S5 Ep11: Fran on the benefits of exercise with cancer

In this episode, Laura talks to Fran, a cancer exercise and rehabilitation specialist.

Fran speaks about her diagnosis of secondary breast cancer at the age of just 25 years old. She tells Laura about how she got back to exercising in incredible time after her surgery, and talks about the importance of 'prehab' before treatment. Fran also describes the work she does with other cancer patients focusing on exercise and strength-training, and lists the benefits of physical activity not only on the body, but also the mind.

You can train with Fran at One Step Training, or follow her on Instagram @franwhitfield

We’re Breast Cancer Now, the research and support charity. However you’re experiencing breast cancer, we’re here. For information and support, visit our website or phone our free helpline on 0808 800 6000 (UK only).

You can also watch this episode on YouTube.

Key Topics:
0:24 Laura introduces Fran
1:29 Fran's breast cancer diagnoses
5:13 How Fran dealt with an alarming prognosis
7:32 Self-advocating for your health
8:32 Dealing with a breast cancer diagnosis during the COVID-19 pandemic
11:01 Side effects of treatment
13:38 Fran's background in fitness
17:39 Managing an eating disorder with breast cancer
25:01 Continuing exercise throughout chemotherapy and other treatment for breast cancer
34:43 Fran's work as a cancer exercise specialist
40:02 How Fran blamed her body for breast cancer
41:34 The mental health benefits of exercise and training
43:03 Fran explains 'one step training'
45:51 The role of exercise in reducing recurrence of breast cancer
49:08 How can anyone begin to do physical training?
55:57 What needs to change in breast cancer?

Episode Transcript

(00:00):
This podcast contains the personal stories,opinions and experiences of its speakers, rather

(00:05):
than those of Breast Cancer Now. Welcome to theBreast Cancer Now podcast, providing support and
information to anyone affected by breast cancer.I'm Laura Price and I'm the host of the Breast
Cancer Now podcast. I'm a food writer and authorand I live with secondary breast cancer. Today on
the podcast we are talking to Fran Whitfield, acancer exercise and rehab specialist with an

(00:30):
extraordinary story. Fran was diagnosed withsecondary breast cancer when she was just 25 years
old. She was told she had just two years to live.Nearly four years later, Fran is 29 years old and
has responded incredibly well to her treatment.She's now working to help other people with cancer
to exercise their way to better health and tobecome stronger both physically and mentally.

(00:54):
Some of you may have heard of Fran before becauseshe featured on the Breast Cancer Now podcast in
2021. I was so struck by her incredible strengthwhich helped me through my own secondary
diagnosis in 2022. Fran and I met at one of thebrilliant get-togethers she does for young women
with breast cancer at Future Dreams House, theBreast Cancer Support Centre in London. She

(01:15):
inspired me to take up weightlifting after my ownmajor surgery last year and that has been a real
game changer for me. Fran, thank you so much forjoining us on the Breast Cancer Now podcast. Thank
you very much for having me. It's really great tohave you here. Thank you. So could you start by
telling the listeners about your diagnosis andthe treatment you've had? Yeah, of course. So I

(01:36):
actually originally found my lump, strangelyabout five years to the day, so like five years to
this month. I found my lump when I was 24 and then Iwent to the GP as an emergency appointment. She
confirmed that the lump was there and then sent meto the the doctor that I saw said to me that because

(01:59):
of my age it was most likely going to be a hormonallump that I didn't need a scan and then sent me on my
way with no further information anything likethat. So for 18 months I didn't realise that the the
lump itself how large it was growing because it wasgrowing inwards until July 2020 when a dimple

(02:22):
appeared and I knew that that wasn't a good signbecause obviously I'd read information before in
my blind panic the night before the GPappointment. So instantly booked in to get
testing done and three days later after having abiopsy done they confirmed that it was breast
cancer and thankfully the doctor that I saw at thetime as a kind of precaution just decided to do a

(02:48):
full body head to toe PET scan and it was pretty muchmy saving grace that he did because then they then
discovered that I had a brain tumor on that PETscan. So that was the kickstart of my treatment
within two weeks of finding that out then they thendid the surgery to remove the tumor did all the

(03:08):
testing confirmed that it was the same genetics ofthe breast so that instantly they made me stage
four. So that was in the August 2020 and then Irecovered from the surgery about four weeks and
then I started chemo so I had six months of chemofrom the September 2020 through to March 2021 and
then after the chemo then they did theradiotherapy to my skull just to make sure that it

(03:32):
wouldn't come back at a 50 to 50 chance essentiallyof the tumor coming back if I didn't have it. So I had
the radiotherapy, cyber knife radiotherapywhich is a great new technique that they've got now
and had that done and then I've been on medicationever since so I've been on a bemoscyclybe I did have
Zolodex but I've had to stop that now due to someside effects that I was getting and then Tamoxifen

(03:55):
as well. So I've been on that since May 2021 yeah Igot my all clear in the September 2021 so actually
since doing the podcast here last time yeah I gotthe all clear and I've been NED since then. NED is no

(04:15):
evidence of disease. Yeah wow so I've had noevidence of disease since September 2021. That's
amazing. Yeah so I did originally go from the twoyear, yeah as you mentioned the two year prognosis
but I quickly moved hospitals after I got thatdiagnosis was not going to have someone tell me
that I had two years to live and put me on palliativecare and then I then moved to the Royal Marsden

(04:39):
which is where I am now and then yeah I've got the allclear and then I turned 30 this year so kind of went
from going I'm not gonna see my 30th birthdayremember saying that to my mum the day that we found
out the news to yeah fingers crossed that's good Iget my 30th birthday this year. And I met you on your

(05:00):
28th birthday. Do you remember you saying thenlike I was not meant to see this day? No. And you know
now you're turning 30 this year so it's absolutelyincredible but just going back to that being told
that you only had two years to live how did that feeland how did you deal with that mentally? I think at

