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Author: Leo Flor

The Cancer Fatigue Library – For Everyone, Anywhere

We get messages from people in Australia. The UK. Germany. Across the United States. From every province in Canada. People living with cancer-related fatigue who have read something or seen something or heard something we’ve put out, and who want help. And most of them, we can’t see in clinic. That’s been difficult to sit with.

So we did the next best thing.

Every conference talk our founder Scott has given over the past year. Every panel. Every podcast, every interview, the CBC Radio Metro Morning conversation that listeners keep writing in about, the CTV News Toronto feature, the long-form CCSN webinar series. All of it, pulled into one place on our website. Free. No signup. No paywall. No email capture. Just the conversations.

Call it Christmas in July.

Because the resource we wished existed for the people who can’t come to us, didn’t exist. So we made it.

What this library is, and what it isn’t

This isn’t a YouTube playlist. It isn’t a list of wellness tips. It isn’t generic survivorship content.

It’s a curated set of evidence-based clinical conversations between Dr. Scott Adams and some of the people most credibly working on cancer-related fatigue in Canada, Dr. Christopher Booth, the team at Colorectal Cancer Resource Action Network (CCRAN), the team at the Canadian Cancer Survivor Network (CCSN), the CBC Metro Morning and CTV News Toronto teams, cancer coach Kathryn White, and survivor-host Carolyn Van. These are the talks that led to people writing to us. If you have ever felt unheard, unseen, or unsure where to even start with your fatigue: start here.

A small note before you click: the short URLs below are case-sensitive. They use all upper case or all lower case, for example cancerfatigueservices.com/CCC or cancerfatigueservices.com/ccc. It’s the internet’s rules we just abide by them! We created these URLs this way on purpose, to keep them clean and easy to share.



The Library

1. CTV News Toronto – A News Feature on Cancer Fatigue Care

cancerfatigueservices.com/CTV

The CTV News Toronto feature that ran in May 2026, reported by Elianna Lev. (👈click)! A patient story, a look at what CFS does, and an unsolicited endorsement from Lindsay Timm, Executive Director of the Canadian Cancer Survivor Network, on the gap in survivorship care that CFS is built to close. Two minutes long. If you’re new here and want the fastest possible overview of who we are and why we exist, this is where to start.


2. CBC Radio One, Metro Morning – Cancer-Related Fatigue, Explained

cancerfatigueservices.com/CBC

The CBC Metro Morning conversation that aired in April 2026. The one we keep hearing back about. Multiple listeners have written in to say it was the first time they’d heard someone describe what they were going through. Less than eight minutes long. If you only have time for one piece in this library, this is the one to send to the person who needs it most.


3. Structured Exercise at Every Stage of the Cancer Journey – Colorectal Cancer Community Conference Panel – Dr. Scott Adams with Dr. Christopher Booth and Dr. Daniel Santa Mina

cancerfatigueservices.com/CCC

Dr. Scott Adams at the Colorectal Cancer Community Conference, in conversation with Dr. Christopher Booth and Dr. Daniel Santa Mina on why structured exercise matters at every stage of the cancer journey. Dr. Booth is one of the senior authors of the landmark CHALLENGE trial, a randomized study showing that structured exercise meaningfully reduces colon cancer recurrence and improves survival. That study reframes exercise as treatment, not as wellness. This panel is where that science meets the practical question of what to actually do about it. If you’ve ever been told to “just rest”, or, at the other extreme, that you’re “doing too much”, this is the panel that gives you the language to push back on both. One of the most quietly important conversations in this library.


4. Exercise as Cancer Treatment: Meet Maria.

cancerfatigueservices.com/CCRAN

Dr. Scott Adams’s full 45-minute talk at the 2026 CCRAN colorectal cancer summit, the single most comprehensive case for exercise as cancer treatment in this library. Scott opens with the CHALLENGE trial published in the New England Journal of Medicine by Drs. Kerry Courneya and Christopher Booth, which for the first time at the gold-standard level of evidence, showed structured exercise reduces cancer recurrence by 28% and the risk of dying by 37%. He then walks the audience through “Maria”, a 62-year-old composite patient diagnosed with stage III colon cancer, showing what exercise can do at every stage of her treatment, from prehab through chemotherapy to long-term survivorship. This is the talk that became the seed of our Maria’s Story social series. If you want the deepest single introduction to exercise as treatment, not as a lifestyle suggestion, not as wellness, this is it. Scott also talks about how he sees different “tiers of support” required for different people at different stages of their cancer journey.


5. Living to Thrive with Cancer – Kathryn White Podcast

cancerfatigueservices.com/KWCC

CFS Founder Dr. Scott Adams and Advocacy and Engagement Lead Peter Laneas in conversation with Kathryn White on her Living to Thrive with Cancer podcast (May 2026). Kathryn is a stage IV colon cancer thriver, certified cancer coach, and author of Living to Thrive: A Holistic Guide to Living with Cancer; someone who knows the lived-experience side of this question intimately. The conversation moves between the science, the patient reality, and the cultural pressure to “just be grateful you’re still here.” If you’ve ever felt that exact pressure, or wondered why “get more sleep” stopped working, start with this one. Peter speaks openly about his own experience too.


6. Relieving Fatigue, Restoring Hope – CCSN Three-Part Webinar Series

cancerfatigueservices.com/CCSN

A three-part webinar miniseries Scott presented in partnership with the Canadian Cancer Survivor Network in November 2025, hosted by CCSN communications manager Trevor Smith-Miller. Part one (Understanding Cancer-Related Fatigue) lays the foundation: what fatigue actually is, what causes it, and why “just rest more” is the wrong answer. Part two (The Most Effective Treatments and Management Strategies) is the practical core: what the research actually shows works. Part three closes with a Q&A featuring Scott and advocate Peter Laneas, where the questions audience members were quietly carrying come out into the open. If you want the most comprehensive single resource in this library, this is it, but be ready to set aside the time. It rewards it.


7. Candidly with Carolyn – One of the First Long-Form Conversations About Cancer Fatigue

cancerfatigueservices.com/CANDIDLY

Dr. Scott Adams in conversation with Carolyn Van on her Candidly with Carolyn podcast (May 2025). Carolyn is a cancer survivor herself, and her show lives up to its name: the conversation is unhurried, warm, and genuinely curious. This is the earliest piece in the library, recorded just after Carolyn visited the clinic, and it remains one of the most accessible introductions to what cancer-related fatigue actually is, why frontline cancer centres so often miss it, and why “just sleep more” stops working. Scott shares the story of a long-time friend who broke down on the stairs to her own front porch, fifteen years post-diagnosis. That captures the lived weight of this condition more clearly than any statistic. If you’ve ever tried to explain your fatigue to someone who doesn’t get it, the language in this conversation is the language to borrow.


One more thing, before you go

We built Cancer Fatigue Services for the people who can come to us. We built this library for the people who can’t… yet.

Even if we can’t see you in clinic, we still want to help. If something here makes you feel less alone, or less lost, or less like you have to figure this out by yourself, send it to one other person who needs it. That single share is the most meaningful thing you can do, especially if you’re in a place where care like this doesn’t exist locally yet. The conversation grows when one person hands it to the next.

Wherever you are in the world: welcome.

– The Cancer Fatigue Services Team

Advocacy Comes In Unexpected Packages

When people imagine cancer advocacy, they often picture fundraising walks, awareness campaigns, hospital events, or educational seminars.

And they’re absolutely right.

But they’re also wonderfully incomplete.

On Canada Day, I had the privilege of producing and hosting a roast comedy show at Toronto’s iconic El Mocambo. On paper, it looked like an evening of comedians teasing one another, raising money, and creating memories. Which it absolutely was.

