Category: Practical Stuff

Strength Training through Chemotherapy: A Case Study

(Title image: Photo by Luis Reyes on Unsplash)

It used to be that people undergoing chemotherapy for cancer were told to be careful with physical activity and restrict themselves to low- and moderate-intensity exercise. Even when I was going through cancer treatment eight years ago, there was concern about how much weight I was lifting for fear of eliciting lymphedema, although by that time, exercise was more encouraged.

I am so glad that our understanding of exercise and cancer has changed! This evolution in thinking is exemplified by a case study that was recently published in the journal Lifestyle Medicine (Rolle & Crane, 2025). The lead author and PhD student in Public Health at U of Miami, LaShae Rolle (age 27), was also a competitive powerlifter who was diagnosed with stage 2B estrogen receptor-positive breast cancer in 2024.

For LaShae, exercise was an integral part of her life, something to which I can relate. She worked with her team to create training sessions that aligned appropriately with her cancer treatments which consisted of four cycles of chemo following a mastectomy.

Remarkably, by modifying her workouts as needed, LaShae was able to maintain 93% of her squat strength (408 lbs of her 441-lb one-repetition maximum (1RM)) and 87% of both her bench press (254 lbs of her 292-lb 1RM) and deadlift (430 lbs of her 497-lb 1RM). This is so impressive considering that throughout her chemo treatment she was still able to squat and deadlift over 400 lbs!

Not surprisingly, attempting to train at high-intensity on the day following her first infusion (!) resulted in severe dizziness and fatigue. By the 3rd and 4th cycles of her chemo, Rolle found that delaying intense exercises for about a week following her infusions allowed her to train more effectively. Note that her chemo cycles were three weeks apart, allowing sufficient time to recover.

Exercising Through Breast Cancer: How One Powerlifter Defied Chemotherapy with Strength Training
Yes, you can train vigorously during chemotherapy!

Why keep training during chemotherapy? There is a rapidly increasing body of research that demonstrates the critical role that physical activity plays in recovery from cancer treatment and avoiding recurrence. Unfortunately, for people who view exercise as a chore or burden, being urged to maintain an exercise program while they’re undergoing something as punishing as chemotherapy may feel like an additional punishment.

But the benefits of exercising throughout treatment, as appropriate, are irrefutable. For those who haven’t previously exercised, it’s important to begin slowly, finding physical activities that are enjoyable and rewarding, eventually ramping up the challenge to include cardiovascular exercise, strength training, balance work and flexibility training.

For those for whom workouts are an integral part of their lives, being encouraged to continue exercising as we have prior to cancer is psychologically uplifting. I’ve written in earlier posts that working out was one of the few things that I could do that gave me a sense of control in the out-of-control landscape of a cancer diagnosis. It helped me feel “normal” when I felt anything but, and that was such an important part of mentally getting through treatment.

Bottom line: Participating in your regular exercise routine during chemotherapy is doable, with modifications, and the physical activity can help you get through the treatment process. While LaShae Rolle did experience treatment side effects, she was able to work around those to limit the amount of strength she lost during chemo to an impressive degree.

REFERENCES

Research Article:

Rolle LD & Crane TE (2025) Exercising Through Breast Cancer: A Case Study on Strength Training During Active Treatment. Lifestyle Medicine, 6, e70034. https://doi.org/10.1002/lim2.70034

Reader-friendly versions:

EurekaAlert!
https://www.eurekalert.org/news-releases/1092107

University of Miami News Article
https://news.med.miami.edu/exercising-through-breast-cancer-how-one-powerlifter-defied-chemotherapy-with-strength-training/

Try a Little Tenderness

(Title image: Photo by Alin Luna on Unsplash)

This is a bit of a departure from the usual posts. But I was thinking about how my emotions get pushed and pulled during the course of the day…

Suffice it to say, we live in contentious times where people are compelled to take sides. That leads to an environment where we think badly of each other which, in turn, adds an underlying level of stress to our daily lives.

