Across the world the incidence of cancer continues to rise and will affect the lives of one in three people. The good news is that an increasing number of people are surviving their cancer in the UK. In 2019, this equated to 2.6 million people. Unfortunately for many this means that after receiving cancer treatments they are left with health problems such as extreme tiredness, mental health issues, lack of confidence and problems with mobility to name but a few.
The number of people surviving cancer is an excellent reflection on how treatable cancers have become. However, developing effective interventions and self-management programmes to support people to improve their health and wellbeing during and after cancer treatments is a priority within cancer care.
The shifting paradigm within cancer care in the 21st century is one that is now striving to understand and meet the needs of an increasing population of people surviving their cancer diagnosis, but whose lives are affected by immediate and late complications of anti-cancer therapies. Effective solutions are required to help enable people with cancer to adopt self-management behaviour habits which enhance their recovery. A shift in approach to care which focuses on recovery, health and wellbeing is a priority.
I am really interested in how we integrate everyday recreational activities into cancer care from diagnosis. There has been an emphasis on effective ways to increase the physical activities of people affected by cancer which is commendable and improves symptom burden, wellbeing and may in fact reduce recurrence in some cancers.
I love my job. My favourite part is listening to the stories of people who have been affected by cancer. It is a real privilege. It was listening to stories that inspired my PhD. After having had bone marrow transplants, people who were really unwell, would tell me of how their family or friends would drive them to their favourite places – be that a beach, the woods, a car park with a view. Even if they were too weak to get out, they could just look at nature, wind down the window and feel the wind on their face. They felt that it helped them put their experiences into perspective and helped them mentally to undertake the work required to get well again.
To this end then, I became interested in how nature is or could be used in health care to improve peoples’ health and wellbeing.
Frumkin (2013) advocates that “nature interactions are widely available and inexpensive; they don’t need to be prescribed or dispensed by highly trained professionals; they are easily personalized according to age, ability, and cultural preference; they inflict few adverse effects; and they offer numerous co-benefits -claims, by the way, that few medical treatments can make. This field deserves far more research attention than it has had.”
Therefore, what do we have in abundance in Highlands?
Natural environments – from sweeping mountains, turbulent seas, golden beaches, meandering rivers to majestic woodlands.
What if there are numerous psychological, physical and physiological benefits to people affected by cancer journeying through our landscapes? Could a nature-based intervention be woven through clinical care which improves people’s adjustment through cancer and their health?
We know that nature appears to provide people affected with cancer with familiar and contemplative spaces where they can develop new emerging perspectives, caring connections (with themselves and others) and enabling spaces to find their way through clinical and personal significances of their cancer. After many conversations with people affected by cancer in my clinical work, the use of electrically assisted bikes seemed to be increasingly popular for helping people keep active, yes, but also to have micro-adventures on.
Cycling is one form of mobility which promotes exercise and access to the outdoors and could support improved health and wellbeing. E-bikes offer the opportunity to people who may not be regular cyclists or who have health issues to undertake moderate levels of physical activity to improve their health and wellbeing.
Social media is full of stories of people who may or may not have been active cyclists who have transitioned to an electrically assisted bike which has enabled them to increase their confidence, maintain their social circles, keep moving, travel further and, most importantly, have fun. A new term seems to have been coined: “e-bike smiles!”
Electrically assisted bikes look just like regular bikes but have the benefit of a motor which can be used when the rider is tired or going up steeper terrain – but you have to keep turning the pedals! The top speed is legally capped at 22km per hour so it’s not a motorbike in disguise!
My PhD is exploring experiences and the potential wellbeing of people affected by cancer as they undertake nature-based journeys on electrically assisted mountain bikes. My emphasis is on the journeys through natural environs and the potential benefits these may proffer, rather than the physical activity of riding a bike. I will be capturing people’s experiences (by video and journals) in the Cairngorms National Park as it offers a wide array of natural environs and it may help to understand whether green or blue spaces have a greater impact on people.
To sum things up, an inspirational friend who has helped me to realise the potential of using electrically assisted mountain bikes, states simply: “Having biked for years and then being diagnosed with Myeloma (a blood cancer), I never thought I’d get the level of confidence, freedom and fun back, but having an ebike has proved this wrong.”
Consultant Nurse, Cancer Care, NHS Highland and University of the Highlands and Islands PhD student