Breast cancer survivor Rosetta Hurley went through chemotherapy to shrink her tumors, a double mastectomy to remove them and six weeks of radiation in Longview, Washington.

After having lymph nodes removed to prevent the spread of cancer, she developed lymphedema in her right arm and had to learn massage and other exercises to help drain the excess fluids building up near her armpit.

All the treatments and complications left Hurley feeling exhausted and overwhelmed. She was contacted by Columbia Memorial Hospital and recruited into a pilot study with several other breast cancer survivors from Clatsop, Tillamook and Columbia counties. She was provided weekly visits with a dietitian and physical therapist, learning good eating habits and exercises to improve her strength and range of motion. A lymphedema specialist helped her learn exercises to manage the condition.

“When you finish treatment, I think without a program like this, you can feel really at sea,” Hurley said.

The post-treatment support for Hurley and others is being expanded by the hospital this spring through Healing at Home, a program to provide rural cancer survivors with a comprehensive care plan. The program is supported by nearly $50,000 in startup grant funding and technical expertise from Oregon Health & Science University’s Knight Cancer Center. OHSU partnered with the hospital to open the Knight Cancer Collaborative in Astoria last year, providing chemotherapy and radiation treatment.

Overseeing the post-treatment survivorship program are the hospital’s resource center coordinator Venus Fromwiller and nurse Paulina Cockrum, who stress the importance of healthy lifestyle choices on surviving cancer.

“Survival does depend on comorbidity,” Cockrum said. “If you’re a cancer survivor but you also have heart disease and diabetes and obesity, the survival may not be as long as if you didn’t have those other conditions.”

This spring, Columbia Memorial will recruit up to 20 survivors with nonmetastatic breast, lung, colorectal, lymphatic, head, neck and prostate cancers. They will participate in a six-month-study similar to Hurley’s, with a focus on improving diet and exercise. The post-treatment focus fits in with the art therapy, yoga, qi gong and other support the hospital provides during treatment, Fromwiller said.

At the end of the year, the hospital will review the study’s findings and determine how to further develop the program, with the ultimate goal of providing most patients a comprehensive survivorship care plan after treatment.

A 2011 survivorship study by the Journal of the National Cancer Institute found that only 20 percent of oncologists consistently offer survivorship care plans for colorectal and breast cancer patients. Time and cost arose as common challenges.

Dr. Jackie Shannon, a co-director of the Knight Cancer Center’s Community Partnerships Program, said OHSU was looking for a way to support community-based cancer programs after raising $500 million in pledges in 2015 to secure an equal match from Nike founder Phil Knight.

The program has distributed more than $2 million in startup grants to cancer screening, treatment and survivorship programs in all 36 Oregon counties. Such programs are a step toward having a cancer treatment program certified through the American Society of Clinical Oncology.

The long-term vision of Columbia Memorial’s cancer survivorship program is to get cancer patients thinking earlier about healthy lifestyle choices that can aid in their treatment, Cockrum said.

Since her two-month stint in the survivorship program, Hurley has been thinking more about her daily eating and exercise habits. She eats more high-protein snacks after learning she wasn’t getting the proper nutrients.

In addition to outings with her dog, Chuchi, she has taken up Nordic walking, while finding videos online showing special exercises to help manage her lymphedema.

“I think the program is very helpful in giving a sense of control that you can help yourself,” she said. “I think for many of us breast cancer survivors, it’s always in the back of our minds, the possibility of recurrence.”

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