(05:25):
first I was inevitably you know you're numb you'reshocked didn't really know how to respond to
someone telling me that I only was going topotentially see my 27th birthday and nothing more
but very quickly I then felt a lot of anger towardsthat situation and not so much the situation
itself but anger towards someone telling me thatthat they were deciding that I had that long to live

(05:49):
whereas I wanted to try everything that I could tocounteract that and I wanted to be put on treatment
and I wanted to try everything that I could that wasout there and that's exactly what we did we moved
and then my new oncologist said to me I'm preparedto put you through everything if you're prepared
to take it and I was like hit me with it let's go andI'll do it which we did and now I'm incredibly

(06:10):
thankful that I did do that and I didn't just kind ofsuccumb to the diagnosis that I had and I was my own
self-advocate and I pushed for it and I believed inmyself as well which I think was a huge thing so even
in that moment of complete terror and fear I knewthat I had the fire in my gut to try as much as I could I

(06:33):
wanted to see my 30th essentially that's all Iwanted to do in that kind of in that moment I was like
everyone you know my friends are celebrated I'veheld a friends and they're celebrating their 30th
and I want to do that I want to have the party and yeahso it was a it was the anger that kind of got me
through it I would say I sort of internalised thatin as fuel yeah fire to actually go through the

(06:57):
fight for it I mean I really hope that that willinspire people given a similarly bleak um
prognosis to fight against that and and obviouslythat's not always possible and sometimes it is
realistic but to be told that in the first instanceby a doctor and to be not offered any hope yeah yeah

(07:18):
at any age is horrendous but at 25 years old like youknow that's the beginning of your life and yeah um
yeah hopefully your story will give a lot of peoplea lot of hope yeah I hope so and I think a kind of you
know you can I'm trying to prove that you can be yourown self-advocate I think a lot of people are quite
fearful of standing up and saying actually no Idon't want to do that and I do want a second opinion

(07:45):
or a lot of people don't actually know that secondopinions exist so I know that I've spoken to a lot of
women that have read my story that now have gone gotsecond opinions or have said actually no I don't
want that or I you know I've heard of this othertreatment plan can we investigate this and
they're actually have an input in terms of whattheir treatment is and you're well within your

(08:07):
right to do that and as you say yeah sometimes it'snot possible but if you feel like it is possible or
you just want to explore it then 100% do that andhave those discussions with your oncologist or
get those second opinions if you're not findingthat you're gelling with the team that you have
because it's incredibly important that you havethe backing of your oncology team behind you all

(08:27):
the way and that you feel comfortable when youtrust them as well absolutely yeah and and all of
this was during the COVID pandemic and lockdownsof 2020 how was that did you have to go through it all
alone uh yeah yeah so my brain surgery was probablythe worst one I literally just had to get dropped
off outside the hospital and then go in by myselfwasn't allowed anyone to come in with me so it was

(08:50):
literally say you got buys at the door and then walkin I wasn't I didn't know if I was going to see my
family again then waking up on the other sideobviously relief that I'm you know still alive but
then having to recover from that alone that waspretty dark I would say there was you know some dark
moments in that but that actually gave me kind ofthe the instigation to get out I wanted to leave I

(09:15):
wanted to get out of the hospital as soon as I couldso I could see my family I knew that my mum would be
pacing up and down and beside herself she was so Iknew that I needed to get out to see her and to see the
rest of my family and it did help I was supposed to bein hospital for about a week and then I left less
than 48 hours after my surgery don't recommendthat to you know I'm not saying that everyone will

(09:37):
do that and I obviously I got the clear to go I didn'tself discharge but it was just I wanted to be able to
prove to the physio that I could get up and I couldstand and that you know he wanted me to walk up and
down the stairs so I was like well I walk up and downthe stairs as soon as I can walk up the stairs and it
was because of the fact that I knew that my familywas at home and that I wasn't able to see them that

(09:58):
kept me going with that and you know proving to themthat I could shower myself and do laps around the
ward and then I knew that I had more treatmentcoming up as well and in my mindset I was kind of like
right get me home get me rehabbed I need to rehabbecause I've got chemo coming up soon so but yeah it
was it was tough I know that there's lots of peoplethat were going through treatment during COVID as

(10:22):
well and experienced all the the funds ofshielding and not being able to go and get yourself
a pint of milk if you want to and those sorts ofthings and relying on everyone else around you as
well and for me it was very frustrating I'm veryindependent person so having to rely on everyone
around me was very difficult I didn't really have achoice I don't know anything different you know I
only know being on my own I only know having chemo bymyself I don't know what it's like to have a chemo

(10:46):
friend and you know as they have in the leaflets andthings like that so kind of now I'm very much now
that I can have people come in with me I find it quitestrange if my mom wants to come into the hospital
with me I'm like no it's fine stay at home I don'tmind and has there been no ongoing effects after
your brain surgery and your brain tumor on your youknow cognitively? Cognitively is kind of a

(11:11):
different if it's a difficult one I think like mymemory is shocking but they don't know whether
that's because of the radiotherapy that I had orthe fact of being in a medically induced menopause
and there's so many different things that it couldbe that make my memory as horrendous as it is so I do
have to write notes for everything if someone asksme to do something I have to write it down otherwise

(11:33):
it will literally go out my mind or if I open an emailand I don't reply to it then it's like it's never
existed which is why I know that it was quite hard toget hold of me for this because I will read an email
and then if I don't reply to it then I will forgetthat it's even in my inbox I have had long-standing
effects of like nerve damage so I've got nervedamage on the right side of my face not visually

(11:57):
thankfully but by touch so if I like scratch thetemple on the right side of my face it feels like
someone's putting needles in my eye and thingslike that so and it's lessened over time but it's at
the point now that it is how it will always be at thebeginning it was unbearable to you know put
moisturizer on my face or to wash my face and thingslike that because as soon as I would touch the right

(12:21):
side of my face then I would then get these reallysharp pains in my eye and I had a lot of numbness
around my mouth on the right side and I wasn't ableto eat because I wasn't able to open my mouth
because they have to cut through all of the chewingmuscles essentially so that has recovered but I
still can't like I still you know if I go to take alarge mouth for I'm like oh my jaw so it's you know I

