The Knowledge Summit Series Part 3: Move Through Cancer with Meaghan Mounce

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Chapters

• 0:00 Introduction to Knowledge Summit
• 6:04 Meet Meaghan: Career and Background
• 11:21 Education Pathways and Teaching Experience
• 22:27 Changes in Massage Therapy Profession
• 29:48 Cancer Treatment and Massage Misconceptions
• 35:04 Exercise Benefits During Cancer Journey
• 40:24 Radiation Treatment and Movement Strategies

Transcript

Eric: 0:13

Hello and welcome to Massage Science. My name is Eric Purvis. I'm a course creator, educator and advocate for evidence-based care in the massage and manual therapy professions. This is the third episode in my Knowledge Summit series. I will be hosting this one-day online conference live over Zoom on October the 5th. This conference will feature five presenters from across Canada and the United Kingdom who will be sharing their knowledge and clinical insights on a variety of topics relevant to the massage and manual therapy professions. Today's episode is with Megan Mounts. Her presentation is titled Move Through Cancer the role of exercise and treatment in recovery. Today, we will discuss some of the content you can expect during her presentation, and she'll also be sharing some of her personal insights into her experience as a cancer survivor. For more information and also to register, please visit my website, thecebecom.

Eric: 1:05

I am also excited to announce that my company and this podcast now has an official sponsor. I'm excited to be partnering with Notero. They are a Canadian company trusted by thousands of healthcare professionals across various disciplines. Notero has been dedicated to serving the healthcare community for 12 years with a comprehensive suite of features like charting, scheduling, billing and the new Notero Go Go is tailored for mobile practitioners, streamlining workflows and helping practitioners run their business more efficiently. Visit noterocom slash C-E-B-E to start your extended 44-day trial. That is N-O-T-E-R-O dot com slash C-E-B-E. Now let's begin this episode. Hello everybody, and welcome to another episode of Massage Science. I'm excited to welcome the pride of Cedar BC today, megan Mount. So, megan, thanks for being here.

Meaghan: 2:04

Thanks for having me Super excited.

Eric: 2:07

This is gonna be another episode in the series on the promoting the upcoming knowledge summit, which is on October 5th. Megan is presenting her one hour webinar called move through cancer the role of exercise in treatment and recovery. Megan also has a mini course, a mini self-directed workshop, on my website as well, but she's going to be presenting I'm assuming, similar material live on October 5th. Thanks for being here, Megan. Why don't you just tell everybody a little bit about you?

Meaghan: 2:35

Yeah for sure. Thanks for having me. So I live in Cedar BC, which is a small community, I guess, on the south side of Nanaimo. I live with my husband, sean, who's great and I still really like him a lot, and our daughter, eva. She's eight years old. We also have a dog who is snoring right next to me, so hopefully you can't hear that on here. We spend a lot of time outdoors. We are living on Vancouver Island. It's pretty incredible for doing any sort of outdoor, year-round outdoor activity. So we go mountain biking, we boat, we have a cabin on a small island near Nanaimo, so pretty lucky.

Meaghan: 3:14

My history, I guess.

Meaghan: 3:15

I graduated from Vancouver Island University 20 years ago this year with a Bachelor of Science, majored in biology.

Meaghan: 3:27

Ago this year with a Bachelor of Science, majored in biology, and that was the time when you graduated with a science degree and there was no jobs, and perhaps that's still the case, but at that point in time there was like almost nothing to get a full-time job in.

Meaghan: 3:39

I did a couple contract jobs for marine biology work but quickly realized that I needed to do something different. So I moved to Victoria and became a personal trainer and group fitness instructor and just absolutely fell in love with working in the fitness industry so have been in that kind of work for almost 20 years as well. And then from I realized I just wanted to help people a bit more and discovered that there was a massage therapy college in Victoria. So I took the 3,000 hour RMT program from West Coast College Massage Therapy and have been a massage therapist for almost 15 years now and I massaged full time for a number of years and now just massage very part time and I also teach group fitness classes but do some other work outside of massage but still have my hands in there.

Eric: 4:38

No pun intended.

Meaghan: 4:39

No pun intended.

Eric: 4:41

Or maybe there was a pun intended. You do have a contract. Your full-time job is with one of the territories that's right.

