Patients learn skills for cancer survivorship

Interventions occur during radiation therapy

An education program to convert active cancer patients to cancer survivors called "Road to Wellness" has lofty goals, according to its author, Matthew Ballo, MD, professor of radiation oncology at M.D. Anderson Regional Care Center in the Bay Area, Nassau Bay, TX.

Although lofty, the achievement of these goals garnered Road to Wellness an Excellence in Patient Education Award from the Cancer Patient Education Network in 2011

The components of the program are designed to equip patients with the skills needed to be cancer survivors. It might be a new normal, because patients learn how to eat healthy and exercise, which might not have been part of their lifestyle prior to cancer, says Ballo. Also they learn skills for coping with stress and smoking cessation, if needed.

When Ballo first sees the patients, they are in the middle of their cancer treatment, beginning radiation. At that time, he introduces the program to get patients to think of themselves as prostate cancer survivors, breast cancer survivors, or colorectal cancer survivors. What is unique about the program is that it is an intervention, explains Ballo.

Instead of just telling people to start eating well and exercising, hands-on instruction is provided. Patients meet with a dietitian who recommends diet modifications or creates a personal diet plan. Also they attend nutrition classes for continued support.

An exercise physiologist assesses a patient's fitness level and designs an exercise plan. A social worker teaches patients stress management skills, such as deep breathing exercises and guided imagery, and offers a stress management class. Finally, if patients smoke, they are referred to the smoking cessation program on the main campus of M.D. Anderson Cancer Center in Houston.

The nutritionist and social worker are provided by M.D. Anderson Cancer Center. The exercise physiologists who participate in the program work at St. John Hospital in a neighboring building. They have an exercise facility where patients can work out for 45 minutes to an hour for a minimal fee when they come for their radiation treatment.

Many reasons for success

"Our program has been a huge success here in the Bay Area because of the collaboration we have with St. John Hospital and the dedication of our nurses, social worker, and dietitian," says Ballo.

Also important is the fact that Ballo as the physician introduces the program, goes over the importance of the four components, and lets the patients know it is important to him that they participate. It is a six-week program, coinciding with their radiation treatment schedule.

The four components of the program were chosen for several reasons. Ballo says he knew what to include from the information gathered in lectures he attended as a physician, a comprehensive literature search, and information from a report published by the World Cancer Research Fund in London, England, titled "Policy and Action for Cancer Prevention — Food, Nutrition, and Physical Activity: a Global Perspective."

The program was first launched on a small scale in 2007. In 2010 grant money was used to create a polished packet of materials for the program, rather than distributing photocopied handouts. Desiree Gonzales Phillips, MCHES, a senior health education specialist within the Patient Education Office at M.D. Anderson Cancer Center, worked on the project. Some of the information was rewritten to a sixth-grade reading level, and additional documents were included from the cancer center's education database.

An evaluation form was created as well, to be mailed to patients a month after they complete treatment. The forms that have been returned indicate that patients find the program very useful in their treatment. Phillips says most continue the interventions.


For more information about the Road to Wellness, contact:

• Matthew Ballo, MD, Professor of Radiation Oncology, MD Anderson Regional Care Center in the Bay Area, Nassau Bay, TX. E-mail:

• Desiree Gonzales Phillips, MCHES, Senior Health Education Specialist, Patient Education Office, M.D. Anderson Cancer Center, Houston, TX. E-mail:

• World Cancer Research Fund report: The report can be viewed or downloaded at Click on "Resource Centre" which displays a page with photos of each report and titles beneath them. Click on "Policy Report."