Breast cancer survivors persevere through paddling
Catherine Hagele found Dragon Boat racing to build community and strength after cancer treatment—embodying the power of exercise for survivorship.
With every stroke of their paddles, a Dragon Boat-racing team of breast cancer survivors pushes back against old conventional wisdom saying, “You can't.”
For years, survivors were told to stay away from intense activity, especially upper body exercise. Even in remission. They were told this to avoid lymphedema, or complications created by a buildup of fluid in the lymphatic system following treatments including surgery for breast cancer.
Then everything changed. A study in the late 1990s showed low rates of not only lymphedema but also cancer recurrence in an unlikely group: Dragon Boat-racing breast cancer survivors.
Paddling toward hope
Dragon Boat racing is an ancient Chinese paddling sport which features a drummer at the front of the boat to help the team keep pace. The boats have a dragon head and tail in the rear. The team sport is gaining popularity across the United States and has been a part of the Philadelphia culture since the 1980s. It attracted growing numbers of breast cancer survivors nationally after the research study gained attention, and survivors began healing by paddling, with other previous patients, often meeting those with similar cancer stories.
Catherine Hagele, the associate director of the Standardized Patient Program at the Perelman School of Medicine is a member of the Hope Afloat Dragon Boat racing team—a Philadelphia team and 501(c)(3) charitable organization, completely run by breast cancer survivors.
Hagele joined the team in 2019, after receiving a diagnosis of triple-negative invasive ductal carcinoma in 2017. She underwent treatment at Penn Medicine including a lumpectomy, 16 weeks of chemotherapy, and six weeks of radiation.
“It came out of nowhere and I found it myself,” said Hagele. “It was a real blow to my life.”
After completing treatment and going into remission, Hagele said she started picking up the pieces and shifted her focus from survival to healing. She investigated different recovery groups but the one that piqued her interest the most was Hope Afloat. With no previous paddling experience, she dove in and hasn’t looked back.
Rising tides lift all Hope Afloat boats
Hope Afloat welcomes all members, regardless of age, gender or ability—the only stipulation being that they are a breast cancer survivor. They have members ranging from 30 to 85 years old.
Hagele recently received a Penn Medicine CAREs Grant to supply new members with their own Dragon Boat paddle, a personal flotation device, and a membership discount. If prospective members cannot pay the membership fee, they will not be turned away. Hagele said, “I am proud to say that Penn Medicine, my place of employment, is supporting our team.”
And Dragon Boat racing is more than a hobby for the Hope Afloat team—they are athletes dedicated to being the best in the sport. Members train during the colder months at an indoor pool and are outside on rivers and lakes across Pennsylvania and New Jersey, racing multiple times a week, June through September.
The team is currently preparing for the annual Independence Dragon Boat Regatta in Philadelphia this summer, with about 120 Dragon Boat racing teams on the Schuylkill River. The regatta includes an entire division of breast cancer survivor teams. Organizers are expecting between six and eight such teams from around the world to compete. The sport is so popular with breast cancer survivors that where there is Dragon Boat racing, there will be breast cancer teams.
“It’s inspiring being with people who have been through some version of what I’ve been through, but we don’t just sit around and talk about it,” Hagele said. “We are 100 percent there for each other if someone is going through something, but when you’re on the water you can’t really think about anything else other than being in sync with each other—it's just a perfect place to be.”
Strength After Breast Cancer Program supports patients in recovery
While the Dragon Boat team was the best choice Hagele could have made to stay active after breast cancer, survivors have many other options and sources of support in their fitness goals. In the last two decades, researchers have amassed ample evidence to show that a slow progression of exercise, with no upper body limit, reduces risk of lymphedema. Regular physical activity has shown to decrease risk of cancer recurrence, disproving an original hypothesis in cancer treatment.
“There was no research behind the recommendation for breast cancer survivors to not engage in physical activity, it was more theory based,” said Sarena Banas, PT, DPT, a physical therapist with Good Shepherd Penn Partners Rehabilitation, and a leader of Penn Medicine and GSPP Rehabilitation’s Strength After Breast Cancer program.
The Strength After Breast Cancer physical therapy program educates survivors about lymphedema and helps them to build strength. It is available to all breast cancer survivors who have completed their cancer treatments.
Wanting to limit the risk of lymphedema, one of the main concerns of breast cancer survivors, is often a goal for those taking part in physical therapy and other exercise programs.
People have between 700-800 lymph nodes in their bodies. Many breast cancer patients have some removed during surgery and those do not regenerate. Removing them can disrupt how the body regulates fluid and fight infection, which can result in lymphedema. This all means the body will have to adjust to not having those lymph nodes anymore.
Updated conventional wisdom says breast cancer survivors can make this adjustment and even regain the status of athlete by working with their oncologist, a physical therapist if needed, and other support groups.
As a physical therapist, Banas is inspired by working with cancer patients and survivors. “This work makes me appreciate things more and their outlook on life is contagious,” she said.
Paddling to the beat of the same drum
As one of the 20 paddlers, 10 on each side of the boat, Hagele is one of the paddlers in the middle of the boat—who are known to bring the power and can elevate a good Dragon Boat team to a great one.
Just as every cancer survivor has their own journey, each paddler has their specific role. Still, together, they all stroke to the beat of the drummer seated in the front of the boat. Hagele says this makes it hard to not be present while you’re in the boat.
“This sport is great for practicing mindfulness—even though you’re working so hard, you feel so at-one with your fellow paddlers. I wish every breast cancer survivor could experience how this sport brings us together.”