Meaghan: 4:48

Yeah, my husband and I lived in the territory of Nunavut for just over a year for his work and when we moved up there I started there as a massage therapist and volunteered at the gym teaching classes. But decided to use my biology degree finally and got a job with the government of Nunavut up there and made some good friends. And then when we returned home a few years later, those friends had started their own consulting company and asked me if I would help them on a project. That project has turned into a very full-time work, so I do a variety of things in supporting the government of Nunavut and Inuit organizations and associations in Nunavut. Very random things to drill in.

Eric: 5:33

Cedar. So I think it's such a neat thing as a neat job and sounds like obviously very important, but it's really interesting that you can do that from way down here.

Meaghan: 5:43

Way down south, way down southern provinces super interesting.

Eric: 5:48

I feel like I learned something new every day, which is amazing one thing that often comes up too, I find with conversations I have with massage therapists is so many people feel like it's I should say I shouldn't say so many, but there's a good number of people that feel that they don't know what else to do. Yeah, yeah, and I always say there's so many other options out there. But really if you don't have a degree or training it doesn't have to be a degree, but our training is something else Then, yeah, your options are limited to pretty much just massage. But the fact that you had that undergrad degree really helped to nail down this other job, so you can. But you can still have your pun intended hands into the massage world and you've got your fitness training so it can give you a few different ways of working and expressing your creative side or with your doing work for meaningful organizations or helping people creating or doing exercise plans and fitness training.

Eric: 6:39

I think it's great, and I always say that it's important, I think, for us as a profession to realize that. You may feel some people may feel like there's I'm stuck, I can only do massage therapy, so there's all kinds of stuff you can do. You just got to explore it. It may not be as wide in terms of options as you would get with, say, like physiotherapy, where you could take like an extremely academic route, or you can do research or you work in hospitals or care homes or those kind of things.

Eric: 7:05

We don't necessarily have that same career trajectory, but I think it's great to hear stories like your own, where you're like yeah, I was an RMT and now I'm working for the government, I'm still massaging a little bit and still doing some fitness stuff. I think it's great. I think it should be inspiring to people that are listening yeah, I think too.

Meaghan: 7:23

I always wondered. I remember when I started my massage, the massage therapy college, going to school there, I was like oh, what a waste of time I did for my biology degree. Like why did I take this? But I think, looking back, it was probably one of the best decisions I made. Honestly, it made me a better student for the massage therapy program, but also I've had so many opportunities because of it, even though I didn't have maybe some right away yeah, that's a really important point, I think, to make.

Eric: 7:52

I went to UVic and I graduated 24 years ago. That's a little bit older than you. I remember speaking with my uncle on my mom's side. He said to me when you do your undergraduate degree, it's not going to teach you how to get a job, it's going to teach you how to learn, and you're going to learn more about yourself. How do you learn? How do you prioritize your time? How do you function with deadlines? It teaches you all these life skills which you can only get from going to university. That was his and that always stuck with me. At the time I was like uncle wayne, whatever. But as the years went on, like I kept on hearing that and again and again. And actually funny, he worked for the nunavut government for years. Oh crazy, yeah, he was up there. He worked up in rank and inlet and oh yeah, uh, kaglaktuk yeah, amazing, I'm saying that yeah, yeah he

Eric: 8:42

worked up there for years. I always wanted to go visit him but it was actually more expensive to fly up there than it was to fly to Australia, oh yes, or the farthest points of the world. It was so far and so expensive. It was more expensive to fly up there. Yeah, definitely is, but that just. Maybe we're off topic. I don't know topic, I don't know. We'll see where this goes, but the I just wanted to talk a bit more about that, about you went and had your undergraduate degree and it teaches you how to learn, yeah, and made you better rmt student.

Eric: 9:08

I felt the same way too, and I think a lot of people that were that really did really well, like some people obviously just were young and just like, went right out to school and they were just, they had the energy, they had the time and they were focused. They did great too. But I did find that people that had a little bit of education it was a much easier process to go through massage school just because you learned how to learn, how to prioritize what was important, what wasn't important, and you don't have to have a degree to do that, but it helps 100%.

Meaghan: 9:36

I totally agree with you.