Peter's Comedy Roast at El Mocambo on Canada Day.

But to me, it was also advocacy.

Not because we spent the evening reminding people that life continues after it.

One of the greatest lessons survivorship has taught me is that purpose doesn’t always arrive wearing a name badge or standing behind a podium. Sometimes it walks on a stage holding a microphone. Sometimes it volunteers quietly behind the scenes. Sometimes it organizes an event, donates a prize, buys a raffle ticket, or simply shows up because someone they care about asked them to.

Every one of those moments matters.

As patients, survivors or thrivers, we sometimes feel pressure to contribute in ways that seem significant enough to “count”. We compare our efforts against fundraising totals, audience sizes, or social media reach, quietly wondering whether what we’re doing is enough.

I’ve learned that advocacy isn’t measured by scale.

It’s measured by intention.

That same spirit of intentional community is something I’ve been fortunate to witness through the Sexual and Gender Diversity in Cancer Care (SGDc) Program at Princess Margaret Cancer Centre. Throughout the year, I’ve had the privilege of supporting SGDc initiatives as both an emcee and survivor participant. Every event reinforces something I deeply admire about the program: creating spaces where people don’t have to wonder whether they belong… they simply do.

Representation isn’t just about being invited into the room.

It’s about feeling safe enough to be yourself once you’re there.

The SGDc Program continues to create those spaces for 2SLGBTQ+ individuals affected by cancer, their loved ones, and their communities. Their work reminds us that advocacy is often less about speaking for people, more about creating environments where people can speak for themselves.

Whether your passion is comedy, education, peer support, fundraising, photography, baking, public speaking, or simply being the person who listens without trying to fix everything – you already possess something that can strengthen a cause you believe in.

Cancer may change many parts of our lives.

But it doesn’t get to decide how we contribute afterward.

A Reflection for All of Us

If you’ve ever wondered whether your contribution is “big enough”, perhaps you’re asking the wrong question.

Instead ask:

“Does what I’m doing make someone else’s journey just a little easier?”

If the answer is yes, then you’ve already succeeded.

Advocacy isn’t reserved for extraordinary people.

It’s built by ordinary people who choose to care, using whatever gifts they already have.

When cause, community, and compassion come together – even through something as unexpected as a comedy show – we’re reminded that hope has far more than one way of showing up.


—- Written by: Peter Laneas
Advocacy & Engagement Lead
Cancer Fatigue Services

Cost Shouldn’t Decide Who Gets to Feel Better

Here is a number that has been hard to sit with: only 1 in 5 of the people who come through our clinic access the services that provide the greatest improvements in cancer-related fatigue.

It is not because people do not want to. It is not because the services do not work, we have outcomes data showing they do. It is because the treatments that drive the strongest, most lasting gains in cancer-related fatigue sit outside OHIP coverage. And once people have already navigated treatment, straining their energy and their finances, the care with the strongest evidence in addressing fatigue is the care most people cannot access.

That gap, between what works and what is affordable, is the problem we set out to close.

Why we changed our approach

We could have offered a discount. We could have added a payment plan. But over time, we came to realize the challenge was greater than cost alone.

The evidence is clear on what works for cancer-related fatigue: integrated, sustained care delivered over months, not single sessions. Physician-led counselling paired with structured rehabilitation, delivered consistently enough for the benefits to last. That is what produces real, measurable improvement. Unfortunately, until now, the treatment options for most people relied on either high-priced private pay services with each session costing $120-$160 /session (for expert-led counselling and rehabilitation; $1,200 to $1,600 per month for 10 sessions) OR being forced to rely on free, but generic, community wellness and coaching programs that may produce disappointing results.

So we restructured how the care is delivered.

How the new care services work (in broad strokes)

We knew we needed to do something differently. So we expanded our OHIP-covered care and reinforced it with a smaller number of additional support services, delivered with the quality of high-cost services but within a healthcare equity cost model (a fancy way of saying priced to be within most peoples’ monthly budgets).

The Integrated Fatigue Care (IFC) Model is the foundation. Every participant completes two OHIP-covered physician counselling sessions paired with Cancer Fatigue Services-covered weekly supervised rehabilitation sessions, at no cost. That is the minimum starting dose of fatigue care for most people. We view this as the starting point, with opportunities for additional support when appropriate.

The Equal Care Contribution (ECC) Program is intended to help people recover further and faster by bringing the ‘ideal’ treatment dose within reach for most. How do we achieve this? We achieve this by everyone working together, as a community, to ensure that no one gets left behind. Until OHIP starts paying for what people need, we are committed to building a fatigue care community, building bridges from the care people need to what they can reasonably afford. For a small monthly contribution, we can provide additional medical-quality rehabilitation, cardiopulmonary exercise test (CPET) interpretations, and rehabilitation prescription updates at substantial cost savings for everyone. For example, through the ECC program we can reduce the cost of supervised rehabilitation to just $15 a session, compared to direct pay rates ($100-$160 for one-on-one care or $50-$75 for group-based care). I know that I am throwing a ton of numbers at you, but it is important that people can see how hard we are working to level the financial playing field so we can help as many people as possible. The contribution supports the reduced rates available through the program, for the person enrolling and for the wider community of patients facing similar fatigue challenges.

What makes this approach different

It is not simply a discount program. It is not insurance. It is a care model designed around the principle that no one should be priced out of feeling better, and a community contribution structure that lets us deliver what the evidence supports, at a price that does not lock out four out of five of the people who need it. The two parts were designed to support one another.

One more thing

We are soft-launching this program this month. The version we are launching now is not the version we will be running a year from now, and that is by design. Your experience, your honest feedback, and your willingness to tell us what is working and what is not, allows us to refine and improve the program over time. We are committed to evolving this based on what actually helps the people in it.

If you are considering participating, know someone who may need this type of support, or would like to learn more about how the program works, you can email our team directly at info@cancerfatigueservices.com.

Because recovery shouldn’t depend on means.

— The Cancer Fatigue Services Team

Summer Mode

I’m writing this inspired by sitting in a busy coffee shop on the first real “summer” feeling day of the year.

The patio is full. T-shirts, shorts, sunglasses, iced coffees and optimistic energy everywhere. You can almost feel people emotionally defrosting after winter. Toronto in the summer has a very specific personality trait: suddenly everyone believes they’re the main character again.

And honestly? I love that for us.

But sitting here brought me right back to my first summer after chemotherapy.

My hair had grown back a fair bit by then, enough that strangers probably wouldn’t immediately know what I’d been through. But internally, I felt completely disconnected from the version of summer everyone else seemed to be stepping into so naturally.

I’d lost so much weight from treatment that I barely recognized myself. And despite having had testicular cancer – a diagnosis that statistically has strong treatment outcomes with early detection – I still felt like an imposter in survivorship. Like I belonged to a “club” I understood almost nothing about yet.

I was afraid to go outside on so many levels.

Afraid of questions.
Afraid of pity.
Afraid of people not noticing.
Afraid of people that did notice.

Even sunshine felt exposing somehow.

The strange thing about summer is that it can unintentionally amplify those feelings. The season carries this unspoken expectation that we should be energetic, social, adventurous, spontaneous, and happy. Summer has branding. It’s marketed to us like a lifestyle campaign.

But cancer, and especially cancer-related fatigue doesn’t care what month it is.

A lot of survivors quietly struggle with this disconnect. Feeling pressure to “get back out there” while still trying to understand who they are physically, emotionally, and socially after diagnosis or treatment. Even when the body is healing, confidence sometimes takes longer to catch up.

Fatigue can make that emotional gap feel even wider.

