Do You Need a Cancer Coach?

Hildreth Stafford arrived at an unsettling juncture after treatment for breast cancer. She had endured a double mastectomy, radiation, aggressive chemotherapy, a hysterectomy and reconstructive surgery. She lost her hair, her eyebrows and her eyelashes, and her husband and young children were left reeling. When it was over, she felt like a different person. Once a hard-driving TV producer, she became fearful and stuck, unable to move forward.

“When I finished treatment, I knew my life was going to change dramatically,” recalls Stafford, 47, who received a diagnosis of stage 2 breast cancer in 2009. “I knew what I needed to do, but I just couldn’t do it. I decided I wanted a life coach to help me, and she completely changed my life.”

Stafford interviewed several coaches by phone, and one of them directed her to Paula Holland De Long, a life coach, author and motivational speaker—and a fellow breast cancer survivor. For Stafford, that was just the connection she needed. After only two coaching sessions with De Long, Stafford felt equipped to act on her plan that alone she didn’t feel brave enough to carry out: In June 2010, she walked away from the successful television production company she co-owned.

“Once I did it, I never looked back,” Stafford says. “It was so hard to walk away after more than 20 years in television, but Paula gave me the courage, the strength and the guidance to do it.”

Stafford is among a growing number of cancer patients turning to life and wellness coaches for guidance in a variety of areas—nutrition, exercise, work, relationships and stress management, for example. Coaches can help cancer patients across the continuum of care, from receiving a new diagnosis with complicated treatment options to end-of-life decision-making.

Although there may be some similarities, coaching is not the same as counseling or group therapy, says Mary Lou Galantino, PT, PhD, a certified wellness coach, clinician and physical therapy professor at the Richard Stockton College of New Jersey and an adjunct research scholar at the University of Pennsylvania, where she conducts research on integrative medicine and chronic diseases. Wellness coaching is generally intended to create positive behavior changes through S.M.A.R.T. (specific, measureable, attainable, relevant and time-bound) goals, in addition to providing a means of emotional support or exploration. It uses proactive and goal-oriented techniques and methods. Life coaching includes setting and achieving wellness goals, but also looks at “the bigger picture of a patient’s life,” Galantino says.

For Hildreth Stafford, the coaching she received from De Long was key to her emotional transformation. Especially important was their shared breast cancer experience.

“My friends and my husband were very supportive of me, but what I really needed was someone who had gone through what I had gone through,” Stafford says. “We had both been through hell and back, and I trusted her completely.”

Stafford, who lives in Georgia, did phone-based coaching with De Long, who lives in Florida. “It’s amazing that somebody I didn’t even know helped me change my life so much,” Stafford says.

“Her strength and support helped me walk away from my production company, and I don’t think I could have done it without her,” she continues. “Paula didn’t tell me what to do, but she made me realize that I could do what I needed to do and survive.”

I knew what I needed to do, but I just couldn’t do it. I decided I wanted a life coach to help me, and she completely changed my life.

While life coaching has been around for several decades, it has recently gained more prominence in the cancer community, thanks in part to the newer field of wellness coaching for survivors. This arose out of a growing awareness—especially among patients themselves—that treatment often didn’t focus on the whole person but rather on the disease.

Pam Schmid, a breast cancer survivor, knows firsthand how difficult the path is to optimal well-being after a cancer diagnosis. “The bumps in the road are numerous,” says Schmid, a health and fitness professional. “I knew what I needed to do to be healthy, but I had one setback after another, as a result of all the side effects of treatment. I knew if I was having trouble, others were, too.”

“People, in general, have trouble managing weight, exercising and eating healthy,” she says. “Add a cancer diagnosis to that, and you have even more of a challenge.”

Schmid established a wellness coaching program focused entirely on cancer survivors and, with the help of Galantino, performed some of the first research around that work. In their study, published in The International Journal of Interdisciplinary Social Sciences in December 2009, 20 breast cancer survivors, seven prostate cancer survivors and three colorectal cancer survivors participated in six sessions of wellness coaching over a three-month period. Participants showed various improvements, including decreased depression and anxiety, increased physical activity, better motivation and a healthier diet.

Developing a trusting growth-promoting relationship, building confidence, fostering positive emotions and having a specific plan to facilitate change increases hope and feelings of well-being.

“A life coach is different than a wellness coach in that a life coach meets you wherever you are on your journey,” says De Long, an associate certified coach through the International Coach Federation and a certified professional co-active coach through The Coaches Training Institute. “Some patients may not be interested so much in wellness as in what’s next. Life coaching creates empowerment in whatever is going on in your life, and helps you to be proactive, to clear away angst and drama, and gives you the tools to make healthy choices.”

De Long knows what it’s like to face difficult choices after cancer. After her treatment, she left a high-profile executive position for a low-paying, mid-level job before she felt inspired to launch a coaching business to help other survivors.

“It took me three years to get my life back, and that was too long and too hard,” De Long says.

Other studies have indicated that coaches can help patients communicate better with their doctors about pain issues, among other healthy behavior changes. And these positive changes were sustained more than a year later.

“In our study, we actually reduced depression scores, which may have been a result of the process of coaching,” says Schmid, who, like Galantino, is also a certified wellness coach through Wellcoaches and the American College of Sports Medicine. “Developing a trusting growth-promoting relationship, building confidence, fostering positive emotions and having a specific plan to facilitate change increases hope and feelings of well-being.”

To assist patients, more hospitals, clinics and advocacy organizations are offering coaching services of various types. Coaching might involve matching a newly diagnosed patient with a long-term survivor who can provide information about treatment options, or it could entail interacting with a health professional who has extensive coaching training and certification and can help guide behavioral change.

At Duke Integrative Medicine in Durham, N.C., for example, there’s a team approach to care that includes coaching, if desired.

“In our program, a physician may be working with a massage therapist, an acupuncturist, a nutritionist, a stress management therapist and a health coach,” says Linda Smith, PA, director of professional and public programs at Duke Integrative Medicine’s Integrative Health Coach Professional Training program. “Essentially, the entire team works together with the patient to develop a health plan.

“As a result, the patient walks away with a substantive health plan that addresses every aspect of health and well-being that they can then take into their real-life situations,” she adds.