Eric: 9:38

I had the same. I had the same thoughts too, about the. When I was in massage school I thought I'm gonna get finish this, I'm gonna have a job like I'm gonna make money, it's gonna be great. I remember thinking why did I spent four years university?

Eric: 9:51

yeah but then, after working for a decade ish, I went back to university to do my master's degree. I was so thankful I had that undergrad because I couldn't have done a master's without it, and of course, that opens up other doors. Yeah, I think you're never too old to learn. No I think I was 4041. I think it was 41 when I graduated with my master's degree.

Meaghan: 10:12

Amazing. Yeah, I have contemplated going back to school Again too, because I love learning, but yes, it's a bit of a step at this age.

Eric: 10:21

I know, as we get older becomes a little less. You know you're like well, I got my kids and I want to spend another two, three, four, five years back in school. Yeah, what would you do if you could go back? Or if you were going to go now and there was like no barriers and you go back, what would you do?

Meaghan: 10:38

Oh, this is a great question. I would probably. My dream actually was before, when I was taking my biology degree, I was planning to go into physiotherapy. That was my dream, so I think I would probably go somewhere along that route, but maybe more on the academic side, like research or or teaching or something I don't know. I did teach at the massage therapy college in Victoria for a few years and I really enjoyed that. So I don't know I would be. I would enjoy doing something like that. I feel like, yeah, I think you'd be great at it.

Eric: 11:11

We'll see. Yeah, we'll see. We'll see. Yeah, I'm biased. Teaching's fun. I love teaching, I love and talking to people about stuff that I find interesting.

Meaghan: 11:20

So if you have that interest, go with it.

Eric: 11:25

Yeah, and PT, the, the pts, and that's one thing that I really wish that we had in our profession.

Eric: 11:30

I wish we had that academic like progression and I know there's a lot of people that probably aren't for that, because they think it becomes a bit of this degree creep where you have to keep on going to university and there's a lot of great therapists that don't have university degrees. I totally agree there's. You don't have to have university degree to be a great massage or manual therapist. I think that for those of us and there's many of us that would appreciate or would enjoy that academic progression, like PTs, it really would be ideal. Yesterday, funny enough, I had a meeting with a researcher who works at BC Children's Hospital. Okay, she's a partner with UBC, wow, and she's a PT PhD and the soccer my soccer team that I coach, we're part of her research project and she's doing something across the island in the lower mainland and she's doing it on injury prevention for on injury prevention protocols for female youth, right, which is what I coach, I coach and I just we had this great conversation yesterday.

Eric: 12:28

I was so excited to talk to her and she was really excited to share her stuff and I thought different life. Yeah, again, you're like that's the kind of stuff I would love to, because she's doing things on like acl prevention and rehab and all the stuff, because it's a huge problem in female sports, particularly soccer knees, hips, ankles and I was so inspired talking to her. I'm so excited to be part of this thing. That's super cool. Yeah, yeah, that's awesome. Sign us up. Yeah, the team. They have to consent, but I voluntold everyone part of next year. You don't have to if you want to, but I really think you should so yeah, amazing cool stuff.

Meaghan: 13:02

Yeah, science anyway.

Eric: 13:04

So you've been practicing for a while and what have been some of the, what are some of the changes that you've seen in the profession during your 14-ish years? Yeah, that's a good question, or have you seen any? I don't know.

Meaghan: 13:19

I think honestly. I was thinking back of when it makes me think of back when we were in school and it wasn't very I don't want to bash any schools or anything, but I feel like it was. There was not a lot of like evidence-based, maybe, curriculum, and I don't know how the schools have progressed since then or if they have at all. But I do feel like massage therapists are leaning towards learning more information from people that have more an evidence-based background or sourcing out that kind of material anyways, and I also think that's a big one that I feel like a lot of the profession has moved to. If you look at the Facebook groups and everyone's, does anyone have an evidence-based course on this or something like that? And maybe it's just a term that's used, overused, I don't know, but I do feel like people are more interested in learning the actual facts about information, less maybe about the modalities that we, the hands-on modalities that were shown in school.

Eric: 14:27

I would agree in some ways. I think in BC I can.

Meaghan: 14:33

Yeah, I'm speaking from BCc, I don't know.