Sometimes, survivorship in the summer looks less like a rooftop party, and more like sitting in the shade for twenty minutes before needing a nap. Sometimes, it’s cancelling plans because your body tapped out before your motivation did. Sometimes, it’s wanting desperately to participate, but not wanting to explain yourself while doing it.

And sometimes … honestly … it’s just surviving a humid day without wanting to choose violence against the sun itself. 😜

That counts too.

What I eventually learned is that these feelings do begin to find their place. Not because they magically disappear, but because over time you start reconnecting to yourself differently. The pressure softens. Your relationship with your body evolves. You stop measuring your healing against seasons, social expectations, or the energy level of the folks around you.

You realize summer doesn’t have to look one specific way to still belong to you.

Maybe your summer is travel.
Maybe it’s treatment.
Maybe it’s recovery.
Maybe it’s sitting quietly with a friend who understands.
Maybe it’s learning how to exist in your body again without apologizing for it.
Maybe it’s more.

All of it counts.

Maybe, that’s the real shift? Understanding that how we choose to be present says far more about who are than the season we happen to be in?

So wherever you find yourself this summer … exhausted, healing, hopeful, uncertain, social, withdrawn, thriving, struggling, or somewhere in between, try not to pressure yourself into someone else’s version of “summer mode”.

Just be present in the day.

That’s enough.

—- Written by: Peter Laneas
Advocacy & Engagement Lead
Cancer Fatigue Services

The Story in Your Data and an Apology to Everyone Who Didn’t Hear Back

(The image above is from Dr. Scott Adams’ talk for Canadian Cancer Survivor Network (CCSN).)

If you completed the Cancer Fatigue Analyzer over the past several months and never received your results email, we want to start by saying this plainly: that wasn’t you. It was us. An issue caused our delivery system to stop working without giving us any visible sign. You filled out the analyzer honestly, you waited, and nothing arrived. We understand how deflating that is, especially if you are already fatigued. We’re sorry.

The good news: it’s fixed. If you’re one of the people who never got your results, we’d love for you to try again. The analyzer is again delivering what it was always meant to, a personalized snapshot of where your fatigue sits, sent to your inbox within minutes.

Here’s what’s remarkable about the tool, and why we kept investing in it in the first place. Even with its short set of questions: your fatigue levels, your risk factors, the symptoms you recognize in yourself, and how fatigue is showing up in your daily life, the analyzer data we’ve collected maps closely to the profile we see in people who come through for a full clinical assessment. The patterns line up. The risk factors you flag and the severity of impact you describe already tell us a meaningful amount about what your fatigue profile is likely to look like, what’s most likely contributing to it, and which interventions tend to help most in people like you. That’s not a guess. That’s our own comprehensive-assessment data sitting alongside analyzer responses and telling the same story.

The measurements from intake exams and reassessment keep validating what the people we work with are already telling us. After working with us for as little as six weeks, people report that they’re less exhausted than they used to be. That they can get through a day without bracing for collapse. That they recognize themselves again. The metrics move in the same direction as the lived experience and that alignment is not something we take for granted.

We’re planning updates to the analyzer so it can share more of what we’re learning, a clearer picture of likely contributors to your fatigue and the kinds of support that tend to help. But we want to be honest about what even the best version of a self-report tool can and can’t do. The analyzer orients you. It doesn’t measure you. Only a comprehensive assessment of your physical, emotional and cognitive health, including cardiopulmonary exercise testing, gives us objective data we can’t get any other way. It removes guesswork. It lets us build a plan around your body, not around a general pattern. If the analyzer suggests your fatigue is worth taking seriously, the next step is worth taking too.

The “Cancer Hero” Myth – And the Cost of Wearing It

There’s a version of the cancer story people really respond to.

It’s the one where you’re strong, resilient, inspiring. You faced something impossible and came out the other side with clarity and strength. You tell it with confidence. You land the message.

You become the “cancer hero.”

And if I’m being honest — I know that version well. I’ve lived inside it and sometimes still do.

Not because it isn’t true… but because it isn’t the whole truth.

There’s a quiet performance that can come with survivorship. A sense that certain versions of your story are easier for people to hear. That hope lands better than complexity. That resolution is more comfortable than ongoing struggle.

And over time, you start to notice something: the more you tell the version that gets the best reaction, the easier it becomes to default to it.

The more you perform it, the more it starts to define you.

Cancer stories are often framed in ways that centre strength, overcoming, and victory. And while those elements are real, they don’t leave much room for everything else — the uncertainty, the fatigue, the moments that don’t feel inspiring at all.

So what happens to those parts?

I’ve felt it myself.

There have been moments where I’ve hesitated to share something real — something unfinished or uncomfortable — because it didn’t fit the “cancer hero” version of my story. Moments where I’ve caught myself editing in real time. Softening edges. Choosing the version that lands.

And it raises a difficult question:

If people respond best to the polished version of your story… how safe does it feel to show them the unpolished one?

Over time, that gap can widen.

You show up as the strong one. The inspiring one. The one who has it figured out.

And slowly, quietly, the rest of you gets less airtime.

There’s a thought that comes back to me when I sit with this:

“Your mask gets so thick, you can forget what your face looks like.”

The truth is, survivorship isn’t two-dimensional.

It’s not just strength.
It’s not just struggle.
It’s both — often at the same time.

And no single identity — not even “hero” — is big enough to hold the full experience of what it means to live through cancer.

A Reflection for All of Us

If you’ve ever felt the pull to present your story in a certain way — to be more inspiring, more resolved, more “put together” than you actually feel — you’re not alone.

And you don’t owe anyone a performance.

You’re allowed to be proud of your strength and honest about your struggle.
You’re allowed to inspire and still be in process.
You’re allowed to be more than the version of your story that gets the biggest reaction.

Because the goal isn’t to be seen as a hero.

It’s to be seen as complete.

—- Written by: Peter Laneas
Advocacy & Engagement Lead
Cancer Fatigue Services

It Wasn’t My Fault: Understanding Fatigue After Cancer

Being in the best shape of my life before cancer and the leanest I had been in years was the result of a good coach, Jason, and my discipline and determination to be healthy, lean and strong.

Getting hit with a breast cancer diagnosis was not only shocking but devastating. There has been blessings in this journey. I felt like I was punched between the eyes and told to stop. The focus now was taking care of me in a different way. I thought I was committed to self-care. After diagnoses, I realized that I was doing the bare minimum. I have friends, family and coworkers doing the same thing. The life lesson was to learn what exactly was self-care and what/who is truly important in life. I have amazing family and friends and have met wonderful people, doctors, psychologists, physiotherapists, kinesiologists, social workers, oncologists, friends, cancer survivors and their families during this journey. All who have taught me something important about myself and life. Thank you! 😊❤️❤️

Recovery from cancer treatments has been quite the journey. Filled with self-blame for how I feel, my lack of energy, my inability to do what I did before cancer, weight gain and other things was due to factors that I thought I could control.

For months, I struggled with my body hurting and feeling drained yet I looked healthy, focused on being grateful for life, family, friends, and kept smiling. People complimented me and some wondered why I wasn’t back to work yet. Many cancer survivors understand the struggle and some go back to work prematurely only to be sick again or diagnosed with a recurrence. Treatment impacts everyone differently.

I experience brain fog, intense fatigue, neuropathy, joint and bone pain, muscle spasms and other side effects. When I take walks, do activities and attend events, I feel happy but there is the cost of increased fatigue. Rest doesn’t help. I pushed myself harder to only feel exhausted for a few days. I didn’t understand why.

In November 2025, I attended Cancer Fatigue Services and completed a medical assessment. I now have a collaborative care plan. Part of this was understanding why I feel the way I do and why the struggle with my energy.