Perhaps you feel it like an annoying irritation, maybe a quickening of the heartbeat or an increase in your blood pressure. Heat under the collar. And suddenly you are imagining what a jerk the other person is.

All that based upon a single interaction. This is an unfair snapshot judgment of people and brings with it the kind of stress I don’t need.

So this is what I do. And I love the instant effect that it has on me.

When I find myself getting annoyed with someone—whether it’s a rude customer service representative, someone interviewed on the news with an extreme political view, even a person who cuts me off in traffic—instead of muttering something hateful under my breath, I pause and think.

What might be going on in someone’s life to cause them to act or think this way?

If you had the kind of day they did, you’d be in a bad mood too.
(Photo by Alex Greenberg on Unsplash)

Did the customer service rep receive bad news at home followed by an interaction with an aggressive customer?

Has the person with distinctly different world views had a frightening personal experience that affected them deeply?

Is the driver who cut me off in a hurry to help someone with a medical condition?

You can say that, no, all those people are just malicious, egotistical jerks. But in reality, they are far more than the two-dimensional view that we have of them. Their lives are as full as ours and they share the same struggles and dreams that we do.

I sit with these thoughts. The “empathy” muscle is an important one to exercise.

For some, this is hard work to do. When we feel slighted, it can be difficult to give someone the benefit of the doubt. And when political tensions are high, some people may feel that being emotionally generous towards someone with views they find odious is like “giving in” to them, letting them “win”.

But you are not losing anything by practicing empathy.

Why do I bring this up? Because this helps give us peace. It makes us less reactive and helps us see things more clearly. It provides space for our brains to function in. It relieves anxiety.

In the end, it makes the world a better place. And we all need that.

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Anger is exhausting. Hate bleeds around the edges. Welcome peace back into your life regardless of whether or not the other person deserves it.

“Dear Princess Kate, I Can Relate”

(Title image: Photo by Bence Balla-Schottner on Unsplash)

Over the last week or so, there have been a number of news articles focused on Catherine, Princess of Wales, who has been talking about life after finishing her cancer treatment.

She is officially in remission from her unspecified cancer, having completed chemotherapy. However, in a conversation on July 2 with hospital patients, staff and volunteers at Colchester Hospital in Essex (in southeast England), the princess noted that there was still more to endure once she was past her cancer treatment.

This is summed up from an article in USA Today (and numerous other outlets):

Kate described the cancer diagnosis and treatment as “life-changing” for both patients and their loved ones. “You have to find your new normal and that takes time … And it’s a roller coaster. It’s not smooth, like you expect it to be,” she said, according to the outlet. “But the reality is you go through hard times. … “You put on a sort of brave face, stoicism through treatment. Treatment’s done, then it’s like, ‘I can crack on, get back to normal,’ but actually the phase afterwards is really, really difficult.”

Wow, this is so relatable! I’m grateful that Kate is discussing life after cancer treatment, especially because she’s a highly public figure.

Many cancer survivors have experiences similar to Kate’s, particularly those, such as breast cancer survivors with hormone-positive cancers, who continue to take “maintenance” medications like tamoxifen and aromatase inhibitors. While many patients expect chemotherapy and radiation to be tough, they are often not prepared for the side effects associated with endocrine treatments that are prescribed to be taken for years after finishing everything else.

Princess Kate breaks with royal protocol in speaking frankly about the struggles following the end of cancer treatment.
(Video from TODAY)

But even without endocrine therapy, many cancer survivors are left with long-lasting side effects of varying severity. Some may be truly life-changing. Most of them will prevent a return to “normal” as we used to know it.

That normal, however, is what others may be expecting of you. Or you might expect of yourself. And that’s tough. Kate mentions the importance of reaching out for professional support if it is especially difficult to manage the phase following treatment, and I concur 100%.

Because it’s not simply the side effects…it’s the frustration that we feel with having the side effects linger. Or even the reactions of loved ones who don’t understand why things aren’t back to how they used to be. There is a grieving process associated with the loss of our previous lives that those around us may not appreciate, so I’m glad that Princess Kate is using her position to bring this out into the open.