Eric: 14:34

Yeah, I would say and I don't want to say go to bc, I don't want to be too bc centric, but I think the just that's where we are and that's where we get most of our most information. We're exposed to an interaction with the profession is in bc. I would say. Here there's definitely this interest, this curiosity, I can say this evidence-based, curious kind of ideas that are starting to percolate through the profession. But I do agree that it's an overused term where people will use it. But they use it and they'll use it in a way and they'll pair it with another word or another phrase.

Eric: 15:05

That's not evidence-based, like evidence-based myofascial release. It depends on how you're using that word. But what do you mean by myof? Mean by mouth? Are you actually talking about like changing the structural integrity of the fascia? Are you talking about like a technique approach? So there's this kind of, there's this, I don't know, misunderstanding or misuse of some of the terminology in a way. So I see people do that and you always want to give everybody the benefit of the doubt to say, okay, what do you mean when you say that? Are you talking, are you talking about like an approach, like a hands-on and movement-based approach, but you're calling it myofascial release, or are you actually teaching people how to break down scar tissue and adhesions and this stuff?

Eric: 15:47

which we know is lacking evidence.

Meaghan: 15:50

So yeah, I do find it gets used and almost becomes like a buzzword yeah, that's yeah, yeah, but I do feel like I think it's positive that people are thinking that way. At least 100 yes 100.

Eric: 16:04

Yeah, and I agree I'm 100. I think it's great that people are asking those questions and wanting to know for sure, and I've spoken before about many of these topics and there's sometimes some of the feedback I get from people is they hear, when you're challenging an idea and when they have, when they're so closely, they attach their identity to that idea. It becomes like a personal attack on them and that's never what's meant to be. It's more. We're just challenging this idea. It doesn't mean that you're a bad person or a bad therapist, but people.

Eric: 16:35

I think that's a problem that in the profession and I've had some talks with some students at some of the massage schools recently. It's something I do as often as I can and I ask them that question. Now you know. But how are you? And like your student, like some of them sometimes are term two, term three, sometimes they're term six or seven, depending on the length of the program, where they are, and I ask them is your personal identity attached to a technique, modality, style, and even in school that most of them will be like, yeah, and then tell me what that is and they will identify I'm a deep tissue therapist. I'm a sports massage therapist. I'm a sports massage person or I'm a myofascial, or I'm going to do MLD identified by the technique. Yes, and it's interesting when I challenge them on that, engage with them I shouldn't say challenge engage them on that in a critical thinking exercise and how they come out of it thinking oh yeah, I guess there is more than one way and I don't have to be this person.

Meaghan: 18:17

Yes, it's so true. And it's funny you say that because I was thinking the other day of how, when I met you, I had been graduated for a while, but I remember being in school and then after school I was just like a massage therapist. I wasn't like a deep tissue massage therapist, I didn't. I didn't feel like I had a title attached to me. I was. I was a real generalist still am really and I remember going to your pain first pain science course and I was like finally, somebody can tell me that I am okay to just touch people nicely, as you, and treat them nicely. You don't have to do something specific to be effective that course was.

Eric: 19:05

I think that was one of the early days. I think that might've been maybe 2017 or 2018, might've been on the early days and I remember that course because I remember you being there and asking good questions and like nodding along and smiling. But that was also the course where I have probably some of the worst memories of teaching. There are some people there that were just horrible to me and just horrible to the room, and it's funny because I've taught that particular course I don't know 50, 60 times probably over the years, like I used to do that course alone, probably 10 to 15 times a year. It was very, very popular and it's funny. I can't remember most of them, but I remember that one in particular and I think, oh my god, it was terrible. Yeah, people did not like that. So I think my delivery got better it was hard.

Meaghan: 19:54

I think for some people it was hard to hear, but you made a fan in me. Yeah, you got one.

Eric: 20:01

It's funny. Even now. It's funny Some of the feedback I get from people, and a lot of times it comes from people that have no idea who I am. Like they've never attended a course of mine, they've just heard things or they've read things, and they immediately at their backup. I had a few times why I've? The last year I had somebody who you really need to improve how you present yourself to the public. I was like you've never taken anything of mine. Yeah, like we've met. We've we've had very few interactions. Oh, yeah, but I've heard on your podcast you say these things, or I've seen these posts. Yeah, but that's you're taking a meaning out of that. That was not intended and you've spun the words to fit a narrative and it's. It's interesting because you could be out there and saying what everybody wants to hear, but then you're just like it's just noise in the background, so you got to say something different and it's funny. It's still amazing to me after all these years how hard is for people to hear something that might challenge their way of thinking.

