education (from Stanford University) and Exercise Psychology and Nutrition (from Cal State Hayward). “She has designed and conducted health education seminars with a focus on healthy aging, exercise and cancer, women’s health, nutrition, fitness, and behavior change” (LSLW - Stanford). Three main organizations played a key role in developing the LSLW program and it’s goals. These programs include the Stanford Health Improvement Program (from which LSLW has received numerous generous donations), the Stanford Prevention Research Center (which has influenced the works of the LSLW organization as a whole), and the YMCA (LSLW’s partner). The Stanford Health Improvement Program (HIP) is a program that aims to create a culture of wellness and increase employee productivity by empowering individuals to be self-managers of their health. It also encourages them to support the wellness efforts of others. HIP models the science of healthy living by using research to promote wellness. One of the key aspects of LSLW is the support participants give each other during the program. This idea of each participant helping each other reach their common goal originates from HIP’s initiative to encourage everyone to support the wellness of others.
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LSLW was also influenced by the works of the Stanford Prevention Research Center (SPRC). SPRC is an association of experts who investigate ways to prevent disease and promote health. These investigators collaborate on numerous projects designed to effectively use their research to promote well-being at every stage of life. “Our goal is to help patients build muscle mass and muscle strength, increase flexibility and endurance; and improve functional ability and quality of life. This program is available at no cost to participants and is not a source of revenue to Stanford or the YMCA.” (LSLW - Stanford). With doctors constantly focused on the treatment process, LSLW fills the void in the lives of cancer survivors who don’t have a recovery plan in place to help them recover from their cancer treatment
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Chapter 2 What are they doing at LSLW The director of the LSLW program, Julie Grosvenor, takes pride in how the program has evolved and grown. She has seen first-hand the impact that this program has on the cancer survivors lives. “It has been the most amazing experience. I have been doing this for the past 6 years it’s amazing to see the difference exercise makes in their lives when they have been so fatigued and fearful of death. They lost a lot of their normal coordination and motivation to get up on the morning. It’s great to see where exercise solves not only their physical health but also their mental health. I get a new group every three months and consistently get the same results every single time. The first day they are often quite fearful and many times they are very tired. By the end of the three months they are changed, honestly they are really changed. They are stronger and happier.
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LSLW starts with an initial assessment to see where the participant’s fitness level is, and set their goals to reach by the end of the program. They give the participants an orientation of the YMCA Strength and Conditioning Gym. The 12-week program has sessions occurring twice a week for 75 minutes each. It is a progressive individual strength program with guidance from highly trained instructors. Some of the exercises that are focused on during the program include cardio, strength training, stretching, range of motion, and balance of the mind and body. Upon completion of the program, there is a final fitness assessment to see how far the participant has come from the beginning. They are given a recommended fitness program to continue the recovery process.
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“The LSLW program is a strength based program that has been designed for cancer survivors and we are actually teaching people to condition their body after they’ve gone through chemo or radiation, and surgery. Sometimes they can be participating while they’re still in chemo. They do a little bit of cardio activity like walking on the treadmill and then move onto weight circuits where we’re going to be building up muscle strength as
well as bone density that they lost during chemo. We end our session with stretching or yoga or meditation. “ (Julie Grosvenor).
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During their exercise sessions, the participants begin with a short warm-up on the treadmill, and then they use the Cybex weight equipment, focusing on each major muscle group. They do these exercises individually under the guidance of the personal trainers who have been specifically trained to work with cancer survivors. They finish their session by coming together as a group and work together on exercises to improve their balance and flexibility. They also do breathing exercises and guided meditation to help with stress management. This group work also provides a time for the participants to get to know each other and form lasting friendships. One of the current LSLW patients is thankful that he was able to participate in the LSLW program. “This programs exceeded my expectations so I’m very pleased with of the work that we do upstairs with the resistance and weight machines. We also do other sorts of things like breathing and stretching, that I normally would not do on my own. I feel like I can continue to improve every session.” (Barry Hubbard).