Oncology Yoga: It’s Not Just for Relieving Stress

(Title image: Photo by Raghu Nath on Unsplash)

Last week I finished up my 75-hour yoga4cancer (y4c) Oncology Yoga teacher training (wow, that’s a mouthful!).

It was about five months of some pretty hefty lessons that spanned the cancer experience, the science of cancer, the science of yoga, the y4c methodology and lots of practice, introspection and critique. And more!

What drew me to this particular specialized yoga training was that it uses yoga as an exercise modality for true mind-body fitness, not simply to help practitioners deal with the stress and anxiety related to a cancer diagnosis, but to tap into the physical benefits of exercise in helping manage treatment-related side effects and prevent cancer recurrence.

Oncology Yoga offers a safe and effective yoga practice keeping the needs of those touched by cancer paramount.
(Photo by Junseong Lee on Unsplash)

I recently spoke with someone who represented another cancer yoga certification. She felt that cancer patients and survivors were not looking for yoga that emphasizes exercise, they wanted the stress-relieving, nurturing aspects of a yoga practice.

And there is some truth to that. I myself made the most use of the Pranayama (breath work) and Dhyana (meditation) aspects of Patanjali’s Eight Limbs of Yoga, of which Asanas (poses) are only one limb, when I was going through my own cancer experience.

But on top of that, I continued to row and lift weights throughout treatment, exercising as soon as I got over the worst days of my chemo. Same thing throughout radiation treatment. Exercise made me feel strong and “normal”, and gave me a sense of control when everything else in my life seemed out of control. This was something *I* could do for myself. It gave me agency over my life.

There is a growing body of evidence that staying physically active before, during and after cancer treatment is incredibly beneficial for survival. The evidence-based y4c Oncology Yoga methodology offers sequences that are appropriate for cancer patients and survivors, taking into account cancer-related side effects. There is ample propping to support the needs of practitioners, while still allowing them to participate in many asanas that you would find in a yoga class that isn’t cancer-oriented, taking care to avoid those that could be harmful.

The y4c methodology incorporates generous propping to allow cancer survivors to participate fully in class while keeping themselves safe.
(Photo by Samantha Sheppard on Unsplash)

No doubt, the stress-relieving aspect of yoga is immensely critical also, at a time when a cancer patient/survivor may be dealing with existential fears. There are studies being run on the impact of mindfulness and meditation as they relate to cancer and results of this research are very promising on a variety of levels.

Oncology Yoga combines the two, mind and body. Breath connects with movement in this specialized vinyasa class. The sequences help with lymphatic drainage, bone and muscle building, relieving constipation, regaining range of motion and more, all the while slowing the breath, calming the mind, lifting the spirit, bringing in a sense of grounding and self-efficacy.

I am very excited about the y4c training and am working on integrating Oncology Yoga principles into classes that I offer. My intent is to use my franticshanti.com platform to post sequences and meditations in the future. Watch this space!

Hovering Over Possibilities

(Title image: Photo by Victor Rutka on Unsplash)

Since I’ve been writing about non-attachment, I wanted to follow up with a description of what it feels like for me.

As an example, I’m currently waiting on medical results for a family member. And I can promise you, there is a particular outcome that I really want. It’s the one where everything works out without any problems and you can look back at what transpired and wonder what you were even worried about. All good!

But that’s a best-case scenario, and wish as we might, it’s not a guaranteed outcome, even when we assume it’s a guaranteed outcome. When reality comes out worse, the let-down can feel intense. I’ve experienced that too many times.

Gently, gently. Allowing thoughts to come and go as they please without holding on or pushing away.
(Photo by Dmitry on Unsplash)

So I’ve taken to holding my thoughts lightly, like you would hold a little bird in your hand. Not grasping them, just keeping my hand open and allowing them to flit in and out of it.

