Innovative Hospital: The University of Vermont Cancer Center

Evelyn Sikorski was a little late getting her mammogram, so she decided to take advantage of a wellness program at work, which allowed her to get her routine mammography during the workday. When she got a call the next day that she had breast cancer, she was flabbergasted. She thought for sure they had the wrong person. 

"It's a diagnosis that really hits you,” Sikorski says. She had some big decisions to make. She needed surgery, radiation, and possibly medication, too. Sikorski, manager of employee health and wellness and the employee assistance program manager at the University of Vermont Medical Center, works as a counselor. But she hadn’t seen the UVM Cancer Center from the patient perspective. It would be a brand-new experience. As someone who leans toward a more integrative approach to her healthcare, Sikorski says it was reassuring to see the resources available and to be able to ask questions and mull things over. 

Integrative Therapy Offerings

In addition to traditional medical care, the UVM Cancer Center offers integrative therapies. These include hands-on therapies such as massage and acupuncture, wellness services and classes such as yoga and mindfulness, and diet and exercise plans. 

Out of these integrative offerings, Kim Dittus, MD, PhD, medical oncologist and director of the Steps to Wellness Program, says that the Steps to Wellness exercise program is the strongest and most unique because it’s something a lot of places don’t offer, or if they do have it, people have to pay for it out of pocket. 

“Insurance doesn't cover individuals with cancer to have exercise rehabilitation as it does for pulmonary individuals who have pulmonary issues or cardiac issues,” explains Dittus. This leaves a gap in rehabilitative services for those who can’t afford it. 

According to Dittus, cancer treatment can knock people down pretty hard, so it’s helpful to have a way for them to get back to being as active as they were before the diagnosis, or even more active, because exercise can help decrease the chances of cancer coming back. She says this is especially true for breast cancer patients. 

The Steps to Wellness Oncology Rehabilitation program began in 2011. It’s a 12-week supervised exercise program that includes cardio and strength training, and is designed to help people regain aerobic capacity, strength, and balance, and reduce fatigue. 

Exercising after undergoing radiation or chemotherapy isn’t easy, so the program is tailored to meet people where they are and help them build from there. Since participants can join the program with different types of cancers that may require more or less aggressive treatments, they first see a physical therapist to screen for issues the exercise trainer should know about. Those who have had a lot of chemotherapy will also meet with a physician assistant to screen for neuropathy and lung and cardiac issues.

Once a person is referred to the program, they see a physical therapist and maybe also a physician assistant, pay a copay for those visits, and then the rest of the exercise program is free. “When I went to the Steps to Wellness program, I found that other people were doing the same thing, and it wasn't easy to do the exercises because of radiation or chemotherapy,” says Sikorski. She says the unique part about going through the program with a cohort of women who each had a different breast cancer experience was that “I didn’t feel alone going through my rehabilitation.”

Using Exercise And Human Touch To Support Cancer Treatment

The data they’ve collected shows that program participants make gains in strength and walking time, according to Dittus, and older individuals see improvement in basic things like getting up and out of a chair. “Of those 65 and older entering the program, 25% have a five-times stand (a test where participants are asked to sit in a chair and stand up repeatedly to measure functional fitness) that is low enough that they are considered at risk for falling; after the program, that decreases to 3%,” she says.

For Sikorski, being able to use integrative therapies at the UVM Cancer Center helped her to create a treatment plan that was truly designed for her. “The thing that was important for me is that I was treated as a whole person instead of just like the cancer that I have,” she says. In addition to the exercise program, Sikorski also had healing touch—energy therapy that can include the gentle touch of a practitioner— during radiation and nutrition counseling. 

While integrative therapies can be very helpful, Dittus notes that they’re not a replacement for traditional cancer treatments. She works with patients to help them make informed treatment decisions based on the severity of their cancer. In Sikorski’s case, the cancer wasn’t as advanced, so Dittus felt comfortable with Sikorski’s choice to forgo medication in favor of integrative approaches. It’s now been three years since her diagnosis, and Sikorski says she still uses the integrative approaches she learned, including exercise and diet to help keep herself cancer-free.

This article was fact checked by Morgan Mullings.