Cancer treatments work by damaging the DNA or growth signals of rapidly dividing cells to stop them from multiplying. During recovery, the body shifts from fighting the disease to regenerating healthy cells and repairing the DNA damage caused by treatment. At a cellular level, recovery means your body is finally redirecting its energy from fighting off the disease and treatment to regenerating healthy cells and repairing tissue damage.

How This Affects Daily Life

  • Physical Fluctuations: You may feel a mix of progress and setbacks as your stem cells work to rebuild tissues and your immune system gradually reboots.
  • Persistent Fatigue: Even after treatment ends, many survivors experience a deep, long-lasting exhaustion that isn’t always fixed by sleep, as the body’s “powerhouse” mitochondria are still recovering.
  • Emotional “Roller Coaster”: It is common to feel a range of mixed emotions, such as relief that treatment is over combined with anxiety or fear about the cancer returning.
  • Adjusting to a “New Normal”: Recovery often involves adapting to permanent changes, such as scars, altered energy levels, or “chemo brain,” which requires finding a new baseline for what feels normal for you.

For example, I couldn’t understand why I showered and brushed my teeth and didn’t have the energy to get dressed right away. I sat down to rest. I was thinking what the %$$# is wrong with me. After this assessment, my anaerobic threshold was extremely poor. My body was only producing enough energy for basic survival, even a simple task such as showering required 100% of my available cellular fuel, leaving me completely exhausted. When I met with the oncologist and he explained to me how treatment impacted me, I cried and said so it isn’t my fault I didn’t keep my fitness up and let myself go yet I was doing fitness and eating nutritious foods (still had treats).

I returned for a follow up assessment with CFS for the police community not Centre of Forensic Sciences. 🤣 I had a small improvement in the anaerobic threshold which is promising. To compare the activities, doing laundry would utilize this level of energy. I take many breaks and push myself to improve.

This program along with Cancer PEP – Patient Empowerment Program, Wellspring, Sudbury Hyperbaric and Wound Care and Health Sciences North – NEOCC and my doctors have been impactful in my healing and recovery. I am grateful for this support. Now instead of taking care of the community, I am using the community supports available to me to heal.

Yes, CTV didn’t spell my name correctly and assumed that I worked locally.

— – Written by: Angela

When the Cure Becomes the Daily Battle: Fatigue, Side Effects, and CML Treatment Adherence

Guest article by Cheryl-Anne Simoneau, Co-Founder & President, CML Society of Canada

CML is one of the great success stories of modern oncology. Tyrosine kinase inhibitors (TKIs) transformed a once-fatal diagnosis into a manageable chronic condition — for many patients, even an opportunity to eventually attempt treatment-free remission (TFR). But between that remarkable possibility and the daily reality of living on TKI therapy, there is a gap that doesn’t get talked about enough: the cumulative, compounding burden of side effects.

Most TKIs work by competing with ATP at the BCR::ABL1 binding site. Because the ATP-binding pocket is structurally similar across hundreds of kinases in the body, these drugs don’t act on CML cells alone — they interfere with normal cellular signalling in healthy tissues as well.¹ The result is a constellation of side effects that many patients know intimately: persistent fatigue, joint pain, muscle cramps, nausea, and digestive disruption. Not as rare events. As daily companions.²

Fatigue, in particular, is among the most commonly reported quality-of-life concerns for people on TKI therapy. It is not the fatigue of a bad night’s sleep. It is the kind that settles into the body over months and years, quietly reshaping what feels possible — what you attempt, what you cancel, what you push through, and at what cost.³

And this is where the clinical stakes become very real.

When side effects are severe or unrelenting, patients may reduce their dose, skip doses, or stop altogether — often without telling their care team. The consequences are not abstract. Missing treatment milestones, like major molecular response at twelve months, can delay or eliminate a patient’s path toward TFR. The window matters. The trajectory matters.

What makes this even more complex is that switching to a newer TKI does not reset the clock on a patient’s physical experience. The body does not restart. Years of fatigue, joint inflammation, and gastrointestinal strain do not simply resolve because the prescription changes. These effects accumulate and carry forward, even as the molecular target shifts.⁴ Meanwhile, the hematologists and CML specialists who might help patients navigate these challenges are stretched. Appointment time is limited. Side effect management often falls through the cracks — and patients, looking for relief, turn to sources that may not understand the delicate balance of CML treatment goals.

This is precisely why specialized fatigue support — knowledgeable, oncology-informed, and built around what CML patients are actually experiencing — is not a luxury. It is part of the treatment itself.

At Cancer Fatigue Services, that is exactly what you offer. And for patients trying to stay the course toward remission, that support may make all the difference.


Notes

  1. Prabhu S, et al. “Tyrosine Kinase Inhibitors in Leukemia and Cardiovascular Events.” PMC / American Heart Association. 2020. https://pmc.ncbi.nlm.nih.gov/articles/PMC6993877/
  2. Richter J, et al. “Skeletal Muscle Toxicity Associated with Tyrosine Kinase Inhibitor Therapy in Patients with Chronic Myeloid Leukemia.” Leukemia / PMC. 2019. https://pmc.ncbi.nlm.nih.gov/articles/PMC6756217/
  3. Hobbs G. “What’s New in CML Treatment: TKIs, Asciminib, and Long-Term Care.” Patient Power. 2026. https://www.patientpower.info/video/chronic-myelogenous-leukemia/whats-new-in-cml-treatment-tkis-asciminib-and-long-term-care
  4. Shanmuganathan N, et al. “Exploring Treatment Decision-Making in Chronic Myeloid Leukemia in Chronic Phase.” Frontiers in Oncology. 2024. https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2024.1369246/full

The Words We Carry – Survivor, Fighter, Thriver

There’s a moment that happens more often than people realize.

Someone hears your story and responds with what they believe is encouragement:
“You’re such a fighter.”
“You beat it — you’re a survivor.”
“You’re thriving now, right?”

And depending on the day — or the person — each of those words can either land beautifully… or feel completely off.

Because language, especially in cancer, isn’t neutral. It carries weight. It shapes identity. And sometimes, it assigns one.

Over the years, both in my own experience and in the many conversations I’ve had within the cancer community, I’ve seen just how personal these labels are. Words like fighter, survivor, and thriver aren’t interchangeable — they reflect different ways people understand what they’ve been through, and who they are now.


The “Fighter”

This is often the first label people reach for. It’s meant to empower — to frame the experience as something courageous and active.

And for some, it fits.

I know it did for me.

I’ve been a long-time fan of Buffy the Vampire Slayer. During my treatment, watching it in real time became something I leaned on more than I expected. It gave me a language, a mindset — a way to make sense of what I was going through. So much so that I got a tattoo that says: “Fight Cancer Like a Slayer.”

At the time, that was my identity. It felt strong. It felt clear. It felt like the only way to understand what I was facing.

But over time, I’ve come to realize that identity doesn’t have to be that fixed.

The idea of being a fighter can be empowering — but it can also quietly suggest that outcomes
are tied to effort. That if you “fight hard enough,” you win. And that’s not how cancer works.
Not everyone feels like they chose a fight. Some people are navigating, enduring, adapting —
and all of those are just as valid.


The “Survivor”

This is the most widely used term — and even here, there’s nuance.

In many medical and advocacy spaces, “survivor” is used from the point of diagnosis onward.
It’s meant to be inclusive.

But personally, it doesn’t always land the same way.

For some, survivor feels empowering — a marker of resilience and continuation. For others, it can feel premature, or disconnected from how they’re feeling day to day, especially when long- term effects like fatigue are still very present.

Not everyone feels like they’ve “survived” something that still impacts them.


The “Thriver”

This one has emerged more recently — often used to signal growth beyond survival.