It feels like I’m hovering over the possibilities of what might transpire. I am aware of the potential outcomes, but not holding on to them. I don’t push them out of my mind completely. Rather, I fuzz my view of them as if with a softened gaze.

Then time stops. And coming down out of what is swirling in my head, I turn my awareness to what is going on right now. Especially what my feet are doing. How my soles feel pressed against the floor. Focusing on the sensations.

Always, when the possibilities get too intense and clear, I return to my feet on the floor. If my recalcitrant mind continues to swirl, I focus on my hands and pour my senses into what they are doing: tying shoelaces, making coffee, doing the dishes—noticing the movements and pressure, watching my fingers. Once I’m anchored in my body, my awareness reaches out again.

I know those thoughts, hopes and fears are there. I don’t try to repress them. I don’t try to analyze them. They simply come and go, and I return to the calmness of where I am.

Admittedly, some days it’s much harder than on other days. “Letting go” is a practice, not a destination. But even brief moments of respite are welcome.

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There’s also something to be said about the underlying fear of waiting for responses, the uncertainty that weighs so heavily upon us. I’ve always felt that one of the toughest times of my cancer experience was when I was waiting for scan results, biopsy results, even doctors’ appointments. That was the real test of “hovering” and it was one that I did not handle well at the time. But thankfully, relief came in the form of a treatment plan, a.k.a. a certainty of sorts. No, it didn’t make everything better, but it gave me a path to focus on.

How’s the Weather in There?

(Title image: Photo by NOAA on Unsplash)

Here’s a fun little way of observing your internal state, thanks to a mindfulness practice that I saw on a Calm app tool.

It illustrates the transience of emotions, driving home the notion that nothing is permanent and even the worst of days will come to an end.

It goes like this: consider how you are feeling in this moment. Simply observe without trying to change anything. Are you feeling content and peaceful? Stressed-out? Unmotivated?

Then try to describe those same emotions in terms of the weather. If you are feeling great, it’s sunny without a cloud in the sky. If you feel anxious, perhaps there are dark clouds overhead. Angry? Thunder and lightning abound. Tired and groggy translates to being in the midst of thick fog.

Feeling amazing? It’s a clear day with a warm, gentle breeze.
(Photo by Vlad ION on Unsplash)

Looking at your emotions in this way enables you make some space between the intensity of what you’re feeling and the present moment, so that you don’t get completely sucked in and consumed by negativity. This is a particularly important part of mindfulness and something to practice on a daily basis.

But creating an internal weather report also provides a different perspective on the all-encompassing nature of some emotions. It can be difficult to see the break in the clouds when you are in the midst of a stormy night. But eventually the storm passes, as do different emotions.

This gives us hope that no matter how oppressive things feel right now, they will pass and better times will appear on the horizon.

Give this simple practice a try and I wish you brighter days ahead.

Energy Modulation through Breath and Imagery

(Title image: Photo by Alexander Krivitskiy on Unsplash)

As my family takes some time to grieve the passing of a family member, I have been using pranayama (breathwork) to help with the broad range of emotions that such situations elicit.

I came across an excellent meditation by teacher Jeff Warren on the Calm app in which he pairs visualization with breathwork as a way of modifying your energy states.

Need to spark yourself? Or cool the sparks? There’s a breathing practice for that.
(Photo by Jez Timms on Unsplash)

It works with the natural ability of inhales to quicken your heartrate and bring up your energy levels and exhales to calm the nervous system and elicit the relaxation response. This is my version of what he instructed (his actual guidance may have been a little different):

To increase energy:
Breath ~ Extended, intentional inhales fully filling the lungs followed by shorter, sharper, quicker exhales. Five such breaths followed by natural breath, then bringing attention to your current state. Important: stop if becoming lightheaded or short of breath. This should increase your energy, not overwhelm or wear you out!
Visualization ~ Imagine sparks of energy rising up from the earth and entering your body, into the fingertips and soles of the feet, coalescing in your core, then shooting upwards towards your head and skyward from your crown. Imagine the sensation of energy coursing through your entire body, and a sense of lightness and bouyancy, as if your body is charged and driving itself.

