Healing with Basketball

Rebounding from Breast Cancer

 

Healingwithbasketball.com

 

 

Methodology of existing clinics:

The Healing with Basketball clinics have been conducted once a month and combine these distinct five goals to allow participants to:

 

  1. Share their recovery goals and bond with other survivors
  2. Improve existing overall strength and endurance
  3. Recover upper body range of motion in arms, chest, and back
  4. Relate to others via peak performance instead of via illness
  5. Use the metaphor of basketball and the emphasis on play and teamwork

  

Specific clinic activities incorporate these five aspects in this way:

 

Sharing and bonding is promoted during the first thirty minutes of each three-hour clinic. All participants sit around the center circle in the gym on a mat or a towel. The sharing is conducted by a trained group psychotherapist and breast cancer survivor. Using the format of a “go-round,” each member shares briefly her experience of breast cancer, her challenge and success with physical activity, and sets an individual goal for that day’s clinic. The group is facilitated to offer support and feedback. This important first aspect of the clinic helps to fulfill the benefits shown from earlier studies of survivorship using group therapy. Most of the studies conducted in the past twenty years show a significant relationship between psychosocial factors and survival with breast cancer patients.

 

Often cited as the prime example, is a study by Dr. David Spiegel (1989) from Stanford University, which found that group psychotherapy for women with metastatic breast cancer improved survival. Spiegel found that women who received group therapy for one year were more likely to be alive eight months after diagnosis compared to a group of patients who received no therapy. Four subsequent studies had similar results. A follow up study, published in the September 1, 2007 issue of CANCER, a peer-reviewed journal of the American Cancer Society, finds patients with metastatic breast cancer who took part in weekly group psychotherapy had similar survival rates as those given literature-based patient education. However, the new study did find that women with estrogen receptor (ER) negative tumors (the hardest to treat post-operatively) did show survival benefit, and that group therapy improved quality of life (QOL).

 

Strength building and range of motion happens in the clinic during the next hour. The trainer helps the clinic participants first warm up with structured stretching. They move next to exercises and drills that focus on improvement of upper body range of motion, full body strength building, and developing better balance.

This part of the clinic helps women survivors develop muscle and aerobic strength over time. The use of drills helps to foster team-building and make the clinic less isolating for members. Unlike a yoga class where participants rarely interact, the trainer uses this time to help participants interact. They try to best themselves using a timer and are encouraged to cheer each other on as they accomplish the stressful strength building drills. The trainer breaks down each component of the drill so that they can be accomplished safely and customized to each participants level of ability.

Research confirms that with the incorporation of vigorous, continual physical exercise, women can improve breast cancer survival and reduce recurrence by rates of 20-50%. Iincreased physical activity after cancer is consistently related to better physical functioning, reduced fatigue, and bodily pain, underscoring the need for physical activity among survivors.

 

But despite such strong evidence, only 32% of breast cancer survivors engage in vigorous physical activity, such as running, aerobics, or strength-training to build muscle. The lack of physical exercise is especially prevalent in women of color. At least one study suggest that differences in physical activity level may contribute to the poorer survival experienced by black breast cancer survivors.

 

Relating to others via peak performance rather than relating via a “victim mentality” is an important aspect of the clinic. Too often, breast cancer support groups and chat boards focus on the illness, as opposed to peak survivorship. At the clinics, survivorship is tied to physical achievement. Each month, women are encouraged to notice how they are improving in the quality of their health and their game.

As one survivor recently expressed:

 

I've been a part of Lynn Grodzki's group of basketball practices.  I can tell you from personal experience that I've quickly progressed from a person who would curl into fetal position if a ball (of any shape or size) was thrown my way.  I'm now re-inventing myself as an athlete-- or progressing towards!  I've not been hugely physically fit in the past.  The 3 hours of training push me to my limits and I find I can do even more than I dreamed.  I also am not in pain afterwards.  The trainer schedules the time so we are not over-taxing ourselves and helps us work with our own goals.  I've learned to dribble, to block, to walk on tip toes, I've done a few push-ups, and I've even shot balls in baskets!  And, had a lot of fun.

 

Using the metaphor of basketball is what gives the clinic its uniqueness. Unlike other sports, basketball is an accessible, familiar sport for most cultures and classes of our society. It is also an easy sport to learn to play.

 

The second half of each clinic is focused on learning to play. The trainer teaches the fundamentals of basketball, which each woman can attempt given her level of competence. Even without prior basketball experience, women easily learn to dribble, pass, and eventually shoot. In our clinics, we teach basic stretching, simple basketball drills (passing, shooting, etc.) and strength-building, aerobic exercises as we practice defense, offense, and running.

 

Basketball is a team sport, and teaches the importance of reliance on others and shared effort to achieve points. In the clinic, the emphasis is on fun and play, not on winning or competition. As women pass and shoot, the workout provides a wonderful upper body and aerobic workout, regardless of one’s level of physical ability. As such, it is ideal for women breast-cancer survivors.

 

Women enter the clinic feeling out of shape and out-of-sorts. They leave with a sense of confidence and excitement. Using our tailored program of building up under-developed muscles and exposing women to teamwork and ball handling, survivors find themselves learning together, laughing together, and over time, becoming a loving team of stronger, more determined women.

 

One of the short-term goals of the clinic is to provide a written manual and video showing the aspects of each clinic for replication in other areas.

 

     

 Citations:

  1. Physical Activity and Survival After Breast Cancer Diagnosis by Michelle D. Holmes, MD, DrPH; Wendy Y. Chen, MD; Diane Feskanich, ScD; Candyce H. Kroenke, ScD; Graham A. Colditz, MD, DrPH JAMA. 2005;293:2479-2486.
  2. Exercise for Cancer Patients: Fitness After Treatment by Matthew Hoffman, MD http://www.webmd.com/cancer/features/exercise-cancer-patients
  3. Ivanhoe interview with Melinda Irwin, Ph.D., M.P.H., Yale University School of Medicine; Archives of Internal Medicine 2006;166:2478-2483
  4. Article: “Effects of Supportive-Expressive Group Therapy on Survival of Patients with Metastatic Breast Cancer: A Randomized Prospective Trial,” David Spiegel, Lisa D. Butler, Janine Giese-Davis, Cheryl Koopman, Elaine Miller, Sue DiMiceli, Catherine C. Classen, Patricia Fobair, Robert W. Carlson, Helena C. Kraemer, CANCER; Published Online: July 23, 2007 (DOI: 10.1002/cncr. 22890); Print Issue Date: September 1, 2007.
  5. Physical Activity Levels Among Breast Cancer Survivors. Irwin, M.L., McTiernan, A., Bernstein, L., Gilliland, F.D., Baumgartner, R., Baumgartner, K., and Ballard-Barbash, R. Medicine & Science in Sports & Exercise 36(9): 1484-1491, 2004.
  6. Physical Activity Interventions Following Cancer Diagnosis: Methodologic Challenges to Delivery and Assessment. Cancer Investigation Irwin, M.L. and Ainsworth, B.E. 22(1): 30-50, 2004.
  7.  Physical Activity Levels Before and After a Diagnosis of Breast Carcinoma: the Health, Eating, Activity, and Lifestyle (HEAL) Study. Cancer Irwin, M.L., Crumley, D., McTiernan, A, Bernstein, L., Baumgartner, R., Gilliland, F.D., Kriska, A., and Ballard-Barbash, R. 97(7): 1746-1757, 2003.
  8. Physical activity, long-term symptoms and physical health-related quality of life among breast cancer survivors: a prospective analysis. Alfano C. et al (2007). Journal of Cancer Survey.