Eric: 21:01

It's interesting Even well-educated, experienced people sometimes will still get their back up and think, yeah, I never said that. Or you heard that and you took this meaning, whereas everybody else took this meaning and same thing with your experience. In that course, you're like, it resonated with you, it hit right. You're like oh, this is what I'm thinking, and other people were you're a heathen, go away. Yeah, so anyway, it's interesting.

Eric: 21:26

It's interesting how you see that, but I do agree. Going back to the initial question, it was some of the changes do find in some of the provinces, though, at least when I pay attention some of the social media things. It's still very technique. What technique should I do for this? What modality do I need to add to my toolbox? And it's all about having tools rather than understanding, and I think that's something where I would like to see things go. Next is more knowledge of what it is that we're actually doing, rather than chasing a million different techniques, for sure.

Meaghan: 22:00

I also think I was thinking also we talked the other day about how, when you're supporting me with the short little webinar, how I think RMTs in BC anyways, I'm sure it's the same across Canada that everyone likes to do short little, just want short snippets of information. Nowadays make like short little webinars or, and it seems like in-person stuff is becoming a bit more non-existent, which I think is why your symposium idea that you have last year was the first one. Last year was the first one yeah.

Meaghan: 22:34

Yeah, like I think this idea of doing getting a bunch of information on one day but people don't have to leave their living room or bedroom or office or whatever I think is genius well.

Eric: 22:45

Thank you, it went really well last year and I'm sure it'll go well again. They sure haven't done too much promotion for it, but I'm sure it'll be great. But I agree that's one reason why I've completely shifted so much of my work to doing short webinars like one hour, 90 minute, two hour webinars, is because they're cheaper for people. But you can actually get your information to more people for 50, 60 bucks or 40 bucks depending on how long it is and people don't have to leave. Yeah, or they come from their home or they don't have to take off a day of work.

Meaghan: 23:15

You think of the old?

Eric: 23:16

system, which, as a teacher educator it was great. I knew that every year I could as many weekends as I wanted to teach. I could get people to come take courses, because people needed those 14 hours every two years, or whatever it was, or 20,.

Meaghan: 23:31

I can't remember now 24 every two years, I think 24, yeah, whatever it was people needed to attend those courses.

Eric: 23:36

You just teach a course, get it approved, and it was great, but from an instructor's perspective it sucked because you were often on the road on the weekends missing family and it was tiring. It was in the courses you had to charge a lot because they were expensive, because you had to travel, hotel rent space and so it wasn't really in I mean, wasn't in everyone's best interest. The same, whereas the online the short snippets is fits well, I think too, with the way the world is right now yes that convenience of online and short little bits of information.

Eric: 24:06

Yeah, agreed, but in-person courses still are pretty good. I'm doing a bunch of, I'm doing a few of them this year and nice still a market for it, but it's I think it's easier to sell online. Yeah, for sure. Yeah, convenience, convenience is great. So let's talk a bit more about your topic, because your topic is on oncology and cancer. Just give us a quick synopsis. I don't even remember we learned about cancer in school, not much. What's that? Entry to level practice knowledge what do you remember from what you?

Meaghan: 24:32

learned. I don't remember much at all. So so in my undergrad degree, my Bachelor of Science, I took a couple oncology courses which were more like cellular biology, intense craziness. But massage therapy we must have done something, because we did do like a practical portion with cancer patients and their caregivers. I do remember that I don't remember, and their caregivers. I do remember that. I don't remember it was probably one day that you in like a systemic treatments class that you did for oncology. Also, when I taught there, I taught the pathology classes and we did some work on oncology then. But I don't honestly don't then. But I don't honestly don't. I remember I don't remember it being a significant thing in my mind when I graduated from massage school that I would feel comfortable working with cancer patients at the end of school.