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Chapter 3 The Science
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This program fulfills an important need of the increasing number of cancer survivors who find themselves in between completing their cancer treatment and feeling physically and emotionally strong enough to return to their normal life. Scientific research supports the effectiveness of strength training for cancer survivors and patients. According to the American Cancer Society, there are many benefits for cancer survivors and cancer patients to exercise. “Some of these benefits are: improved balance, lower risk of broken bones, improves self esteem, lessens nausea, lessens fatigue, and lowers the risk of being anxious and depressed.” (cancer.org). According to the American College of Sports Medicine (ACSM), their exercise guidelines strongly recommend that cancer patients and survivors engage in regular physical activity. “We’re seeing better everyday function and overall higher quality of life for cancer survivors who exercise. Clinicians should advise cancer survivors to avoid inactivity, even for patients with existing disease or who are undergoing difficult treatments.”. (ACSM).
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Exercise can not only help them return to a normal life but it can also help keep their cancer in remission and increase their survival rate. According to the Nursing Times, “Cancer survivors can benefit significantly from undertaking exercise and it can even help them stay in remission. This comes after a review of more than 60 studies carried out on behalf of the charity revealed that exercise can greatly aid recovery and prevent long-term illness in cancer patients.” According to Joyce Hannon, the founder of LSLW, “There is a lot of research that substantiates what the exercise can do for cancer patients, and survivors. Exercise was shown to increase self esteem, energy levels, strength, quality of sleep, and reduced stress. Our program showed this also. We took research, pre and post self reporting, and our participants verified these results.”
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According to the American Cancer Society, exercise improves bone density and helps prevent osteoporosis, which is important for this group because chemotherapy increases ones risk of developing osteoporosis. Improving strength, balance and flexibility also reduces their risks of falling. “This is an important benefit of our program because cancer patients have a real fear of falling and ending up back in the hospital.” (Joyce Hannon). There was the myth that exercise would decrease the immune system for cancer survivors because they were already fatigued. “However, current research is showing that exercise actually improves the immune system of most cancer survivors.” (Joyce Hannon).
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Conclusion
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The LSLW program has had a positive impact on hundreds of cancer survivors, lives and their families. Their emotional impact is just as great as the physical benefits, that are experienced by the participants. “I was experiencing a little bit of depression and I was feeling isolated and lonely because nobody understood what I was going through and everybody wants you to get back your old ways of being. When you go through having the surgery and everyone want you to to be ok but your life has been totally flipped upside down. Exercising and coming together with twelve other women and men who were going through what I was going through was great because it was a support group. Being with people who knew what each person is going through felt so good. It was nice to be in a community where you do not need to worry about putting on a happy face when you are having a bad day. You can just be you and people would get it. “(Kim Bailey).
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Not only are the participants benefiting from the program, the staff who work with the cancer survivors also benefit. “I think I get more out of it than the participants do. First of all I gain knowledge of how people process devastating news. I had a chance to learn how to care for somebody in a subtle way or to care for somebody in a very powerful strong way. So, it’s been challenging for me to learn my own skills of how to respond and adapt, maybe even win in the same hour that I’m working with someone. I need to be there and I need to be their coach and I need to be their support. So, yes, I get a lot of of this. It’s an honor to be able to teach them about health and fitness and teach them a new skill of being strong. Being a part of helping people to make a lifestyle change and live healthier just makes my day. I love my job.” (Julie Grosvenor).
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There are many memorable experiences for both participants and the staff. “I remember working with someone who was having panic attacks of not wanting to come to class and they would cry in the middle of of class to being somebody that I would see three or four times a week in the gym. That has been a powerful experience. A difficult part of LSLW is that sometimes people don’t make it. One of my most unusual and special experiences was with a member named Steven. He was very ill when he was in the group but certainly fighting. It wasn’t long after that I was sitting in my desk and I picked up the phone and Steven was calling me to thank me for the program but he was also calling me to say goodbye. I was very moved by his kindness but also knowing that these were his last days and he took the time to connect with me was a powerful experience.” (Julie Grosvenor). The LSLW program follows the mission of the YMCA by improving our community through strengthening the physical and mental well being of cancer survivors. This program has demonstrated many positive benefits to the individual participants, their families, the YMCA staff, and our community.
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