With cancer research and treatments improving all the time, survival rates are on the rise which is great news. However, this also means many cancer survivors are living with the after effects of treatments such as surgery, chemotherapy and radiotherapy. While once there were few options but to live with those effects, now there are choices. In particular, Pinc and Steel provides physiotherapy-led rehabilitation for people who have had cancer.
What exactly is Pinc and Steel, where did it start and when?
Pinc and Steel was created by a New Zealand physiotherapist, Lou James. She recognised the need for cancer rehab but also had the vision to see that she wouldn’t be able to treat all the patients herself. In 2006 she set up the Pinc and Steel Trust to help fund treatments and she also set up training courses for other physiotherapists in New Zealand and around the world. Lou has been made a Member of the New Zealand Order of Merit for services to people with cancer.
Why the name Pinc and Steel?
Initially set up as Pink Pilates the name was changed when Lou realised it was so much more than Pilates and then included a programme for men as well.
P – Physiotherapists that deliver the programmes
I – Individual prescribed sessions
N – Nurturing to reclaim quality of life
C – Cancer rehabilitation
What is your role with the organisation and how did you become involved?
I am a trained Pinc physiotherapist. I began specialising in working with cancer patients in 2001 after training in the treatment of lymphedema. I found more and more woman coming to the clinic with issues post cancer surgery.
What is the general thrust of the rehabilitative programmes and how do they differ?
Our model of care is to start with one-to-one sessions with a physiotherapist working on individual needs and goals. Patients can start treatment at any time, even before cancer treatments start. We can work on post-op scar tissue and strengthening during follow-on treatments such as chemotherapy and can help patients manage fatigue, a common side effect.
Once treatments are finished, we encourage patients to join group exercise classes so they are supported in their return to activity not just by a physio but by other cancer sufferers. Next Steps is an exercise class consisting of yoga, Pilates, and step aerobics over 10 weekly sessions while PaddleOn teaches stand up paddle boarding.
What does the PaddleOn programme involve?
Patients are taught how to stand up on a paddle board and proper techniques and safety considerations regarding weather and tide. There are eight hour-long sessions over four to five weeks. The last session is a short trip on the boards which is a real achievement.
PaddleOn is significantly subsidised by the Pinc and Steel Trust. The cost for 8 sessions is $40 which is more like the cost of one private session. There is no age restriction. Patients need to have finished their treatment and have the physical fitness to complete the course. Those who haven’t been seeing a Pinc and Steel physio need to attend a free screening test to make sure they are fit enough. This ensures everyone is safe on the water. People living with metastatic disease can take part if well enough but may require medical clearance.
What is the general reaction when paddle boarding is prescribed as a treatment and how does it help?
The most common reaction is “I couldn’t do that”. But everyone ends up surprising themselves. Paddleboarding works on core strength, balance, and aerobic fitness, which are all important for rehabilitation. It is also very calming and enjoyable to be out on the water and this is just as therapeutic in some cases as the exercise. The sense of achievement when mastered is fantastic! Lastly, groups tend to create informal support groups adding another layer to the rehabilitation.
Have outcomes been pleasing/encouraging?
There have been fantastic outcomes from both Next Steps and Paddle On in small trial groups and we are now starting to monitor outcome measures pre and post rehabilitation to produce more data to support our programmes.
Two of the most interesting outcomes, in my view, are increased relaxation and improved social participation. Cancer is obviously very stressful and can be socially isolating for many reasons. I find it wonderful that an exercise programme can help with both of these issues.
How is Pinc and Steel funded?
In New Zealand there is no public funding for cancer rehabilitation. We can currently fund cancer rehab in the following ways:
Through medical insurance.
Low income patients can apply to the Pinc and Steel Trust for funding.
Friend, relatives, and workmates can gift sessions via the Pinc and Steel website. This is a really practical way to support someone going through cancer.
Patients can pay privately if able.
Does it rely on volunteers?
The Trust has very dedicated volunteers who help with administration and the regular fundraising events. The physiotherapists are all paid health professionals but many also give up lots of their time to fundraise and do extra activities with patients.
If you could be Minister of Health for a day what would do first and why?
I would make sure there was equity and access to health care irrespective of where one lives or what the condition/illness is. It might take more than a day to organise!
If you could ask any three people to dinner (living or dead) who and why?
Robyn Williams because he was one of the funniest people I have ever seen and yet he was so complex and sad underneath. My mum. I lost her three years ago to cancer and I’d love one more dinner. George Clooney for obvious reasons but mainly for mum to talk to, of course!
For more information regarding Pinc and Steel’s programmes, visit pincandsteel.com.