Eric: 25:29

Yeah, that is my memory of my emotions, about how I felt. I remember being in school and it was more about being scared about cancer other than how can you best support somebody or help them. It was more about we don't know we could. You could spread cancer or you could make them worse and that was the thing is, you weren't supposed to treat people that had cancer or might have cancer, because there's that fear of harm. But even if we look back at the evidence from 30 years ago, I never said that no, but there was.

Eric: 26:01

This is this goes the idea of there's, when beliefs start to inform curriculum, right. A whole other topic and I've probably talked about this last before on this podcast and other things is that if the belief is that massage increases systemic circulation, then if that could be true, then there could be the possibility that you could spread cancer cells. Yeah, but we know those two things aren't true, but right based on belief. So, yeah, I think there's there's and it's still. Uh, from, I see it's using our very evidence-based reading what people talk about online anecdotally, we do see that still, a lot of people are still afraid to treat people that have cancer because that's what they were taught. Oh, I learned in school that you shouldn't yeah, yeah, which is really unfortunate.

Meaghan: 26:49

And if you go back to your increasing circulation can spread cancer. So can walking up the stairs or going for a brisk walk, which is and anyone in the oncology world is telling their patients to maybe they're not because there's not a lot of exercise prescription, but there is no evidence that cancer patients should just be lying down all the time to not increase their circulation, like they're being encouraged to get up and go for a walk and increase their circulation. So we're not going to spread cancer, like exercise is not going to spread cancer, and neither are your hands-on techniques.

Eric: 27:27

Yeah, it's actually the opposite. I would imagine you'd want to do anything that you could to make the person feel better, maybe increase their immune system functioning, which exercise is shown to do so, to kind of move on to that topic. So I know you have your background in exercise and tell us a little bit more about the benefits of exercise with people, whether it's active cancer during pre-post treatment.

Meaghan: 27:52

Yeah, so there's lots. Science, the last few years specifically, has shown there's a lot of research coming out that exercise can be super important for cancer patients before diagnosis. Even so, if you have not been diagnosed with cancer, exercise is super important in preventing cancer. And I think there's I don't have them off the top of my head, but there's at least over 10 different cancers that doing regular exercise can be prevented. Cancer can be prevented by doing regular exercise. Didn't say that properly.

Meaghan: 28:26

But also during treatment and then after treatment, exercise is super, super important as well. Specifically after treatment there's there was a new study that came out this year actually that shows there's 10 specific types of cancer. Now that exercise, regular exercise, can decrease the chance of reoccurrence of cancer, and that includes breast cancer, which is very prevalent in our populations these days. But then during cancer treatment as well, like rehabilitation from surgery, exercise, range of motion exercises can be super helpful Helping people when they're taking doing chemotherapy or radiation treatment. Exercise is super helpful in increasing the immune system function, making people feel good. Honestly, that's a big one. And then, yeah, just keeping people moving. And so in the when we do the symposium, I will go through kind of information for patients that have had surgery or have been going through chemotherapy treatment and through radiation treatment, and we'll give some exercise recommendations on those topics.

Eric: 29:33

So yeah, it just is a general rule. There's no reason why massage or exercise could not be used by someone who has cancer.

Meaghan: 29:50

There's no reason why they're that they should not utilize.

Meaghan: 29:53

No the only thing that you should be cautious of is if someone has had their cancer spread to their bones and then you would want to know where that location would be, and if you are touching them in massage therapy touching them gently over those, but you're not going to spread cancer or cause any issues. I think both modalities exercise and massage therapy are 100% valid for cancer patients in any stage of their treatment. But there are things to consider. People going through chemotherapy often feel like garbage for a lot of the time, so there's ways you can work around those days that they're feeling really rough and then massage them on non-treatment weeks or ask them to increase their steps on non-treatment weeks when they're feeling a bit more energetic. But yeah, I think exercise and massage therapy are super helpful any point in time for a cancer patient, and specifically after.

Meaghan: 30:59

It's funny when you I haven't talked yet about my cancer journey on this podcast, but specifically after you have gone through cancer diagnosis treatment. It's like you're riding this adrenaline high for so long, appointment to appointment due to surgery, to different types of treatment, and then all of a sudden you're just thrown back into this real world of you're fine now and you're supposed to figure out what you like and what you enjoy, and so I think exercise, specifically, can be super therapeutic, even if it's just going out for a walk or remembering those things that you enjoyed doing before cancer treatment. Was it? Is it yoga? Is it going to the gym, is it mountain climbing, mountain biking or rock climbing or whatever. I think it's important to remember what you enjoyed previous.