To come into calm:
Breath ~ Four-count inhales through the nose breathing into the diaphragm followed by 6-count extended exhales through pursed lips. Five of these breaths then moving into your natural breath, noticing the stillness. If available to you, extend the exhales to eight counts. This helps elicit the “relaxation response”.
Visualization ~ Imagine heat and sparks draining down from your body, into the earth. Feel a coolness washing over you, notice a solid foundation beneath you. There is a slowing and steadiness, a pleasant grounding and a clearing of the ears. Notice the sensations of your surroundings in the present moment.

Sometimes a mind-body break is in order.
(Photo by Victoria Tronina on Unsplash)

Quite honestly, I rarely need to increase my energy levels due the the ability of my parasympathetic nervous system to get activated quickly. If I am feeling fatigued, I don’t do breathwork to rev myself up. More likely, I will exercise…or I’ll respect the fact that my body is telling me that rest is needed and will respond accordingly.

On the other hand, I make frequent and liberal use of calming breaths and find that my ability to handle difficult emotions has improved because of it. Of course, I still struggle from time to time, but that is why this type of work is called a “practice.”

I hope these help you too!

It’s Not a Crisis, It’s an Opportunity

(Title image: Photo by Nick Fewings on Unsplash)

So I’ve been playing with another mental challenge.

For the past month, it feels like I’ve been dealing with a lot.

So many things weighing upon me: obligations, deadlines, upcoming responsibilities, health woes. At least I think there are many things.

Lately, I’ve been getting overwhelmed by what needs to be done. I manage to trudge through everything but procrasination becomes harder to resist and a good night’s rest is harder to get. I’m more susceptible to distractions, which end up resulting in more stress because now, of course, I’m getting even less done.

Life can look scarier than it actually is. Awareness illuminates reality.
(Photo by Razvan Sassu on Unsplash)

It is a self-fulfilling prophecy of sorts.

But when I pause and identify the sources of stress, there aren’t that many. The ones that are there expand around their edges, looking bigger than they really are and that creates a crisis in my brain.

If I were a purely mindful creature, I’d be able to notice this immediately and gently put a stop to it. But, alas, I am clumsy human being. Even with all my practice, mindfulness can easily evade me at times when I need it the most.

So for this round of dancing with anxiety, I’m reframing what I’m experiencing as a fortuitous learning opportunity. And it’s a very “safe” one because quite honestly nothing that I’m going through now is life-threatening.

I am not currently dealing with a cancer diagnosis. I am not about to be kicked out onto the street with my life in peril. I am not dodging bombs or searching for missing loved ones.

Instead, I only need to de-escalate what my brain is blowing out of proportion. This is in fact an ideal situation to be in because I can’t get it wrong. The only question is how long this process is going to take. Everything else is time-limited. Sooner or later it will work itself out and I know I’m going to be okay.

Every challenge is another chance to practice mindful awareness.
(Photo by Gantas Vaičiulėnas on Unsplash)

This is a chance for me to practice shortening the time it takes to notice that no true calamity has befallen me. The more I sit with the things that I’m grateful for, the more I reinforce the realization that not everything that I experience is a stressor and there are so many awesome things that perfuse my day.

And once that realization lands, once I see that my feet are planted on the ground and the din of fears in my head fades, everything feels clearer and calmer.

Why didn’t I do this earlier?

Today I’m Looking Forward To…

(Title image: FranticShanti)

Here’s a slightly different type of gratitude practice. It’s a nice little way to bring more joy into your life.

Instead of looking for things to be grateful for, try simply thinking of things that you might be looking forward to.

They don’t have to be big productions like an expensive vacation or some sort of exclusive party. This works just as well, perhaps even better, with something small.

Grab a pen and a sticky note and start looking forward to the little things.
(Photo by Ravi Palwe on Unsplash)

How small? How about receiving a new calendar you ordered that has pictures you find particularly soothing? Or maybe going to a museum that you haven’t visited in a while. Or visiting a local garden shop just to browse and take in the glorious colors.