(12:47):
still can't fully open my mouth like I used to beable to or and yeah I do have long-standing nerve
damage but in terms of the cognitive thankfullyactually my surgeon did an incredible job and in
terms of the radiotherapy because it wascyberknife they managed to miss the optic nerve

(13:09):
which is what they said that if I had the other typethe generalized radiotherapy I would have gone
blind in my right eye because of the location ofwhere the tumor was and where they would have had to
cover but thankfully due to these newtechnologies they're able to pinpoint exactly
where it is and so I've kept my sight in my right eyeso that was a huge win well yeah and that's all
thanks to research and all the advancements we'vehad in the last you know a few years yeah wow thanks

(13:36):
thanks to that yeah and just tell us a little bitabout your your background before your diagnosis
in terms of exercise you talked about training andracing but what were you racing I know you
mentioned Ironman yeah so um originally my kind ofsporting background I suppose started off
weightlifting um so when I went to university I wasjust studying psychology nothing sport related

(13:58):
at all and um kind of funnily actually I hated PE as achild um I was very self-conscious I was kind of a
bit of the dumpy one in school and even though I wasquite good at sport I hated being in PE I hated being
exposed and being in front of kids and shorts and at-shirt and made to do sports so I used to forge
notes from my mum and um so they didn't have to takepart in PE and I used to go in with like tape to tape up

(14:23):
my fingers and pretend that I'd sprained a fingeror these kind of things I never had to actually do PE
and then it all kind of then changed when I went touniversity um because actually during my first
year of university I became anorexic so I had aneating disorder and um I had to leave university to

(14:43):
then recover from that um and I picked upweightlifting and that really helped with my
recovery because you know it's kind of cliche as itsounds I did go from the mindset of wanting to be
skinny to then wanting to be strong and it yeah andit was a complete game changer for me so I was kind of
and in those days as well it was which doesn't it'snot really that long ago but um you wouldn't see

(15:07):
girls in the weightlifting kind of area in the gym Iwas still very new at that time so um a lot of my
friends used to ask to come along with me and thensee what I was doing and they knew that I was lifting
weights and they wanted to kind of get involvedlike female friends and so I then started to train
them and then that's when I then found the love fortraining other people and seeing them grow and you

(15:29):
know flourish in terms of their self-esteem andconfidence um and that's how I then got into the
fitness industry ironically I then decided to dothis challenge for cancer research um in memory of
my grandparents um where I would do an event everymonth for a year and then finish with the Ironman
for anyone who is not aware what is an Ironman yeahso um it's a triathlon essentially um but it's an

(15:58):
insane triathlon extreme um yeah it's an extremetriathlon yeah um and you've got so after your swim
um which is a 4k swim I want to say 3.9 um you then do180 kilometers on the bike and then you finish with
the marathon casual yeah yeah so that was the aim umand it was going very well but thank you COVID and

(16:21):
then obviously all of my diagnosis I actuallyhaven't finished it um but you know never say never
but I was doing all of my challenges so I thenstarted to race um and then so it just kind of
started off with doing some 10ks and kind of at thebeginning like the first like month and then I was
like oh you know what I'll push myself a little bitmore so then I did the Richmond duathlon and I never

(16:45):
I hadn't ridden a bike since I was about 12 years oldin in Centre Park so that was an interesting one
getting like you know my first kind of road bike andthen I was like yeah I can do a duathlon that's fine
take out Richmond Hill multiple times yeah andthen it just kind of grew from there really so every
month I was doing either a running or a duathlon or atriathlon and then endurance kind of endurance

(17:07):
sport I suppose became my thing in that time thatobviously with the end goal of being um being
Ironman but weightlifting still always been mypassion and that's what I then got back into now but
with a combination so now I'm a crossfitter so Ikind of have combined the endurance and the
cardiovascular stuff with the weightlifting andwith other crazy things thrown in the mix as anyone

(17:31):
that sees crossfitters do yeah well understandI've got so many questions to ask you relating to
that um but first I just wanted to ask is I didn'tknow about your eating disorder oh yeah did you I
mean you had anorexia when you're at universityhas has all of this allowed you to have a sustained
recovery from that or is it something that it stillaffects you oh yeah um so I would say that before I

(17:58):
was diagnosed with cancer things were probablygood um they always say that you know having an
eating disorder it will never go away it'll alwayslive with you it's whether you can manage it and my
dietician at the time she was incredible and shedescribed it as having like the gremlin in your
shoulder and it's whether you listen to thegremlin and I learned very well to not listen to the

(18:21):
gremlin kind of in my early 20s and going forwardbut I would say that since diagnosis and going
through treatment it becomes very difficultbecause you know when you're pumped with steroids
and different medications you put on um hormonalmedication that then puts you into a medical
menopause and then I am 15 kilos heavier thanbefore I started my cancer treatment now

(18:47):
admittedly quite a lot of that is because I alsothen changed my training so I went into CrossFit
and I have gained a lot more muscle mass howeverthere is my body shape is completely different my
hips are so much bigger than they used to be um I'mlike three dress sizes bigger than I used to be all
those things are massive triggers for me um and Ihad a lot of low moments going through treatment

(19:13):
and um where I really struggled seeing the weightgo on I got back into the habit of weighing myself
which wasn't helped by the fact that when youobviously go in for treatment they weigh you at
there so that started to trigger me I then startedto weigh myself at home so I did do things to help so I
said to my team if you weigh me you cannot read outthe number I don't want to see the number on the

(19:39):
scale but also the nurse can't kind of say it whileshe's writing it down I don't want to know I can't
know which I imagine is very hard given that you youusually get a different member of staff every time
you go to the hospital and you get passed between somany different people yeah so if it was if it was
someone new or someone that I hadn't had before Iwould then just say oh by the way can you not say the

