Anchorage Daily News

Treadmills, dumbbells, weight machines -- this could be any gym, anywhere. The men and women in sweats, T-shirts and tennies could be fitness buffs anywhere too.

Don't they wish.

This is one gym nobody wants to be a member of. It's inside the Providence Cancer Center, and everyone working out is either undergoing cancer treatment or recovering from it.

For years, oncologists emphasized rest for patients being treated for cancer. Now, along with other components of the cancer-fighting arsenal -- surgery, chemotherapy, radiation -- prescriptions for exercise are becoming increasingly common.

A growing number of studies shows that exercise helps combat some of the symptoms of cancer and side effects of treatment -- nausea, neuropathy, fatigue, muscle wasting, anxiety, insomnia and depression. This is in addition to other research showing people who are physically active, particularly those with breast and prostate cancer, fare better than those who are not.

Health clubs and personal trainers have cancer survivors among their clientele. But the exercise programs at the Providence and Alaska Regional Hospital cancer centers are tailored to cancer-traumatized bodies and staffed with registered nurses and other health-care professionals who do evaluations and design individualized exercise programs. They check labs and scans so they won't be pushing a patient to do something that could do more harm than good. And there are also situations where it's best to hold off entirely.

The Providence gym, the only one devoted entirely to cancer patients, is run by registered nurse Cindy Decker and physical therapist Meaghan Kuklok, both of whom have added cancer-exercise certification to their credentials.

"We have all different kinds of cancers in all different levels of their journey," Decker said. "Some are stage four and are at the place where they're needing to come to an acceptance of transitioning off the planet. Some are disease-free and just want to build their strength back up."

That would be Mina Barzel-Freeman, who's three years out from treatment.

"In a place like this, you have no worries," she said. "You can take your wig off if you need to. You can wear a tank with a breast missing. Even though it's co-ed, it's OK.

"We're so grateful."

Phyllis Webb, who wrapped up her treatments almost a year ago, feels the same.

"I love knowing everybody in here is going through the same thing."

WONDERFUL BONDS

Cancer patients often feel overwhelmed and isolated, especially if they check out of their regular lives to focus on the fight. For them, the oncology rehab gym can be an important social outlet.

"There's this wonderful relationship that goes on in here that you could never set up," Decker said. "They support each other."

Some patients who end up at the gym have never worked out. Some are exercise addicts who try to plow their way through treatment with the same pre-diagnosis routine.

There is such a thing as overdoing it.

"We rein them in hard," Decker said. "When you over-exercise and get your heart rate at high levels for extended periods of time, it stresses your immune system. And the immune system is already being stressed from the chemo and radiation."

Prescribing exercise to fight fatigue may seem counter-intuitive. But it really works, Decker said.

"What a lot of patients report is that the more they sit around and don't do anything, the more fatigued they get. So it's a vicious cycle."

With a doctor's referral, the exercise program at Providence is covered by certain insurance plans and by Medicare. Once that runs out, patients can buy 20-session punch cards for $100.

The rehab gym at Alaska Regional is shared with cardiac and pulmonary rehab patients. Because the center's cancer exercise program is still developing, it's covered by some insurance plans but not yet Medicare, according to Ruth Townsend, director of the Health Management Center.

SPREADING THE WORD

Prescribing exercise for cancer patients isn't new, but the word is still getting out. A group of University of Alaska Anchorage nursing students evaluating the Providence program found that some oncologists tell their patients about the gym, some don't.

Before his first chemo session, Jim Nelson got a tour of the cancer center, and that's how he found out about it. He had a regular athletic club membership at the time, but with a compromised immune system, the oncology gym felt safer, a place he'd be less likely to pick up some bug.

When Barzel-Freeman was going through treatment three years ago, she never heard anything about exercise being beneficial.

"It was something I wanted to do and nobody told me it was OK."

She found out about the gym while serving jury duty with a cancer center administrator.

" 'Have you used the oncology gym?' And I said, 'Oncology gym? You're kidding. I've been looking for something like this.' "

If Barzel-Freeman had known about exercise being beneficial at the time she was getting treatment, she thinks it could have saved her a lot of grief.

"I had breast cancer," she said, "so I got a certain combination of chemo medicine that affected my joints, and that included my hips, my knees and ankles. And the bottoms of my feet.

"I used to walk the Coastal Trail pretty actively, prior. And then the first time after chemo I went back, my knees gave out on me. I fell. I had nothing to strengthen them during chemo or radiation."

Trying on her own to get back to what she calls her "new norm," she kept hurting herself.

"Coming here, they understand your limitations and they build you up to your best potential," she said.

Plus she appreciates the camaraderie and support.

"It's an emotional time besides physical time. For some of us, it's an unknown still. We don't know what's going to be next."

Find Debra McKinney online at adn.com/contact/dmckinney.

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