Clean out your coffee maker and look forward to having tomorrow’s coffee brew in a clean machine.

Or look forward to getting into bed in the evening and stretching out comfortably.

Consider the things you could potentially look forward to…get granular about it…and try to see what the smallest thing might be that you could look forward to enjoying.

There’s a lot of good stuff in between those pickets.
(Photo by Brad Switzer on Unsplash)

The “grandness” of the thing doesn’t matter—what matters is how you feel about it. And perhaps, at first thought, you consider it insignificant, but when you lean into it, you realize that it truly is something that brings you joy.

The more of these little things we can find, the more we realize that little bits of joy are scattered throughout our lives. And once we become aware of one, we might start noticing them everywhere.

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Speaking from personal experience, I find it very easy to become overwhelmed with the negatives in my life. There are times when it seems like all the difficulties come crashing down at once, at the worst possible moment.

However, it is worth shifting our focus and noticing the things that aren’t going wrong. It’s as if you are looking at a picket fence. The fence itself might be the negatives and they’re hard to miss—after all, they’re right in front of you.

But if you look through the posts of the fence, into the space between, that’s where you see everything “not wrong”. And you might find that, in fact, there is more “not wrong” space than there is picket fence.

So I encourage you to take some time when things get difficult to look through the fence and find your little joys to look forward to. Focus on them, write them on a sticky note and put the note somewhere where you’ll see it in the morning.

And then smile.

I have my note ready…

But What If Everything Goes Right?

(Title image: Photo by Aaron Burden on Unsplash)

Friends, I am a worrier. You’d be hard-pressed to find something that I wouldn’t worry about.

I know better. And I’ve actually gotten better.

But even with practicing mindful self-awareness, those foreboding thoughts of “what if everything goes wrong” creep in, particularly at night.

Because 2025 is a year of big changes for me, there have been many opportunities to awaken in the darkness, worrying about how this and that can go totally downhill.

A few days ago I was on the same train ride, hurtling through fears, when it hit me that, in the same way that I can imagine everything crashing and burning and my life being miserable and terrifying, I didn’t have to fear the worst. Things could work out.

Call that the “Schrodinger’s Box” philosophy of life. At the same time that things could be awful, they can simultaneously be fabulous—or somewhere along that spectrum. No matter what you’re anticipating, it won’t be until you finish the exam, give the speech, get the biopsy results or have the conversation that you will really know how things turn out.

Fear and avoidance are not the way to go through life.
(Photo by Alexander Grey on Unsplash)

So if you don’t know, you might as well think positively, tempered with a healthy dose of realism. Things are rarely black or white. Just as we shouldn’t be “all negative”, we shouldn’t be “all positive” either.

Ok, so right here I need to backtrack and say a word about “positivity” and “negativity”. When we practice mindfulness, we strive to release expectations, to not attach ourselves to an outcome. Yes, I get that.

That is an ideal. Our minds don’t always allow us this.

But if there is a choice between being morose or upbeat, you are still better off being upbeat. Realistic and upbeat.

I’ve heard people justify constantly being negative by saying that at least they will be “prepared for bad news” so that it’s not a shock. I used to think that too, fearing the precipitous drop in spirit when you’re expecting something good and get something bad instead. But I’m no longer convinced that doom-and-gloom saves you from anything.

Consider the “coward dies a thousand deaths” adage. Perpetual pessimism can lead to all sorts of health issues, mental and otherwise. For example, living in constant fear may result in anxiety, depression and high blood pressure,among other things. And with enough time, those can turn into something worse.

Again, the ‘ideal’ is non-attachment. But if you cannot completely disengage from imagining an outcome, your mind and body will be better served by considering that everything will work out in the end. At least you’ll be able to sleep better at night.

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And what is recognized as the optimal way of thinking? There exists the concept of “short-term realism, long-term optimism”. This means that you take care of the tough stuff in the present, facing challenges head on, but keep your chin up and not lose hope for the future.