(19:59):
number I'm not going to look and they they know theykind of I think they get it quite a lot so I never had
anyone kind of go oh why is that or anything you knowit was oh yeah yeah that's fine but I also found that
my way of if I lose control in other aspects of mylife and this is very common with people with
eating disorders when you find that you are losingcontrol the only thing that you feel like you can

(20:21):
control is your weight and your diet and yourexercise and so that's where the gremlin I suppose
as it was was a lot harder to not listen to because Iwas I had no control over my cancer or my treatment
plan and what it was doing to my body so in my mind theonly thing that I could control was what's on my

(20:44):
plate and what I eat and what I don't eatessentially and then trying to control my weight
which I then discovered actually I have zerocontrol over when you're going through treatment
as well because there's so many other factors thatcome into it but it was yeah it was very hard to kind
of know in my mind I really need to eat well and eatenough food to keep my body healthy to withstand

(21:11):
the treatment that's going on but then also withhaving that background not relapse and not kind of
think oh well I'm another kilo heavier anotherkilo or I shouldn't eat that then okay let's slash
my calories down and you know I'd be lying if I saidit didn't happen yes it did there were times where I
ate significantly less than what I should do but Igot help for it and I think that's a big thing like I

(21:36):
as soon as started to see that happen I reached out Itold my team about it I told my nurse about it they
know my history they know you know everything to dowith my anorexia and the disorder that I had I was
very open with them about that from the beginningso I worked with a dietician and then kind of
gradually got you know a little less panickedabout the whole weight aspect of it I still

(22:04):
fluctuate now in terms of my mental health with it Istill struggle you know I'd be lying if I said that
I'm absolutely fine with it no I'm not but there areways that you can deal with it and I think
particularly now in the sport that I'm in thatreally helps because we eat a lot and I'm you know

(22:25):
I'm in the gym with other girls who are eating a lotand so I see them eating that and knowing that
that's fueling them for what we're about to do whenwe train and also it helps me in my job now to educate
people that are going through cancer treatmentthat you know you you do still need to eat because I
see it but then you know I kind of need to practicewhat I preach right because I tell my clients you

(22:50):
need to eat to be able to maintain your muscle massand these kind of things it sort of helps in some
ways because I then need to be like oh actually wellI'm telling her that's why am I not doing it myself
you know thank you for being honest about the factthat you still struggle with it because I'm sure
that will resonate with people and also I'm reallypleased to know that your team have been

(23:11):
supportive around that because you know from whatI remember from having chemo my advice from my
oncologist was eat as much food as you can becauseyour body needs it and I can imagine that if you have
an eating disorder that's really hard to hear andreally hard to do yeah yeah especially when some of
the advice is like eat whatever you want just youknow whatever you fancy eat cake and you're like I

(23:32):
don't want to eat the cake yeah I got it through whenI had the surgery as well because when your body is
recovering from surgery if you don't eat and youdon't you know feel yourself then actually your
recovery is going to be significantly slower thanwhat it would be if you maintain that healthy diet
yeah you know and also trust that things willchange because I know with me I put on weight when I

(23:58):
want to have my secondary diagnosis and started aload of drugs that basically did things to my
hormones and my you know put me into even more of amenopause than I was before but that regulated
over time and I kept eating lots and kept eatingwell so yeah um yeah but also just you talked to your
team about these things as well yeah I'm gareth theeditor of vita magazine vita is breast cancer

(24:25):
nerves magazine for anyone affected by breastcancer it's full of inspiring real-life stories
expert tips on coping with the effects of breastcancer and articles on health and well-being in
our new spring issue you can read about a mother anddaughter who were both diagnosed with breast
cancer 12 years apart find out the latest in breastcancer research get tips on coping with fatigue

(24:50):
read about the benefits of getting outdoors andmuch more subscribe to vita now at
breastcancenow.org forward slash vita so back toexercise you're a personal trainer you were a
personal trainer before you got your diagnosisbut you incredibly kept on exercising and

(25:10):
training throughout your chemo and yourtreatment tell us about that yeah um yeah I kind of
got a bit of a reputation I think for being slightlynuts um but actually all I did was it was sensible
and it wasn't nuts I think just to the outside worldit probably looked it um but um yeah so I yeah been a

(25:33):
coach for number of years now god maybe eight yearswhen I went started to go through chemo I knew in
myself just from the kind of the the backgroundthat I had um in terms of my like my job that I uh the
importance that it would have for me to be able tokeep exercising one for fatigue I knew that was a

(26:00):
big thing anyway um but then also I knew that one ofthe side effects from chemo as I said was muscle
wastage um because for various different reasonsone the drug itself but then also two because you
become more sedentary so the more sedentary we arethe more prone we become to then losing the muscle
that we've got because obviously we're notworking them those two things pretty much

(26:22):
terrified me I would say like I didn't want to befatigued I wanted to still be able to coach my
clients as much as I could do you know I wasself-employed as well so from a financial
perspective it was tough and obviously we hadCOVID anyway but I still had clients online that I
could still try and coach and um be there on theother side of the laptop but then also before I went

(26:45):
into treatment I was the fittest I'd ever been youknow I was obviously training for the Iron Man and
everything and I loved my body for the first time ina long time and I loved what it was doing and I loved
the you know the strength that it had and thefitness that it had and I didn't want to lose all of
that and I knew that I was going to lose thatinevitably some of it but I wanted to try and keep as

(27:06):
much of that as I could and in my head I was like wellthere must be some sort of correlation between if I
try and keep up my strength and my fitness togetting through this treatment and to try and get
it through it in uh you know a safe but healthy way asyou can probably tell I am a geek and I do my research
and I knew what these drugs were kind of they weregoing into me and everything and I knew what it

(27:27):
would do to my body and I knew the sort of the sideeffects it can have on your heart and things like
that so it helped me mentally to write myself a bitof a training program and to think okay I'm going to
try and stick to this and do this a couple times aweek that was around kind of the the three to four
day window when I might feel a little bit rubbish umand I very much learned quickly and the hard way um

