A sharp wind is slicing across the reed beds of the Stour Estuary in Dorset and a steady drizzle has begun to fall, but spirits in the Pink Champagne dragon boat are high. The crew launch into a robust team chant.
To my right is Mia, who had breast cancer diagnosed at 32 and is only one month out of reconstructive surgery. On my left is Brenda: aged 65, she is back in the boat after a third bout of cancer and surgery to remove her gall bladder, half her liver and part of her bowel.
“I am freezing and terrified but this is still absolutely wonderful,” she says. “I’ve been down to the boat a couple of times before and was upset that I couldn’t get in. I’m waiting for my surgeon to tell me I can start paddling again. But I feel I’ve turned a corner just being back on the water.”
Pink Champagne is one of a handful of dragon boats in the UK — and part of a worldwide network of 150 — crewed entirely by survivors of breast cancer. These remarkable women teamed up in 2008 after staff at the Royal Bournemouth Hospital recognised that patients needed support after cancer treatment. Last year they finished a creditable 34th out of 73 teams competing in the International Dragon Boat Festival for breast cancer survivors in Toronto.
“As a specialist nurse working in breast cancer, I saw the impact of the disease and treatment on patients’ lives,” says Mary Milne, now chairwoman of Pink Champagne. “We knew there was research showing that exercise had physical, psychological and emotional benefits for cancer patients, but we weren’t offering or recommending anything, partly for fear of doing harm.”
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Healthcare professionals at the hospital sought advice from the nearby Littledown Centre, a large leisure centre run by a non-profit trust. As a result, the Bournemouth After Cancer Survivorship Programme (BACSUP), a free 12-week physical activity programme for men and women, was born three years ago. Dragon-boating was offered as a low-cost option once the course was over. As a result, Bournemouth has found itself in the forefront of a national movement focused on improving life for cancer survivors. It has become one of 17 adult pilot projects funded by Macmillan Cancer Support and the Department of Health as part of the National Cancer Survivorship Initiative (NCSI).
“There’s evidence to suggest that being physically active can help to prevent cancer recurrence and reduce the chance of dying from breast, colorectal [bowel] and prostate cancer,” says Professor Jane Maher, an oncologist and Macmillan’s chief medical officer. “For example, a study in America found that women with breast cancer who walked more than three hours a week at an average pace had lower recurrence rates and better overall survival than those engaged in less exercise. “Research has shown that a cancer diagnosis offers a ‘teachable moment’ when people are more likely to change their behaviour than at any other time in their lives. All this adds up to a compelling case for targeting this group.”
Maher has altered her own approach in the light of the evidence. “I used to tell my patients that if they felt tired, they should give in to it. Now I say they should do what they can during treatment and build up their exercise regime afterwards.”
Even when treatment succeeds, survivors can find themselves with weight gain, osteoporosis, fatigue, depression, anxiety and loss of confidence. Women with breast cancer may also experience hot flushes and lymphoedema, a disabling build-up of fluid in the upper arm. As figures from the BACSUP pilot show, a well-planned exercise programme can bring spectacular results. Of the 200 breast, colon and skin cancer patients involved, 59 per cent lost weight, 94 per cent said they felt less tired, 97 per cent reported improved wellbeing and all felt that their self-image had been boosted.
Cardiovascular fitness improved and blood pressure dropped in nine out of ten of the patients who had recorded high readings. As a result, BH Live, which operates the Littledown Centre, has received funding to run a similar programme for another 250 patients.
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“The course costs just £200 a patient to run, compared with between £120 and £180 for a ten-minute follow-up with a consultant,” says Dexter Perry, consultant surgeon at the Royal Bournemouth Hospital. Any exercise regime for cancer patients and survivors has to be appropriate and safe; vigorous activity is not recommended until about six weeks after surgery.According to a report for the NCSI by a panel of experts: “There is substantial evidence that the physical activity recommendations developed by the Department of Health are sufficient for most cancer survivors — a total of at least 30 minutes a day of moderate-intensity physical activity on five or more days a week. The more physical activity, the greater any benefits.”
One charity, Casting for Recovery (castingforrecovery.co.uk), offers women who have had breast cancer the chance to join others in fly-fishing. But giving survivors an information leaflet for exercise and expecting them to get going is not enough, Maher says.
Male and female BACSUP participants have a thorough health assessment by an exercise professional, who devises a personalised programme for them. As well as 12 weeks of free leisure centre membership with access to fitness classes, swimming pools, a gym and acres of parkland, participants get life coaching, nutrition advice and beauty treatments. Many are still exercising six months later.
“This kind of programme helps with the transition from patient to person,” says Liz Gifford, a clinical nurse specialist in breast cancer. “It helps to restore self-confidence. I have seen changes in the way people hold themselves, walk and speak. They begin to engage in life again.”
The 30 or so members of Pink Champagne prove her point. “After my treatment ended, I felt I’d been dumped by the medical profession and became quite depressed,” admits Christine Bailey, 50. “Now I feel I’ve been reborn.”
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The squad has lost one member to cancer and another is in palliative care. But its powerful team spirit ensures that the social and psychological benefits are huge. “I feel my recovery has been helped by dragon-boating,” says Kate Gross, 40, who had a second mastectomy last year and raced at Toronto two months after finishing chemotherapy. “It’s not like we speak about cancer every week, but it’s good to know everybody understood what I was going through.”
Pink Champagne’s patron, Dexter Perry, wants more health authorities to develop a holistic approach to cancer management: “After a heart attack, rehabilitation is more or less compulsory. It should be the same for cancer.”
To find out more about activity in your area, go to nhs.uk/ letsgetmoving or, in Scotland, ouractivenation.co.uk