Prescription for normal

A cancer diagnosis can generate a great deal of uncertainty.

How do I tell my family and friends?

What treatments will I have?

Can I still live a normal life?

“When they tell you that you have cancer, you’re in shock,” says Tammy Pedersen, who was diagnosed with breast cancer in November of 2014. Pedersen’s care team skillfully guided her through treatment, and her breast-conserving surgery and radiation were completed by the following February.

“I had a lot of faith in my doctors,” she says. “Everyone was so positive, I never felt down."

However, uncertainty doesn’t always pass when treatment is over.

“The down part came afterward. When I got home, I was up for a little while and then all of a sudden, I was scared,” recalls Pedersen. “There’s nobody there now to watch over you, and tell you what to do.”

Being a survivor requires creating a new definition of “normal,” which can often produce just as many questions as the diagnosis. At home in Louisiana, Pedersen took a hormonal therapy that, over the next several months, caused terrible hip and joint pain. She tried a few exercise classes, only to be left exhausted for hours afterward.

“That scared me,” she says. “I thought, ‘What’s wrong with me?’ I was scared to do anything else.”

Research shows that exercise can improve survivors’ quality of life and decrease the risk that cancer will recur. However, the physical stresses coupled with mental anxiety about the cause of her pains led Pedersen to stop exercising altogether.

Then she met Susan Gilchrist, M.D., a cardiologist and associate professor of Clinical Cancer Prevention. Gilchrist runs MD Anderson’s new Healthy Heart program, which helps patients monitor and maintain heart health during and after cancer treatment through personalized, evidence-based exercise prescriptions.

“One of the things we have found, especially with breast cancer patients, is the leading cause of death in these patients is actually heart disease – not breast cancer,” says Gilchrist.

The first step in the program is a consultation with Gilchrist and an exercise physiologist to discuss the patient’s concerns, goals and needs.

“A lot of my patients are worried about their health after cancer. They don’t know what they can and cannot do,” Gilchrist says. “And so as a cardiologist, I can provide in-depth discussions regarding their heart health and the right amount of exercise for them.”

Participants then complete a cardiopulmonary exercise test. It’s similar to what professional athletes might do to optimize their training, complete with heart and oxygen monitors. This allows Gilchrist to assess the health of a patient’s heart and lungs, and objectively determine their capacity for exercise.

“I want each of my patients to feel like they are a professional athlete in my program,” she says.

Pedersen was afraid she wouldn’t be able to complete the test, but she was surprised at her own abilities and reassured by the results.

“I never broke a sweat. I wasn’t breathing heavily. It just really surprised me. My heart and lungs came out great.”

Every cancer patient undergoes different treatments, and every individual has a different fitness history. Therefore, Gilchrist analyzes each patient’s current status and his or her needs going forward in order to reduce any existing heart-risk factors.

“It’s reassuring to patients to have an exercise test, review their heart health, and come up with a strategy and exercise training regimen that’s right for them,” she says.

Gilchrist’s prescriptions are tailored to meet the individual needs of each patient, whether that means more focus on weight loss or rebuilding muscle mass. Each prescription lists detailed goals for both exercise volume and intensity, and is based on regimens proven to be successful in prior scientific studies.

Gilchrist, a former collegiate and professional tennis player, has always been committed to maintaining peak physical fitness.

She carried this determination with her into medical school when her tennis career was ended by a torn rotator cuff.

“I always had inspirations to be a doctor after my tennis career,” says Gilchrist. “Cardiology is a great fit for me. I became interested in cancer patients mainly because there was no one thinking about how they might be at risk for heart disease. I feel like I’m one of the few cardiologists in the country really pounding the cancer community about the need to keep hearts healthy, especially for breast cancer patients.”

Pedersen now completes 160 minutes of moderate-intensity cardio each week, in addition to three days of conditioning such as yoga or swimming. She bought a treadmill, which she uses daily, and does water aerobics in her pool with friends.

After meeting Gilchrist just a few months ago, her energy and outlook have markedly improved.

“I feel positive,” says Pedersen. “I don’t feel like I’m in limbo anymore. I’m heading forward and leaving all that behind. I’m normal. It’s like they told me, ‘Yes, you’re normal!’”