(27:53):
of how you need to kind of reserve your energy whenyou're going through chemo so my first chemo
session I came out thinking that I was superwomanthink the amount of steroids that I had I came home
and I was like I actually feel great like this isfine I don't know what this like chat about EC is I
don't know what they've had and I haven't what'sEC? EC are so yeah yeah EC yeah sorry yeah and so when

(28:18):
I came home from my first one of that I feltabsolutely fine the following day my mom came down
to visit and we went on a 8k walk came home I did aworkout I did one of my sessions I was you know doing
some push-ups a bit on the bike some lunges variousdifferent things she thought I'd lost the plot um
and then the following day I went to Sainsbury'sand I had to get an Uber home And that shocked me

(28:42):
because I've never had to use public transport tokind of, you know, get home from the shops, right?
It's like 15 minutes around the corner from myhouse. So I very quickly learned that's not what
you do. You don't have chemo and then exercise tothat level. So then the second time I then had it,
felt a little bit worse as you do with these,obviously, that cumulative, that's the one. But I

(29:09):
still moved. I would say I would moved rather thanput myself through that level of intensity that I
did before. So I still kept up with kind of walking,but to a lesser of degree, I didn't go for the kind of
eight, nine K. I use my resistance bands at home totry and still preserve, as but it was kind of an

(29:35):
experiment for me. I was changing the program as Iwas going through it, and I was writing different
things and trying different ways of stillexercising, but always keeping some energy in the
tank. And that's why I always say to everyone is youstill want to move and you still want to do some
activity and exercise, but you always want to do itknowing that you've got energy reserves in the

(29:56):
tank. If you don't, then that's what's then goingto cause you to then get the uber home from
Sainsbury's the next day. From there, once I'dkind of got through the EC and then I went on to
Paxiltaxal, it became a little bit better in termsof my nausea and things like that. And I was
recovering a little bit quicker than I was from theEC before. So that's when I then started to do more

(30:21):
kind of like intensity stuff that I was used to,still very much to a less degree than what I had done
before. But I never fatigued in chemo. That was thenumber one thing that I never experienced. And so
from that is that there must be some sort ofcorrelation between the fact that I've kept up my
exercise and I'm moving a lot. And what they say isactually true. The fact that, you know, they do say

(30:50):
if you try and move, then movement helps withfatigue, not just in cancer, but in general kind
of, you know, other health conditions that causefatigue movement can help whether that be a 10
minute walk, you know, just something to try andkickstart because you can go on a downward spiral
if you feel fatigue. So you sit down, you don'tmove, then you feel even more tired. So you sit

(31:10):
down, you don't move. And you're kind of always onthis downward spiral unless you break it. And when
I then went through the six months of chemo and Icame out the other side not having experienced
fatigue, but knowing that I had kept up with myexercise all the way through, it was like, there
must be something to do with that. Also in terms oflike my strength when I actually was allowed to go

(31:31):
back into the gym and gyms reopened after COVID.And I went back into weightlifting. Yeah, I was
weaker than what I was before, but that was alwaysgoing to happen. But I could still lift. I knew that
I had a long way to go to where I was, you know,before, but I was actually quite surprised and
pleasantly surprised at the amount of muscle massthat I'd managed to just maintain. And that was my

(31:54):
aim the whole time going through chemo. I knew thatI wasn't going to get stronger. And that's what I
try and say to, you know, all of my clients as well,like you won't get stronger going through chemo.
We can never think of it as a linear progression.Your aim now is to maintain and that or and to not
drop off as much as you would do if you weren't tomove. I proved to myself that I had done that. So

(32:17):
kind of the experiment, I guess, that I put myselfthrough in those six months proved to myself that
actually exercise works. And then the fact that Ihad such a fantastic outcome of my treatment as
well. And I said to my oncologist when I got my clearresults, because he actually had said himself,
you know, you've, you've constantly moved,you've always, and he was always very pro that he

(32:42):
never wanted me to stop that. And he said, you know,listen to your body. And that's what I did the
entire time. And then when I went when we got theclear results, and I said to him, do you think there
is anything involved in this, the fact that I'vekept moving and I've responded so well to
treatment. And he said yes. And so from there,that's when I was like, right, that's why I've then

(33:05):
gone into the job that I do now. I will never ever saythat exercise is a treatment. It's not a treatment
on its own. You should never view exercise as a curefor cancer. That's not what we're saying. But it
complements the treatments that you will have inthe hospital. And it actually, because of the fact

(33:26):
that it helps you to get through it, and you can staystrong, you can keep your heart healthy when
you're going through chemo. Because of that, itshould be seen and they are starting to actually
view it now as a treatment for cancer, butalongside medical treatment. And the two work
hand in hand, I was determined to not become whatyou see on the films and the TV, which is completely

(33:53):
not what happens anyway. They always get thinner,whereas actually, when you're on chemo, you
always get bloated. And you don't go gray, you gored instead. Yeah. But yeah, I was determined to
not go down that route. But then as it thenprogressed in the six months, I then started to see

(34:14):
the huge benefits that I was having from it. Andthen that's what then led me into qualifying for
what I do now and moving forward with that. It'sabsolutely incredible. I hadn't realized quite
the extent of the amount and the intensity of theexercise you were doing throughout your chemo
treatment. And then to have that resultafterwards and to still be able to lift, you know,

(34:40):
not too different is incredible. So tell us aboutwhat you do now with cancer patients. Yeah. So I
think I was sat in the chemo chair at the time and Iwas like, right, there has got to be some sort of
qualification that I can get because more peopleneed to know about the benefits of exercise when
you are going through cancer treatment. And Ican't just sit here and sort of say like, hello, you

(35:03):
know, I'm an advocate for this, I need to haveactual grounding for it. And then sure enough,
there actually was. So I came across can rehab,which is the qualification that I've got. And it
meant that I could then work with cancer patientsusing exercise. And it's not physio, but it's a