It’s hopeful. Forward-looking.

But it can also carry pressure.

Because not everyone feels like they’re thriving — and suggesting they should be can unintentionally overlook the reality that survivorship isn’t always linear, and it isn’t always easy.


More Than One Word

What I’ve come to understand — both personally and through the people I’ve met — is that identity in survivorship isn’t static.

The version of me that got that tattoo needed the word fighter. It helped me get through something incredibly difficult.

The version of me now understands that there are more dimensions to who I am — and that those can shift over time.

And that’s okay.

Some people prefer “person living with cancer.”
Some resonate with “survivor.”
Some reject labels entirely.

There isn’t a right answer — there’s only what feels true to the person living it.


A Reflection for All of Us

If you’ve been through cancer, you get to choose the words that feel right — and you’re allowed to change them as you evolve.

If you’re supporting someone who has, there’s a quiet but powerful shift you can make: instead of naming their experience for them, create space for them to name it themselves.

Because feeling seen isn’t about being labeled correctly — it’s about being understood.

The language we use doesn’t just describe experience. It shapes how that experience is carried forward.

And sometimes, the most important thing we can offer isn’t the right word — it’s the willingness to listen for it.

— – Written by: Peter Laneas
Advocacy & Engagement Lead
Cancer Fatigue Services

When Age Isn’t the Difference – What Peer Support Keeps Teaching Me

For the past year, I’ve had the privilege of co-facilitating six-week peer support groups focused on cancer-related fatigue alongside a social worker/psychotherapist. Going into this most recent group, I noticed something I hadn’t fully anticipated: with a majority of the participants over the age of 60, and many had been recently diagnosed with their respective cancers.

What surprised me wasn’t their presence – it was how familiar the emotional landscape felt.

As the weeks unfolded, I found myself recognizing the same patterns I’ve seen time and again while supporting young adults diagnosed with cancer. The questions. The pauses. The recalibration.

The quiet processing of identity – Who am I now? What does this mean for the life I thought I was living?

The only notable difference was the absence of conversations about fertility. Everything else felt strikingly parallel.

Age, as it turns out, doesn’t change how disruption feels.

Across the group, participants spoke about fatigue not just as a physical symptom, but as something that reshaped how they saw themselves in the world. They talked about independence shifting, confidence wavering, routines changing, and the unexpected grief that comes with not recognizing your own energy anymore. These weren’t conversations about age – they were conversations about identity.

And that’s something I’ve learned again and again in peer support spaces: when cancer enters your life, it doesn’t check your birth certificate before it challenges your sense of self.

Whether someone is navigating a career they were just building or a retirement they were finally stepping into, the emotional work looks remarkably similar. There’s the shock. The trying to understand. The quiet comparisons to “before”. And eventually, the slow work of figuring out how to carry the word survivor alongside who you already were.

Peer support works because it strips away the idea that experience is only valid if it matches someone else’s timeline. In these groups, people don’t connect because they’re the same age – they connect because they recognize themselves in one another.

A Reflection for You

If you’ve ever found yourself surprised by who you relate to in survivorship – someone decades older or younger than you – that makes sense. Cancer has a way of levelling the emotional playing field. The questions it raises don’t belong to one generation.

Healing doesn’t move faster or slower because of age. It moves at the pace of understanding, adjustment, and self-compassion. And sometimes, the most powerful realization in a peer support space is this: the person across from you doesn’t need to share your life stage to understand your experience.

They just need to get it.


—- Written by: Peter Laneas
Advocacy & Engagement Lead
Cancer Fatigue Services

Life Is Change

Covid changed everything!!
After having worked for the Provincial and Federal governments for 15 years and directed/facilitated seniors’ programs for 30 years – I was lucky I was able to retire just before the lock-down. We adapted, went online to find resources to cope, support and maintain communication with family and friends, and create communities through zooms. I wanted retirement to be creative, joyful and supportive – I wanted to continue with my passion of supporting seniors.

I had been enjoying 8 years of “Indian Healing Dance” classes for seniors, led by the unstoppable Munni Subani, our professional classical Indian dancer/teacher. As lock-down started, Munni figured we had to take the classes online to support isolated seniors, and asked me to help coordinate. What a learning curve! Within months, 150 of us in Canada and around the world were having fun meeting up twice a week to dance and keep mentally, physically and socially connected.

February 1st 2024 changed everything, again!
Munni passed away, on the same day I was diagnosed with breast cancer (Grade 3, Stage 1). The news slowly settled into my bones. I was determined to stay positive, and felt carried and miraculously connected to all the support angels as needed: a wonderful medical team of Anna Robinson (NP), NYGH, Dr. P. Fishman (Oncologist), Dr. Y. Botros (Surgeon), Liam & Martha (Naturopathic Drs.), CCNM Integrative Cancer Programs Jin Wang (CM Acupuncturist). My Husband, Son, family and friends were right there helping with anything I needed. And boy did I need them!!! Being the independent organizer that I was, it sure was a lesson in love and vulnerability. I was surrounded by caring people and wondered how others who did not have the support they needed managed. I felt blessed.

The surgery in February was not difficult. I kept driving and meeting up with people while supporting my immune system with nutrition and care. Chemo was a different story – it started mid-April and it knocked me out! I had never been so aware of how exhausted and frail we could become in such a short time. By August, the radiation series compounded the exhaustion, and then I started the 7 years of daily Anastrozole (Arimidex) medication. Each treatment was taking a toll on my body and mind, and I was determined to fight the challenges with all the supports that I could access and afford.

The physical exhaustion/fatigue shocked me, stopping me in my tracks. I would hit a wall after about 20 minutes of going about daily tasks – walking, sitting, or moving. As my body suddenly lost all its energy, and with the neuropathy in my feet, I felt like I might fall if I didn’t sit immediately. This made me realize I had to embrace the journey and do things to stay positive or I’d be lost. The fatigue was frustrating, yet I knew I had to keep moving or lose any muscle and strength I had. I knew it would get worse, as some of the many Arimidex side effects over 7 years included bone loss, neuropathy, brain fog, dizziness, depression, etc.

Using recordings Munni’s husband generously gave me, I started running online zoom classes twice a week for 20 of Munni’s zoom dancers. I also taught myself how to administer Munni’s website – it helped support my mental fog. I pole-walked with my neighbour in my condo hallway and driveway; did online seniors’ HASfit exercises with my husband Andrew; went for weekly physio and therapeutic massages; safely had friends and family visits, and attended Wellspring programs online to keep my spirits up, but the fatigue and side effects were unrelenting.

My car had been sitting in its parking space for over a year, so by June 2025, I decided to sell it. I became overwhelmed by the realization that I was moving further from independence. While I kept working on a number of areas (nutrition, exercise, social and mental fitness), I was barely holding my head above water – with the fatigue always holding me back.

In November 2025, my wonderful CCNM Integrated Cancer Program referred me to Cancer Fatigue Services. The program started with thorough assessments by physicians and physiotherapists. They kindly and patiently questioned all aspects of my journey and how my body and mind were handling the challenges of cancer fatigue. The report I received from Dr. Bain put together a story that helped me see the holistic reality of what I was going through. It was encouraging to know that I was doing all the right things, and had all the right supports, but it was great to know I could overcome some of the fatigue that I had taken for granted as being an unavoidable part of my journey.

The results of the thorough Cardiopulmonary Testing showed that my heart and lungs were working at 55% of their capacity. They said that the reason I had been crashing after 20 minutes of activity was that my body switched to accessing anaerobic energy from my cells – which was very hard to maintain. The Cancer Fatigue Services staff put together a report and plan for me to increase my aerobic energy while raising my anaerobic threshold.