Eric: 31:50

Yeah, yeah, you're fine now. You're fine now. I'm currently cancer free. Yeah, does that mean I'm fine? What about all the other stuff? Yeah psychosocial, emotional stuff. I guess that's a western medical thing. Is the you're fine from a medical biological perspective for now?

Eric: 32:11

yeah but yeah, the there's a huge benefit, like you said, with returning to those things that you want to do. I know he is not respected anymore, but lance armstrong was somebody that I used to be. I used to cycle all the time. I didn't have a car until I was 20 28. I rode my bike everywhere and I cycled and I rode with cycling groups and it was a big part of my life up until my probably early 30s and I had a couple of accidents. I got kids I'm not going to die, so I don't really ride much anymore but anyway I was a big fan of his at the time because he was winning everything and he was this cocky character, so he was easy to like.

Eric: 32:54

Yeah, At least for me he was yeah and I remember reading his books that he wrote and of course they're full of all kinds of lies, which he later admitted, obviously. But I remember one of the things that really stuck with me, which just came to me when you were telling me about things people need to do during and particularly afterwards, is that when he had his cancer and it had spread from testicular cancer, I think, and he had it in his brain and it all over the place and he got he still got up and gotten his bike every day during that treatment as much as he could, and afterwards, as soon as he could, he got back on his bike because that was what provided him happiness.

Eric: 33:30

yeah, exactly I think that always stuck with me and that's something in clinically, over the years, I've seen patients that have. You know what the evidence says. That's good. And here's a experience, here's a story from somebody. Whether you like him or not, he survived cancer and this is how he got one of the ways he got through it yeah I always found that was people tended to resonate with that more often than not.

Meaghan: 33:54

Totally.

Eric: 33:55

I think, yeah, one thing just to think about would be just for people listening and maybe, if you want to expand on this a little bit without going into too much detail because you don't want to give your presentation on a podcast Leave some mystery here for people to come listen to stuff and attend live. I would imagine, though, there's two things that come to my mind is modifications that we need to be mindful of for people under going, either during or after, cancer is would be radiation as well as surgical incisions. Sure, what would your recommendations be on that for, say, say, somebody's going through radiation? Yeah, what's the role of massage and exercise in that regards?

Meaghan: 34:34

radiation. So generally you will have radiation over a extended period of time. So people often get ready like do four weeks of daily radiation treatment for, say that per se. That's often a usual prescription that they get, and so tissue can get super fragile. It looks like they have a super awful sunburn in the radiated areas and it can stay that way for a few weeks after radiation treatment has ended. And so changes you would need to make if you're treating that person is, if it's very uncomfortable for them, you just avoid that area.

Meaghan: 35:11

For massage, however, they are often told to use like a specific lotion to keep things hydrated. So I, when I have worked with breast cancer patients that have had radiated skin, I've often just very gently massaged their specific lotion onto their skin in that area. And then, specific to breast cancer patients, because they get radiation in the chest and armpit area, it can get quite tight or they are uncomfortable moving their limb. Any sort of work on range of motion exercises which can be done on the table as a massage therapist, helping with passive range of motion within a, within pain tolerance, or if you're an exercise professional, you can prescribe, you can suggest doing range of motion exercises. It can be very simple just like flexion and extension, move them in whatever move movement they are comfortable doing and to show them that it's okay to move as well yeah, that's important.

Eric: 36:17

So often in musculoskeletal care human care, human is a hurt care there's this fear of damage or there's a fear of doing more harm. And in my experiences and probably in yours as well and it sounds like in your experiences ours probably are very similar is that just simple movement, simple exercises, can be the most powerful.

Eric: 36:49

It doesn't need to be anything crazy, and we see that all the time in our profession, don't we People just don't feel comfortable getting people moving or giving them exercise. And because we have this maybe it's in our head, maybe it's cultural, maybe it's societal, I don't know, maybe it's just what patients expect, but we only touch people is this idea that so many of us have but five minutes of range of motion, maybe a little bit of resisted range of motion or giving someone permission to move, can be so powerful? It's within our scope of practice? Yeah, and most places some places in the states I don't think there is. I think some places in the states you can't do any movement stuff, but most people listening are probably you can get someone to do some active and passive range of motion. Yeah, yeah, for sure. Encourage them to exercise with the exercise stuff.