(35:26):
exercise specialist. So in the hour sessions thatI have with them, we exercise as you would do with a
personal trainer. But it's working with someonethat is qualified to be able to exercise knowing
what drugs you're on, what no knowing what surgeryyou've had. And, you know, if you're going through
chemo and you've got a pick line or a port, it'sknowing about what what movements you can and

(35:50):
can't do with those particular things. When I thenstarted to research into this qualification, I
was like, right, that's what I'm going to do. So Istarted studying just before I finished chemo. So
I started, yeah, studying while I was goingthrough treatment. Then when I finished
treatment, then I then ramped up, did all of myexams. And then I qualified kind of around the same

(36:13):
time that I found out that I had the all clear,actually. And that's what I've done ever since. So
since around kind of September 2021, I have been acancer exercise rehabilitation specialist is
actually my formal title. And I love it. The workthat I do, it's rewarding doesn't even do it

(36:35):
justice, I think that, you know, but it's, it isincredible to see the benefits, not just physical
but mental that it exercise has on people whenthey're going through treatment. And a lot of
actually what I do is prehab stuff as well. It's notjust rehabilitation after treatment, but it's

(36:55):
actually prehabbing people before they go intotreatment or before they go into surgery. So I'll
be working with someone that's, for example,going through chemo at the moment. And so our goal
at the moment is, as I've said before, is tomaintain so to try and prevent muscle atrophy, try
and prevent fatigue. But also from a mental healthperspective, it just helps them to feel normal

(37:21):
because they're doing something that is outsideof the hospital and it's outside of the world of
cancer. And it's something that maybe they didbefore or maybe they didn't do before, they might
not have exercised before and this is a new thing tothem. They can feel the benefit of it, they can feel
the benefit of particularly strength trainingand using weights because it makes you feel

(37:43):
powerful. But they do, you know, so I'll be workingwith someone through chemo doing that, but then
knowing that we've got surgery coming up,whatever surgery that might be. So I've got people
at the moment that I'm leading them into having ahysterectomy or and mastectomy. And there's

(38:04):
various different things that we'll be doing. Soif it's mastectomy, we're working a lot on upper
body strength and mobility because your mobilitycan suffer once you've gone through mastectomy
surgery. And there's a massive correlation at themoment, the NHS are now starting to see it, that the
more we prehab patients going into surgery,actually it's more cost effective for them

(38:25):
because their recovery times are quicker, whichmeans they don't have to be an inpatient for as
long. They don't have to be on medications for aslong. So it means that they don't have to get
prescriptions for as long. And so I kind of when Ifirst started my job, it was really hard. It was
really hard to get people to listen and to see theimportance of exercise and to take it seriously.

(38:48):
Whereas now with more research that's coming out,they're actually they're seeing that this is
legit, because it's a win win. And the patientwins, but also the NHS wins because they're not
having to spend as much money in terms of theiraftercare. But then also obviously from the rehab
perspective, I get people that have come to me posttreatment. And it might even be like a year post

(39:13):
treatment, but as you know, like you still haveside effects afterwards. And I still get side
effects of kind of the chemo side of things, likeeven though it was, it was like ages ago. And from
that kind of development, it's that is where youcan then start to rebuild. So I call it the rebuild

(39:34):
because when we're rehabbing, yeah, we can startto build strength again. And then seeing people
start to lift heavier. And when they come back to meweek on week, and then they start to be able to lift
like the heavier dumbbell the next week, theymight be able to do like a couple more reps than they
were able to do the week before. And then justseeing the kind of the little like glint in their

(39:58):
eye, like you can always see it and you know thatthey're starting to believe in themselves again.
And I think that's a huge thing as well is that whenwe go through these kind of terrible diagnosis,
really, you lose your self belief, because youkind of whether you consciously or
subconsciously think it, you kind of think why hasmy body done this to me. And it's very easy to kind of

(40:21):
blame your body for it. And it was something that Italked to my therapist a lot about was the fact that
I kind of blame my body for doing this to me. And thatwas something that I battled with for quite a long
time. And my clients are very open with me, whichI'm really grateful for. And I try and create like

(40:43):
an open space for them to talk about it in thesession. And it's a common theme that I get with a
lot of people that I see is that they don't liketheir bodies anymore, because their body did this
to them. Whereas when you're then going throughthe kind of the training programs that they go
through with me, they can start to accept theirbody again and like their body again, because

(41:07):
their body is actually helping them so much. Itwasn't your body that did this to you. Your body is
actually trying to help you now. We're putting itthrough hell, essentially in terms of these
treatments, but it's still there for you. As youcan tell, I love what I do. I can imagine that the
reward for your mental health as well forimproving someone else's mental health has a

(41:31):
knock on effect to you. So yeah, great job. And alsoit's kind of, we have chats, you know, like they'll
chat to me, they ask me questions. I'm very openwith them and honest with them about my treatment
and what's going on with me. And I think that's alsowhat they love about it as well is the fact that I'm
not just trying to help them with their exerciseand things like that, but I understand it. I've

(41:56):
been through it myself. So it's kind of, I would saylike 75% exercise, 25% therapy sometimes. Or
sometimes it might be like half and half. They'vegot that safe hour where they can talk to me about
anything. And if they've got worries or theirbloods might not have been so good, or maybe
they've got like scam results coming up, like I getthat. I understand the scan ziety as we call it.

