Marcia McFayden, a retired elementary school computer teacher, came to Memorial Sloan Kettering Cancer Center (MSK) determined to recover her health when she was diagnosed with stage 1 breast cancer.
During her successful treatment, Marcia also set a new goal for herself: She wanted to live a healthier life and prevent cancer from coming back.
That goal is one of the pillars of the MSK Healthy Living program, which aims to help people live their best lives during and after cancer treatment.
The program brings together all the resources of MSK to help a patient with nutrition and exercise; integrative medicine, such as acupuncture and massage; support for mental, emotional, and spiritual well-being; sexual health, fertility, and body image; sleep; financial health; and many other issues.
A Personal, Customized Plan for People With Breast Cancer
The program begins with a patient answering a comprehensive questionnaire. “Our questionnaire was created and scientifically validated to find out what’s most important to a person’s health and well-being, across every aspect of their life,” explains program leader Neil Iyengar, MD, a medical oncologist who cares for people with breast cancer and a renowned researcher on the relationship between diet, exercise, and cancer.
The answers to the questions are used to create a customized plan that is unique to each person in the program.
Breast cancer oncologist Dr. Neil Iyengar leads the MSK Healthy Living program.
“Too often,” Dr Iyengar explains, “people facing cancer are given broad, generic recommendations that end up forcing the patient to figure out what they should eat, what kind of exercises they should do, and where they can get counseling for emotional well-being and other needs.”
In contrast, the MSK Healthy Living program makes patients’ lives simpler by giving them a customized plan — and a dedicated team to be with them every step of the way.
“After we give a patient their personal plan, a Nurse Navigator discusses it with the patient,” says Nurse Leader Andrea Smith, MSN, RN, who helps administer the program. “Together they decide on the MSK services and resources that are right for the patient, and the Nurse Navigator makes the appointments and ensures everything is running smoothly.”
So far, over 645 people being cared for at MSK have participated in the program—including Marcia.
After a few months in the MSK Healthy Living program, the patient completes the questionnaire again, to see if their needs have evolved. Dr. Iyengar explains: “One of the foundations of the program is to tailor the care specifically to what’s right for the patient. As that person moves through different phases of treatment and recovery, the program adapts accordingly.” More than 365 patients so far have had a second plan generated at the 6-month mark.
Again, a Healthy Living team member is on hand to help. “After a patient has been in the program a few months, they are assigned a second person, called a nurse practitioner,” says Nurse Smith. “Together with the patient, they map out the best course of action for the remainder of treatment and beyond.”
Nurse Leader Andrea Smith is a member of the MSK Healthy Living team.
Nurse Smith stresses that the patient’s oncologist and other care team members are always kept in the loop. “It really is a village taking care of each patient,” she concludes.
An MSK Healthy Living Success Story
That was the feeling Marcia had when she began MSK Healthy Living soon after surgery for breast cancer, which is the entry point for all people who participate in the program. “I knew I wanted to live a healthier lifestyle, but I didn’t know where to start. MSK Healthy Living really opened my eyes.”
Nutritional counseling helped bring new insights into healthier eating patterns, “including my beloved bacon,” Marcia says with a laugh. She credits the program with helping her lose 30 pounds, even as she pulled together weddings for two of her four daughters as she underwent treatment.
Another high point for Marcia was her new commitment to exercise. MSK exercise physiologist Kylie Rowed created a personalized plan for Marcia, and they held training sessions over Zoom because of COVID restrictions. “One of the primary goals of exercise during treatment is to help minimize some of the common side effects from both cancer and the therapies used to treat it,” Kylie explains. “Research has shown that exercise can help.”
Kylie also stresses the mental health benefits that exercise has been proven to provide. “Aerobic exercise specifically — like walking, running, the elliptical trainer, or swimming — has been shown to improve mental health, such as decreasing anxiety and depression.”
MSK exercise physiologist Kylie Rowed
A bonus was the bond that developed between the two women. “She’s absolutely wonderful,” says Kylie of Marcia, “and her commitment was really inspiring.” Marcia calls Kylie “my baby,” and thanks her for devising an exercise program to help with nagging knee pain.
Through MSK Healthy Living, Marcia also took part in counseling sessions with MSK social workers and other people diagnosed with breast cancer. She recalls that “being there with other ladies going through situations similar to me was so beneficial.” She adds, “It helped me understand things that might block me from achieving my goals and really helped my mental and emotional health.”
She also credits her supportive family, saying: “My best friend, who is the father of my children, came to every chemo session with me and he would wait no matter how long it took. One of my daughters also took family leave to help me.”
She continues: “My spiritual health was also encouraged through the program. I was able to speak to a chaplain who, along with my church family, prayed with me and for me.”
Evidence-Based Program for Diet and Exercise
Dr. Iyengar believes the MSK Healthy Living program is well placed to bring the latest research about lifestyle interventions to people with cancer when they need them most.
He explains that “MSK is a pioneer in research in fields like diet, exercise, and cancer, including our Exercise Oncology Service, one of the first in the country.” That means, he continues, that the “MSK Healthy Living program is evidence-based and built on principles that have been tested and proved in rigorous research.”
Among many examples is starting early in a patient’s treatment, right after surgery. Members of the MSK Healthy Living team, including breast oncologist Sherry Shen, MD, studied the impact of providing exercise and other lifestyle interventions to participants in the Healthy Living program early during their breast cancer treatment. The team found that participants reported improvements in emotional and physical outcomes, and that exercise slowed declines in quality of life during cancer treatment. The results were reported in June 2023 at the American Society of Clinical Oncology Annual Meeting, the country’s premier cancer conference.
Dr. Iyengar says: “We found that intervening while a patient is still in treatment produces better outcomes, both while they are being treated and years afterward. We really want to help people not just while they are in active treatment but throughout the rest of their life.”
For Marcia and the other people who have benefited from MSK Healthy Living, that is exactly what the doctor ordered.
“The program has been so enlightening for me,” Marcia says. “It’s really made a big difference for my physical and emotional health.”