Recumbent Bike Data

Three weeks ago, I started my program with incredible support from Matthew on the Cancer Fatigue Services Team. I’ve been working on a recumbent bike at high, medium and low exercises levels to 70’s music, while my heart and fatigue levels are constantly monitored. By the second week, I felt a shift that allowed me to breathe better, and to feel more relaxed, while being aware of stopping before I reached exhaustion. I am starting to feel energetic and not hit the exhaustion wall as often. I’m also getting back to not running out of breath while singing or talking, and I am cutting back on my asthma puffers and Fisherman’s Friends. 😊

I cannot tell you the immense relief of knowing that some of the debilitating fatigue, I had thought I would have no control over, is not something I have to just accept. Even though I will have to continue with my medications and support the bone and muscle loss, neuropathy and other expected side effects for the next 5 and 1⁄2 years, with all the support I have put in place – I can do it with a positive spirit. I feel very lucky that this ground-breaking, science-backed Cancer Fatigue Program, which has only one location at this time in Canada, is only 15 minutes away from my home.

This program gives me great hope. It is a program that all cancer patients who suffer from fatigue due to treatment should be able to access across Canada. I hope this happens sooner rather than later, as there are too many who suffer from, or who accept, cancer fatigue (including the medical community) as being a part of the journey. Patients and the medical community need to realize that cancer fatigue – or at least part of it – is something that can be overcome.


I thank all who have and are supporting me through this ever-changing cancer journey.

—- Written by: Stephanie Alexander

Clinic’s Perspective: You Are Never Too Old To Feel Better With Or After Cancer

There’s a common, unspoken assumption in cancer care that addressing survivorship and fatigue is primarily for younger survivors. The idea tends to sound something like this: older adults should expect to slow down, or they’re already used to having less energy.

But clinical experience and patient voices tell a very different story.

Recently, our Advocacy & Engagement Lead, Peter, shared an observation from the peer support group he co-facilitates. Several participants, in their mid-60s and older, who are newly diagnosed with cancer, expressed fears, frustrations, and emotional responses that mirrored what we often hear from much younger adults. Their reactions were strikingly similar: worries about identity, lost independence, unfinished plans, and the desire to keep living fully.

This matters, because it challenges a deeply ingrained misconception: that acceptance naturally replaces hope as people age.

In reality, many older survivors still have clear, meaningful goals. They want the energy to play with their grandchildren. To travel. To stay independent. To participate fully in their relationships and communities. Fatigue threatens all of that, regardless of age!

From a clinical perspective, accessibility means more than physical access to services. It means ensuring that evidence-based fatigue support is offered to people across the lifespan, without assumptions about who is “worth” investing in. It means recognizing that functional improvement at 70 can be just as life-changing as it is at 40.

In our clinic, we regularly see individuals in their 60s and 70s make meaningful gains in strength, stamina, and confidence when fatigue is properly assessed and addressed. The goal is not to “reverse aging” or push unrealistic expectations; it’s to help people feel capable in their own bodies again, at whatever stage of life they’re in.

Cancer-related fatigue is common, but it is not something anyone should be told to simply accept. Support should be guided by what matters to the person.

No matter how old someone is, having the energy to live well is worth pursuing.

Social Gatherings After Cancer – Navigating Connection and Expectation

The holiday season always brings a mix of warmth and complexity, especially for those of us who’ve lived through cancer. The lights, family dinners, gatherings with friends, and casual invitations to “come as you are” can feel like invitations and tests all at once. For many survivors, engaging socially during the holidays can be both joyful and quietly challenging.

Cancer changes us in ways that aren’t always visible, but can deeply affect how we interact with others.

Research shows that many survivors experience social challenges and isolation in the months and years after treatment as relationships shift or expectations don’t match reality. People often feel misunderstood, emotionally distant, or “othered” even when they are physically surrounded by friends or family.

https://www.cancer.org/cancer/managing-cancer/side-effects/emotional-mood-changes/social-isolation-loneliness.html

It isn’t uncommon for survivors to feel like they should be “past” the hardest parts, especially during holiday gatherings or reunions … well, I can speak for myself saying that.

But healing and adjustment don’t follow a universal timetable. What looks like “normal” on the outside can feel like a thousand unasked questions on the inside. Things like lingering fatigue, anxiety, or altered self-perception can make social settings exhausting, overwhelming, or emotionally complex.

There’s also the layer of social expectation that reaches beyond cancer itself. For people from historically marginalized communities, there’s a parallel of added pressure experienced to “perform” or conform in social settings. Suppressing certain aspects of an identity, or minimize personal needs in order to fit in or avoid discomfort. This isn’t just an abstract idea — as an LGBTQ cancer survivor, I can speak to unmet care needs, identity concerns, and lack of culturally competent support can contribute to emotional strain and social hesitation.

So how do we navigate this messy, meaningful terrain of connection and self-care?

Here’s a few grounded reflections I’ve carried forward as a survivor myself:

  • Accept that social energy isn’t infinite. Fatigue isn’t just physical … it impacts our emotional reserves too. It’s okay to step back from gatherings even when everyone else seems “fine”.
  • Adjust expectations – including your own. You don’t have to be who you were before cancer. You don’t have be who others expect you to be now. Your presence is enough.
  • Communicate where you feel safe. You’re allowed to share, “I’m still healing”, or “I need a break” without apologizing for it. That honesty can feel freeing and sometimes helps others understand you better.
  • Lean into community where you feel seen. I’ve experienced firsthand fellow survivors feeling more connected with others who’ve lived through cancer than with healthy peers alone and I can say the same for myself.
  • Notice difference without judgement. Your experience post-cancer may not match anyone else’s … and that’s ok. Healing takes time and isn’t linear. There’s no standard for a “finish line”.

Ultimately, the social world after cancer isn’t a test you pass or fail. It’s a space you navigate with compassion — for yourself and others. You might walk into a room and feel strong one day, and then in another, you might leave early to rest. Both reactions are valid. Both are part of healing.

The holidays and social gatherings remind us that connection matters. But so does how we connect — with intention, with boundaries, and with the understanding that healing isn’t on anyone’s schedule but your own.


—- Written by: Peter Laneas
Advocacy & Engagement Lead
Cancer Fatigue Services

Getting My Fire Back

I was diagnosed with Colon Cancer in May 2025. I experienced symptoms a couple months before my 50th birthday. (Screening for this type of cancer begins at age 50).

Immediately after the colonoscopy the doctor took me and my fiancé into a room and explained that he saw a tumor and it was cancer. It was surreal. That moment remains clear in my memory.

After that, despite moments of extreme emotion alternating with the out-of-body surreal, I felt a fire inside me – preparing me to be capable of hard things.

A few weeks after diagnosis I had sigmoid colon resection surgery. I was an excellent patient! Recovery went well. I walked and gardened, being gentle on the surgical site. I tried manifesting a best-case scenario biopsy result. I imagined a powerful version of myself overcoming this disease. I visualized my body healing and being cancer-free.

Well, the biopsy results were out of my control. The cancer had gotten out beyond the wall of the colon and was labelled Stage 3. I saw an oncology team at Northumberland Hills Hospital (a wonderful small-town hospital) to get things rolling. I would need 6 months of FOLFOX chemotherapy. Before chemo started, there were CT scans, MRIs, and a PET scan. Suspicious lesions were deemed most likely benign with no metastases. The stress waiting for the results of these scans was one of the most difficult times during my cancer journey.

I needed to tip the balance between stress and positivity. I researched, read books written by cancer survivors, and lined up all the resources I could before treatment started. I needed to plan. I needed my family supports to know how to help me and how to help themselves. I needed to control my fate as best as I could while I was relatively healthy, before chemo started. I am so grateful for my family and friends, my workplace and Wellspring therapy and support groups. They all helped cheer me on, connect to other cancer thrivers, and hold me in a hopeful place.