(42:20):
It's not just the physical side of things, but it'sthe mental health side of things that I think is so
important. And that's quite a large bit that'smissed, I think, in terms of when you're going
through treatment, like not having that exercisespecialist to go through that with you. But ever
since I qualified, it was always my goal that whenyou're sat in that room and you get that diagnosis,

(42:41):
that you will have an exercise specialist thatwill go through this with you. So I'm just hoping
that I can build up an army. Got it. Well, you'retempting me, but I think I've got too many jobs at
the moment. But I would definitely train with you.So how does someone sign up to be your client? Yeah,

(43:01):
so I've got a website. It's called One StepTraining. The reason behind the name is because I,
when I was going through treatment and peoplesaid, and even now people say to me, how did you get
through it? How do you get through all of this? Youknow, you've from the brain surgery and then the
chemo and like stage four and you're young and da,da, da, like how are you dealing with all of this
mentally? And I was like, to be honest, I've alwayshad the same motto going through treatment and

(43:26):
that's literally taking one step at a time. And Inever thought about the bigger picture or coming
out of it or, you know, what's going to happen in ayear's time or even what's going to happen in a
week's time. I would literally just think, well,what's the next step that I have to do? And whether
that was just go and have a scan, not think about theresult, but have the scan. So at the beginning, I

(43:50):
was like, okay, right, so I've got to go and have anMRI. I'm not going to think about the result of the
MRI. I just know that I've got to go and have an MRI.You have the MRI. What's the next step? Go and see
the oncologist. Obviously, yes, for the results,but I wouldn't think about that. I would just
think, what's the next step? Hospital. That's it.That's all I need to think about. I know that on
Monday morning, I've got to go to the hospital andbreaking it down into really small steps like that

(44:13):
really helped me. And when I started to kind of tellother people about that, then it started to then
help them. And I saw that actually, as simple as itsounds, just a one step at a time, if you actually
properly break it down, it does significantlyhelp. And that's kind of I suppose what inspired
the name for this now is because I try and get myclients to see that as well and patients to see that

(44:42):
that, don't look at the bigger picture in the senseof, okay, you can't do one push-up now. So how are
you going to do 10? Don't think about it like that.Just think the aim is one. The one step, the way that
they're going to get to, is actually doing anincline push-up on a wall. That's your step one.
That's all I want you to do. And they can do that. Soit's like, okay, you can do that. So then we then

(45:05):
build it into stages. So everything always has aone step in front. And you never have to think about
two, three, four, because that's way toooverwhelming for anyone to cope with. And so
that's what inspired the name for this. So I doone-to-ones in London, house visits, and I've got
a space inbox or gym space there that I use. But Ialso see clients all over the world, which is

(45:28):
really pretty cool. Whether you've got bits of kitat home or not doesn't matter. I kind of always
start off my online clients with one piece of kit,and that's just a resistance band. And that's all
they need. So it means that I can access everyonefrom anywhere. Yes, you can find me on
onesteptraining.com. Perfect. And we'll putthose links in the show notes as well. We know there

(45:52):
are benefits to exercise, not just in terms ofbuilding strength after or during cancer, but
also in terms of helping keep cancer away. How doesthat work? Can you tell us a bit about that? Yeah. So
there's has been longstanding research anywayinto the kind of the preventions of cancer. So
there's lots of different things that people saythat you can do to prevent your chance of getting

(46:16):
cancer. And that's a combination of not smoking,drinking, diet, and exercise. There's always
been a big one. Kind of reasons for that, weight. Sothere is a correlation between obesity and
cancer. So obviously, exercising helps withkeeping weight down and the prevention of

(46:40):
obesity, which can then help with the preventionof cancer. Hormonal profiling as well. So
actually, for females that have a higher body fatpercentage, that can then increase the kind of the
estrogen levels, which can then cause cancers.Again, breast cancer is a big one for that. So when

(47:04):
you're then talking about people that havealready been diagnosed with cancer, but then have
come out the other side of it, and we're talkingabout the recurrence rates, kind of have to view it
in the same way. That, you know, if you do exerciseand you can keep your body like the hormonal
profiling regular, and you can keep your weightdown as much as possible after treatment as well,

(47:31):
then that all contributes to recurrence rates andmortality rates too, as a result of that. So yeah,
even when you have had cancer and you've come outthe other side of it, still view the knowledge and
the research that we have that exercise preventscancer, even if you already have it, you know,

(47:54):
because like, for me, I exercised as a vegetarian,no family history and didn't drink, smoke,
whatever. I still got cancer. So if I was to thenview that and then go, well, I did all of these
things and I still got cancer, so screw it, I'm justgoing to do all of those things. I'll just be
shooting myself in the foot, whether that'sbecause of the fact that I've already had it, and

(48:16):
it's a it's a recurrence that would have happened,or I've accelerated the chance of it happening
again, because of the fact that I then did all ofthese things that then increase the castings and
you know. So for that reason, I would always say topeople, don't view it as a kind of give up case of,
oh, well, it's happened now, so, you know, I'm justnot even going to bother, actually, no, still see

(48:41):
it as a way to try and prevent recurrence fromhappening by doing exercise, then you're helping
with that as well as trying to keep your weightdown, which obviously, you know, we discussed at
the beginning, like, it can happen and it happensto all of us with these treatments. So if we can try
and keep it down as much as possible, then it thenall then contributes to helping prevent the

(49:05):
cancers from coming back. Yeah, where if someonehas is going through cancer treatment or has just
had a surgery and has never lifted weights before,and they have no idea where to start, where would
what would you recommend they do to get started? Sofirst of all, always seek professional. If you
haven't done anything before, don't start tryingto do like YouTube videos. And, you know, things

(49:32):
kind of and hit training and things like that,because it's too intense. And hit training and
stuff, especially like on YouTube videos, theyinclude a lot of plyometric stuff, which is not
what you want to be doing right at the beginning.What's the time it took time at so jumping. Oh,
right. So things like squat, jump, star jumps,tuck jumps, those kind of things, you know, a lot of

(49:55):
hit training videos on YouTube include that andI'm not naming names of people, but there are
particular people out there that have YouTubevideos that use a lot of jumping in as part of their
workout videos. And it's very easy to jump on thoseand to follow those because you probably think

(50:17):
like, oh, I'm a beginner. So I'm going to followalong with these videos. But actually, they're
not designed for people that have, you know, egg onthrough these various different treatments or
have had these surgeries. But also, if you'venever done anything near that, you'll find that
you'll be incredibly sore and it'll probably putyou off and you'll never want to do it again. So the