Eric: 37:41

Now would you? Now, obviously this is very person dependent, but when you're talking about exercise, you're not talking about cause. There's this connotation you'll have with exercises like involves weights and exercise. What do you mean, mean by it? How would you define exercise for this population? What would that look like?

Meaghan: 37:59

good question. In the webinar, we mostly talk about exercise as like range of motion, movements or simple anything that brings you joy, and I think that is the most important. So after surgery, range of motion I feel like getting back. Range of motion is super important and something you can work on right away.

Meaghan: 38:25

All the research on cancer and exercise is based on moderate intensity exercise. So most of the studies are have people going for a brisk walk as their moderate intensity exercise. So that's as simple as it can be. It doesn't have to be complicated, like you don't need to be going to a CrossFit workout or to be doing hot yoga or anything that feel would feel too intense. However, if that is what you enjoy, then maybe that's what you want to do.

Meaghan: 38:58

For me, when I had my first breast cancer surgery, I was in the gym three days after surgery because that's what made me feel good. I felt at home at the gym. I felt like I could do my range of motion exercises at the gym and that felt really good for me because I love going to the gym. But for someone else that could be just going for a walk in the woods for half an hour, and all this the science all says you for moderate intensity exercise you need only 150 minutes a week for to prevent cancer or to extend your life if you have terminal cancer, or to prevent reoccurrence.

Meaghan: 39:39

So 150 minutes is not long in a week that's two and a half hours a week yeah, yeah, 30, 30 minutes, five days yeah, and you take two days off exactly but you don't have to yeah, exactly, and that, and yes, I think exercise can be what you want it to be, if you're, if your patient is going through cancer treatment, I think, and you want to keep them moving or get them moving. It needs, you need to. Just communication needs to be the big thing. What do they like to do, what do they hate doing? Because you're not going to tell them to do what they hate doing.

Eric: 40:13

Yeah, Especially during probably the most stressful time of their life. Most people don't like it when you give them a sheet and say do these exercises 10 times, three times a day or whatever. That's totally useless for most people and not meaningful. No-transcript. It could be dance, it could be yoga, it could be hiking, it could be doing push-ups and sit-ups on the floor or whatever you feel like you can do, could be doing push-ups and sit-ups on the floor or whatever you feel like you, you can do.

Eric: 40:56

yeah, and when you say the moderate intensity and correct me if I'm wrong that's usually at the level where you can still have a conversation that's right.

Meaghan: 41:01

Yeah, yeah, like you're, you feel your heart rate and your breathing rate increasing, but you could still. If you're walking with a friend, you could still carry on a conversation but maybe be breathing a bit heavy. Yeah, I think, maybe if you are like a heart rate person, it's like a zone two heart rate. Lower end of zone two, I think, is moderate intensity.

Eric: 41:23

And then if you're into more intense exercise.

Meaghan: 41:28

you only need 75 minutes oh is that right?

Eric: 41:31

Yeah, intense exercise a week to have cancer benefits oh, I should put the soccer boots back on, yeah get moving play once a week.

Eric: 41:43

Okay, I'm done that's it, yeah just kidding, doesn't work that way, but yeah, that's great. Well, that's great, megan, thanks for that. You provided a good synopsis of kind of some of the key things you'll be talking about, and I know you go into more detail in your presentation. It should be good. If I remember correctly, I believe yours is the second to last presentation on the day, so I believe 1 pm Pacific time. For anybody that wants to take Megan's course, it's available on my website, thecebecom slash courses. You can get it from there and October 5th hopefully people can attend and for anyone that is going to attend live, it is recorded. So if you can't make it live, you will have access to it afterwards. But if you have any questions, there will be a short Q&A as well. Megan will be available for you for that.

Meaghan: 42:36

Yeah, ask me I'm. I have an open book. Ask me anything perfect.

Eric: 42:39

Well, thanks, megan for being here and you have a good day and we will connect soon yeah, see you in october thank you for listening.

Eric: 42:49

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