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Activity and camaraderie help cancer patients and survivors feel stronger


Working out to Increase Strength and Endurance (WISE)

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Christie Wise of Bloomington always enjoyed gardening and the strong, liberating feeling of "striding out the legs," when she walked briskly. But exercise? When her good friend Jeanne Johnston suggested she try a new exercise program at the local YMCA, she wasn't sure it was for her.

But then, again, breast cancer wasn't for this avid gardener, either, and neither was the arthritis that made gardening and her brisk walks impossible. And because Johnston, an exercise physiologist at Indiana University Bloomington, was naming the new cancer rehabilitation program for Wise, she thought she should give it a try.

Wise started with walking and using the recumbent stationary bike. She lost the 50 pounds she had recently gained.

"It was a benign peer pressure," said Wise, an attorney. "We were all kind of in it together."

She quickly found that Working out to Increase Strength and Endurance (WISE), now it its seventh year, was about much more than exercise. She now considers her friend a "hero" for bringing such an uncommon program to the Bloomington area and to its residents who are coping with cancer treatment or recovering from it.

"I felt so bad for so long. It was nice to get some positive feelings from physical activity," Wise said, sitting amidst workout equipment at the Monroe County YMCA. "But even if people can't exercise, they come here to get out of the house and to socialize. If someone doesn't come for several sessions, we track them down and find out how they're doing."

Jeanne Johnston and Christie Wise

Jeanne Johnston and Christie Wise

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Rehabilitation and quality of life issues are relatively new areas of cancer research because so much of the research has focused on detection and treatment. Research is finding, however, that physical activity can decrease the nausea and fatigue people experience during treatment, Johnston said. Fatigue, she noted, can last for five years after the treatment.

Sticking with an exercise routine can be a challenge for most people. Johnston said cancer rehabilitation programs have an 80 percent to 90 percent adherence rate. She said the physical activity can be beneficial, but it's important for people to consult professionals and to follow guidelines designed specifically for cancer rehabilitation, especially people who are undergoing treatment. Dramatically fluctuating white and red blood cell counts, and rapid heart rates are just some of the reasons careful monitoring is a critical component of cancer rehabilitation programs. Cancer treatment also can break down body tissue, so strength training must be modified.

At WISE, sometimes clients are sent home after their vitals have been measured -- and sometimes they are sent to a medical facility. Their workouts are geared toward their individual needs and how they feel that day.

"Sometimes they walk a lap and rest, walk a lap and rest," Johnston said.

Margie Kobow

Margie Kobow

Cancer rehabilitation programs are rare now and were even more so in 2001 when WISE began. Johnston said it took a team effort, involving the Monroe County YMCA, Indiana University and generous funders, such as the Bloomington Community Foundation, Bloomington Hospital's Olcott Center for Cancer Education and Hoosiers Outrun Cancer, to get the program off the ground and to keep it going in a community setting.

"If you're a cancer survivor, you don't want to go back to the hospital," Johnston said. "I firmly believe programs like these should be in a community setting where it can be a positive experience."

The program found a willing home at the forward-thinking Monroe County YMCA, which has a long-running cardiopulmonary rehabilitation program, called the HEARTEAM.

"It's been incredible to see people change and get through their treatment a lot easier," said Margie Kobow, YMCA's health and cardiac rehab director and a certified cancer exercise specialist. "I see it make a difference every day."

Kobow said the program, which has 57 members, is seeing an increase in referrals from oncologists, who realize that cancer patients benefit from being active during treatment. Johnston said fitness professionals are learning more about the special needs of cancer patients and survivors through college courses such as those at IUB's School of Health, Physical Education and Recreation. HPER students have worked with WISE clients over the years. Johnston said she would like to see cancer rehabilitation become a specialty in the fields of clinical exercise physiology and rehabilitation.

Wise can't say enough nice things about Johnston and the YMCA for making the program available. She said it has made a big difference in the lives of many people and that some clients participate in the program literally until their dying day.

"We've lost some wonderful people but they're in our hearts and memories," Wise said. "To a person, they've been such wonderful role models, so courageous."

The WISE program is an inexpensive avenue to overall health and wellness for cancer patients and survivors. It is available for YMCA members and non-members, too. Financial assistance is available, as well. To learn more about the WISE program, please contact Margie Kobow at