(50:43):
first and foremost, it would be to seek someonethat is a professional. To help guide you through
that. But then also just starting off with bodyweight. If you think what you weigh is what you're
then going to be working with when you do certainbody weighted movements, right? So body weighted
squat, you're working with your body weight. Bodyweighted lunges, you're working with your body

(51:08):
weight. Push ups, planks, you know, all thesedifferent things. There's so much that you can do
with your body that you are using the load ofyourself without having to even lift anything up
additionally. So you don't even have to lift aweight at the beginning. You don't you don't have
to fear lifting weight to get resistancetraining. And I think that's a big thing when you

(51:34):
talk about resistance training, peopleautomatically think lifting heavy weight and
that's scary. And I can't do that. But that's notwhat we mean when we talk about resistance
training. It's about moving your body withadditional load, but using your body and doing
lunges and squats, that's still resistancetraining because you're still working your

(51:55):
muscle, you know, you're not going for a run,you're not doing cardiovascular stuff. You're
not doing star jumps, right? But you're actuallydoing controlled movement. It's all about
training your body to move in a safe and effectiveway, building strength back up in whatever way

(52:16):
that might be, whether that's using your body atthe start, or starting to introduce some
resistance weights in. People get scared at thebeginning. And that's completely normal. It's
completely normal to feel scared and intimidatedby exercise. But it's about viewing exercises
different to what you probably think it is rightnow. And it's not the kind of hard, sweaty,

(52:39):
grunting type of training that you probably seeand think that that's what exercise is. It's not.
It should be fun. And but you should come out of it,think feeling better than when you walked in.
Yeah. And I think one of the fantastic pointsyou've made is the one about prehabbing before
treatment and before surgery, because I think alot of people will think about getting better

(53:02):
after cancer treatment after surgery, butactually you can do it before, during and after.
And yeah, that's really. And actually, the sooneryou start, the better. Yeah. Yeah, I think that's a
huge thing. A lot of people, I have had people cometo me and say, oh, I've got, you know, chemo start,
I'm in the middle of chemo, I finish in three monthstime, can I contact you in three months and start

(53:25):
then? And I say, well, you can. But actually, it'sbetter if you start now. And sometimes that can be
because people are feeling so fatigued and prettyrubbish. And their self confidence has taken a
massive dip. So they mentally, they think, oh, inthree months time, I'll be out of this phase of my

(53:49):
treatment. So I won't be fatigued. And I'll feel abit strong and I'll just feel more myself. But
actually, it's the opposite. But you might as welltry now before you actually get to that point. So
then you can kind of nip it in the bud, as they say.Just to go back to the cancer diagnosis. So you were

(54:12):
obviously given this incredibly bleak diagnosisa few years ago. If someone is listening to this
podcast and has just had a similarly awfuldiagnosis or prognosis, what would you say to
them? I would say, at the moment, it feelsterrifying. And the unknown is the worst. Not know

(54:36):
if you don't know what your treatment is that'scoming up. And what that's going to look like,
that's often the worst part of it. Once you get yourtreatment plan, and you know the direction that
you're heading in, it'll feel a lot clearer. Andit'll feel better. But I would then say that all

(54:58):
through it all, just don't give up hope. That's thenumber one thing that I kept throughout the entire
time. I didn't know if I was going to come out theother side. I knew that I was going to go through all
these treatments, but I didn't know if it was goingto be a wasted effort. But I just never saw it as a
wasted effort. I always tried to keep holding on tothe hope that I had. That, you know, if we're going

(55:23):
to try everything, and the greatest outcome thatwe can have is that I'll still be here on the other
side of it. That's, you know, that's the bestresult that we can have. Times can feel bleak, and
there can be times where you do want to give up onhope. But if you hold on to that, and then you keep
believing in yourself and believing in the workthat is going into these treatments and the

(55:48):
research that's going into it, and more things arecoming out, and just hold on to that, you'll get
through it. Yeah. On that note, we ask everyone thesame question at the end of this podcast, which is,
if one thing could change in terms of breast cancerdiagnosis, treatment, and beyond in the next few
years, what would you like to happen? When you havethat diagnosis, and you receive that as part of

(56:15):
your information that you get, whether that befrom the team or the leaflets that you get and
things like that, you have access to an exercisespecialist. You know, you have access to your
nursing team, you're on a oncologist, you haveaccess to the dieticians in the hospital,
physiotherapists, but we don't have enoughaccess to a cancer exercise and rehabilitation

(56:38):
specialist. And that's the number one thing that Ireally want everyone to be able to have access to,
or pointed in the right direction, because peopledon't know that we exist, and people don't know
that actually exercise is so important for yourtreatment, and you can still trust your body when
you're going through treatment to be able to beable to do these things and not feel weak and not

(57:04):
feel scared to move in certain ways. And in themeantime, until we have that access to everyone,
how can people find you online on social media? Soon my Instagram, my Instagram is at
Framwickfield, and then in my bio there is the linkto my website as well. And happy to receive DMs, or

(57:26):
there's a form submission on my website that youcan write a form out, and then it'll go straight to
my email, and then I then contact people from thereto then get them started. And we'll obviously put
all those links in the show notes as well. Finalquestion, how are you going to celebrate your 30th
birthday this year? Oh, that's a big party,obviously. And then I really want to do kind of my

(57:47):
dream trip to go to Africa. I've wanted to do it eversince I was a little kid, and it was kind of one of the
things that I was so fearful of, I'm never going tosee an elephant. And so I really want this year to be
the year that I see an elephant, and not in a zoo. Anactual elephant in the wild. That's yeah, that's
how I want to celebrate. That sounds like a greatplan. Well, I wish you all the best in your year of

(58:12):
work and exercise and travels and elephantspotting. And yeah, congratulations. And Fram,
thank you so much for joining us on the podcast.Thank you for having me. It's been great. And you

(58:51):
can follow Breast Cancer Now on social media atBreast Cancer Now. All the links mentioned in this
episode are listed in the show notes in yourpodcast app. Thank you for listening to the Breast
Cancer Now podcast.