Despite trying so hard to keep a positive attitude, my motivation waned part way through treatment. My fire became an ember. I felt I was just “getting through” each day. Each day during and post-chemo can be a massive feat. I tried to manage fatigue, nausea, and neuropathy. There were days when my main accomplishments were getting up and drinking fluids. This was nothing to be ashamed of when going through treatment and healing. Sometimes we need to be gentle with ourselves. We deserve to celebrate small wins.

I reached out to CCRAN (Colorectal Cancer Resource and Action Network) and found incredible support via dietician, Cancer Coach, Support groups, and one on one discussions. CCRAN listened and helped me move forward. When learning of my drop in energy and positivity, they recommended I connect with Cancer Fatigue Services.

Cancer Fatigue Services tailored an exercise plan based on my body’s capacity. The goal was (and still is!) to reduce fatigue, to strengthen my body, and to reduce the risk of recurrence of cancer. I became focused on exercise targets, was motivated by the compassionate staff (especially Matt!).

Working with Cancer Fatigue Services was one of the best choices I have made on my cancer journey. I am physically stronger. I have energy. I feel empowered to manage my health. I got my fire back.

Clinic’s Perspective: What Does It Mean To Be A Caregiver?

(Tim, his partner and Advocacy & Engagement Lead pictured here at the Canadian Cancer Survivor Network Charity Golf Tournament last summer.)



I have always felt great about helping others out. Throughout my life I had no problem jumping into action when a family member or friend needed assistance. This has led me to numerous jobs in the customer service industry, allowing me to continue to help people.

It wasn’t until my wife was diagnosed with a severe form of lupus that I truly started to understand what the term ‘caregiver’ really meant.

It is more than just helping with an isolated problem. It is the willingness to take responsibility for the care and well-being of another person, while respecting that person’s dignity and needs.

Caregiving can take many forms.

The person may need help with physical tasks such as bathing, dressing, and taking medications or day-to-day practical tasks like cooking, cleaning, or transportation.

The person may need help with managing their health needs through administering medication, attending appointments or monitoring their symptoms for any irregularities.

The person may need help with emotional support and look to you for comfort and reassurance.

The person may need help with advocating for themselves when dealing with the general public or health care providers.

Or they may need help with all of it…

This is why being a caregiver is such an important role in the lives of those who need it. Successful caregiving can provide a sense of purpose and personal growth for the caregiver, while boosting confidence, independence and deepening relationships for those who require care.

Depending on your situation, you likely didn’t start out caregiving with patience, empathy, and emotional strength. I know I didn’t. I just knew that I loved my partner and would do what ever it took to help. That is an important first step….committing to help, regardless of the context.

You will gain rewards and encounter challenges while acting as a caregiver.

My emotional IQ has grown by leaps and bounds. Thinking about WHAT are my partners needs, and HOW best to meet those needs for HER has become a catalyst for strengthening our relationship and increasing our trust in each other.

It has also provided me with a deep sense of purpose and meaning that helping others in my previous customer service roles could never bring. Seeing her smile on a daily basis is reward enough for me and helps me keep motivated to continue to provide care, strength and understanding, even when times are hard.

Being a caregiver can also come with its challenges.

There is an emotional strain that comes with caregiving as you might not feel you can provide the right type or amount of care that is truly needed for an individual. I know I have felt this way at times over the years with my partner. There have been moments I have felt very guilty for not being able to help more..to remove more burden from my partner’s life…to just, do more. Try to be as realistic about each situation you can, and understand that the goal is consistent long-term assistance, not trying to fix every little issue.

There may be a financial burden to taking on the role of a caregiver depending on if you need to alter or leave existing employment.

Sometimes trying to strike a balance between your own needs and the needs of those in your care can be difficult. It is important that you do not lose your identity to being a caregiver only, as the emotional toll can lead to burnout.

If you do not take care of yourself, then eventually you won’t be able to care of the important people in your life who depend on you.

Do not be afraid to ask for help. We all need help sometimes and that includes caregivers. Lean on your family and friends. They can be an invaluable source of comfort and emotional support during difficult times.

—- Written by: Tim Marnoch
Director of Customer Care and Services
Cancer Fatigue Services

Clinician’s Perspective: The Science of Motivation

January is a time where we often make ambitious goals to move more, eat better, or finally read those books on the nightstand, however this enthusiasm often fades quickly for many people… sometimes even before February arrives.  Research shows New Year’s goals frequently lose steam as motivation wanes, however evidence-based strategies can help you maintain this motivation and turn your good intentions into long-lasting habits.

Motivation fluctuates over time, depending on your goals, external environment, and sense of purpose and reward.  Studies have shown that intrinsic motivation, or doing something because you genuinely enjoy it, is more sustainable than doing something for external reasons, such as wanting to look a certain way or please others.  Therefore, finding something meaningful and genuinely enjoyable to you will be easier to sustain and continue the behaviour throughout the year.

Here are some tips on how to stay motivated and engaged with your New Year’s goals:

  1. Set realistic, meaningful goals

A common reason motivation wavers is that goals are often too ambitious and vague.  To boost early success, it is recommended to start small, such as swapping one unhealthy snack for fruit, or adding in 10 minutes of physical activity on most days.  These small wins build confidence and continue momentum.  As mentioned above, it is also important to connect goals to your personal values, and ask yourself why you want to improve your health.  

  1. Build habits through consistency

Motivation is strongest at the beginning of a change, meaning it is easier to stay motivated early in January than February.  However, habit strength will grow as the behaviour continues.  Research shows that new habits take approximately 2 months to form, but can take longer depending on the habit and the person.  It is important to remember that consistency is more important than perfection.  For example, doing a shorter walk every day is more effective than a long walk once a week.  Something called habit stacking can also be useful for establishing new behaviours.  This involves pairing a new behaviour with an existing routine, such as doing some stretching right after your coffee, which can help make new habits a part of your already established routine.

  1. Personalize and track your progress

Personal feedback and accountability help maintain motivation.  Self-monitoring and recording your activity, through journals or various apps, can help make your progress more visible and give you the objective information to adjust your goals.  Similar to above, this tracking doesn’t have to be perfect, just consistent.

  1. Tap into your social support

Motivation is more effective when there is social support and a person is a part of a supportive environment.  If possible, try partnering up with a friend to boost commitment to your goal, and make it more fun.  

  1. Be flexible

Rigidity in your goals can backfire and decrease motivation.  Research on goals has shown that being flexible, and adjusting your expectations and goal strategies when life inevitably gets busy, helps sustain motivation over time.  It is important to remember that if you miss a session, do not stress; it does not derail all the hard work you have put into your goal, and reframe these setbacks as learning opportunities, rather than failures.  Psychologists emphasize that self-compassion is a critical factor to success and recommend treating yourself kindly when things don’t go as planned.

January is a great place to start for establishing new habits and goals, but it is important to remember that real change can happen at any time, and occurs through consistent action.  Align your goals with what truly matters to you, build your routine gradually, track your progress, and be kind when things don’t go exactly as planned.  Remember: motivation comes and goes, but good habits can be here to stay with supportive strategies and purpose.

—- Written by: Amy Gildner, MScPT
Director of Clinical Services & Operations
Cancer Fatigue Services

When Cause, Community, and Charity Connect: Look Good Feel Better Series – Cancer Fatigue

There are moments in advocacy when everything aligns – the cause, the community, and the care behind it. The recent Look Good Feel Better: Cancer Fatigue workshop was one of those moments.

