My interview and survey project is in full swing! This week, I interviewed 8 women who were currently undergoing or had recently undergone chemotherapy in order to learn what they would want in a technology-supported physical activity intervention. These women were recruited from a previous observational study at the Exercise and Health Lab, where I intern, so they were eager to share their opinions with me. Many of them were also very active both before and during treatment. Their dedication to staying active during such a difficult time in their life is so inspiring to me.
During the interviews, I go through a guide with a number of questions that I ask each participant. First, I ask them to discuss their breast cancer diagnosis and treatment. What I have learned from their responses to these questions is that there are SO many types of breast cancer and even more ways to treat them. In order to respond to what they are describing, I have done some more reading about types of breast cancer and the metabolism and side effects of common chemotherapy drugs.
Next, I ask the women to describe why they would or would not be interested in either a physical activity or sedentary behavior reduction intervention during chemotherapy. My project is focused on physical activity, but recent research suggests that reducing your sitting time also has great health benefits. Maybe some of my findings will be able to help Monica Hsu, the other URG recipient in my lab who is designing a sedentary behavior reduction intervention for breast cancer survivors!
Then, we talk about the biggest barriers and facilitators to exercise when the women are undergoing chemotherapy. Fatigue is the most common complaint of cancer patients receiving treatment- “my legs feel like lead”, “I get winded washing the dishes”, and “I could barely walk, let alone run” are common phrases I hear. Interestingly, family and friends don’t always help women be more active because usually they want to “protect” the patient and encourage them to “rest”, even though this is often counterproductive! It shouldn’t be too much of a surprise that one of the best things you can do during cancer treatment is exercise. It has the same benefits to cancer patients as it does to the rest of the population in managing stress, fighting disease, managing weight, and increasing energy. The active women I spoke to described how working out while they were receiving chemo helped them gain back a sense of control, empowering them, as well as helped them manage the physical side effects of treatment.
Breast cancer in particular is often glamorized in the media. Yes, cancer patients and survivors are incredibly strong. The women I speak to every day have drugs destroying their bodies and often develop resulting depression and anxiety. Several of the women I have spoken with have cried on the phone with me. Sometimes, they tell me, they consider not returning for their chemo treatments because the tiredness, pain, nausea, and hair loss are overwhelming, but they go back anyways. We should celebrate these women for their determination as well as genuinely take the time to appreciate all they have been through.
As for the features they would like to see in a technology-supported intervention, it is too early to determine conclusively any results, but overall they are fairly consistent with the findings we have incorporated into the design of our Fit2Thrive program for breast cancer survivors. In particular, the women I have interviewed share how they want to connect with people “going through the same thing”. It is hard for their family, friends, and even doctors to relate to what it is like to receive chemotherapy, and many of them yearn for social support in managing their emotions and their motivation to fight back through physical activity. Much of this stems from a desire for more education- what exercises are safe to do when receiving chemo or recovering from surgery? How do I know when to push myself and when to relax?
Speaking with these women has been one of the most humbling experiences in my life. I always thank them for their willingness to share their journey with me, because it is often very difficult for them. Beyond an Amazon giftcard, the greatest benefit they receive is the knowledge that they are helping future women undergoing chemotherapy. I have gained such an appreciation for what it means to fight cancer, and they inspire me in my pursuit of medicine as a career because I want to be the one who is there in person to provide comfort and help them make the best decisions for their futures.
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Exercise and Health Lab Interns, Left to Right: Manish Narasimman, Monica Hsu, Austin Gardner, and Annie Nielsen (me!)
On a lighter note, I also enjoyed brunch this week at Kanela Breakfast Club in Streeterville with a few of the other interns in my lab. We enjoyed omelettes, blueberry pancakes, and chicken and waffles. The leftovers made for a great lunch the next day!
I am learning so much about physical activity, cancer treatment and survivorship, and study design and implementation through my research this summer. I am looking forward to analyzing my survey and interview data as I come closer to answering my questions about how to design an effective exercise program for women receiving breast cancer treatment!
Annie