I had the privilege of participating in this session alongside a record-setting number of registered and attending participants. From the very beginning, the energy was unmistakable. The chat was active, the questions were thoughtful and structured, and the engagement was constant. Hearts, thumbs-up, and bursts of laughter emojis filled the screen. Even more so when I found the right moments to lean into bits of well-timed humour.

That’s the thing about fatigue conversations: they don’t have to feel heavy to be meaningful.

Cancer-related fatigue is one of the most common side effects of cancer and its treatments. It’s persistent, it’s disruptive, and it often lingers long after treatment ends. What made this workshop special was how openly people “showed up” – not just to learn, but to be seen. Honest experiences and questions were shared and leaned into the reassurance that fatigue is common, but not something that has to be accepted as “normal”.

Moderated by the wonderful Sue Larkin, the session flowed with a care and intention. Her guidance created a space where education felt approachable, where questions were ready in advance and no feelings of being rushed. Medical questions that required deeper insight were expertly addressed by our founder Dr. Scott Adams. His expertise ensured participants received clear, evidence-based responses alongside lived-experience insight from yours truly.

Together, we explored what cancer-related fatigue is, why it happens, and most importantly … what can be done about it.

What stood out to me the most was the sense of community. This wasn’t a one-way presentation. It was a shared experience rooted in hope, curiosity, and mutual understanding. People stayed engaged, supported one another in the chat with real-time reactions, and how managing fatigue isn’t about pushing harder – it’s about being supported better.

This is what happens when a cause meets a community through a charity that understands both. Education becomes empowering. Connection becomes healing and advocacy becomes something lived, not just discussed.

If you’d like to learn more about this workshop, I encourage you to visit Look Good Feel Better’s Cancer Fatigue page here: https://lgfb.ca/workshops-top-page/cancer-fatigue/

Workshops like this remind me why collaboration matters. When organizations like Look Good Feel Better create space for honest conversations, and when survivors are invited to bring their lived experience into those spaces, something powerful happens. People leave feeling informed, encouraged, and a little less alone.

That, to me, is what connection looks like when it’s done right.

—- Written by: Peter Laneas
Advocacy & Engagement Lead
Cancer Fatigue Services

My Cancer Fatigue Story

My story starts in the spring of 2016 with a sudden sharp pain about where my stomach is, when I got in to see a doctor in the family clinic that we were members in he suspected an ulcer. At the time I mentioned that my flow was reduced as well. His response was that they only deal with one issue at a time. As it turns out they were both symptoms of prostrate cancer and if he had done a simple digital exam he could have diagnosed my cancer then and there and saved me months of scans and tests and not knowing. I will never again accept the statement that they will only consider one issue at a time, and I suggest that you don’t ether.


One of the aforementioned tests was a look inside my bladder with a camera. When I registered at the hospital I was given a gown and told where to change then wait in the waiting area. When the nurse called me for the procedure she asked the same questions that I answered at the reception desk, when I asked why she asked questions that I had already answered she said they had to make sure they had the correct patient to which I thought if they knew why I was here there isn’t a man in town that would pretend to be me. The Urologist subscribed to the bandage theory (the faster you pull the less it hurts), if any Urologists are reading this the bandage theory doesn’t apply in this case. I suspect that he had trouble getting the camera past my prostrate because once he was done with the camera he did a digital exam and said my prostrate felt funny and yet he wasn’t laughing. So he cancelled the procedure that would have sent a camera passed the bladder to the kidneys and instead booked a biopsy.

When doing a prostrate biopsy they use an ultrasonic probe to guide the needle, when inserting the probe he said I would feel a little pressure, he was lucky he was behind me where I couldn’t see him because it felt like he shoved a cucumber halfway up my but, and not one of those skinny English cucumbers. If you are ever in BGH and you see finger sized dents in the rail of a gurney it might have been me.

It took some time to get the results, (I think the Urologist had them for a little while) but when they did come in I was a 10 out of 10 on the Gleason scale. When the office called to tell me the results were in I asked if I could come to the office now and they said yes, it was one of very few times my wife didn’t come with me as she was shopping when the office called, and since she wasn’t home when I got home, and this wasn’t news that should be delivered over the phone or by text, I simply texted “bring home some mix”. I was well into my second double (triple) Kraken (dark rum) on the rocks when she did get home, so I added a little coke to my drink and filled her in on what I could remember. The hardest part of this whole journey was the call to tell our sons that I had cancer, not knowing if I would be able to beat it or not. The one thing that the Urologist did right was to get me into the Juravinski cancer clinic right away.


My treatments started with chemo and one day I was about an hour into a three hour bag when I noticed a security guard in the entrance way, something I had never seen before, a short time latter a woman went by wearing a level “A” fully encapsulizing hazmat suit. The next time a nurse came close I asked what was going on and she said there was a chemo spill. To which I thought you are going to extraordinary measures for cleanup, and yet you are pumping it into my arm.

After months of chemo my next course of treatment was chemo on Monday and radiation 5 times a week for 7 weeks with the last treatment on December 20th. On the 20th the technician said that the side effects would continue to get worse for about a week which took me to Christmas, (Merry F#$K!N Christmas) anyone that has had radiation therapy knows how fatiguing it is. After Christmas the fatigue started to get better, but months later my energy never got above about 70%.


I should mention that I am a retired Toronto Firefighter (35 years), and also a City of Brantford Councillor for over 20 years. In the years since my treatment I have had to pass on seeking the nomination for both MP and MPP strictly due to the lack of energy from my cancer fatigue. I recently heard someone say that it takes 2 months of recovery for every month of treatment to get over the fatigue. To that I say HOGWASH my fatigue has gotten worse especially since the spring when the pharmacy changed the dose of my hormone therapy without telling me which resulted in me taking a double dose for about a month, as a result I can’t climb stairs without pulling on the handrail or on all fours if there isn’t a railing. As luck would have it the Mayor was unable to attend a cancer survivors event being held in Brantford and I attended to bring greetings in his stead, and that is where I found out about the Cancer Fatigue Clinic.

As I write this I have started my third 6 week prescription, and while progress is slow and at times it seems that I have traded cancer fatigue for exercise fatigue at least things are now going in the right direction. It was week 5 when I first noticed the improvement, we travelled to Vancouver to visit our son and daughter in law I was able to maintain a faster walking pace than I expected even when going up slight inclines that would previously slowed me to a snails pace. However it was after lunch that I noticed something else, the walk to the washroom that was just across the food court and down a short hall and back wiped me out. So I believe that when my body is busy digesting food I don’t have the energy to do much else, and now plan my activities accordingly.


I was a little skeptical about the program but my quality of life has dropped so far I was willing to try anything. And with each retest I have had a slight improvement. So as I said at the start don’t let anyone dictate a lack of treatment, insist on the treatment you need and deserve. And good luck with whatever stage of treatment or recovery you are currently experiencing. And wish me luck as I continue working to regain my life.

Greg Martin

Clinician’s Perspective: Why I Value Comprehensive Assessments for Cancer-Related Fatigue

By: Dr. Abeer Majid, MD CCFP

Working in primary care settings as a family physician, I’d often find myself wishing for more time. Assessing cancer related fatigue within a 20 minute appointment window, often shared with other health issues, can be challenging. I’d also feel disheartened by experiences of often not being able to fully prioritize and accommodate the helpful pacing and rhythms of people experiencing fatigue during the very limited appointment time available, such as time to rest, pause, and take breaks.

The Canadian Cancer Society identifies fatigue as the most common symptom for people with cancer and also the most common side effect of cancer treatment. A small amount of activity can be exhausting and it can persist for several years and have a profound impact on the lives of people experiencing it. Its comprehensive assessment can sometimes fall through the cracks both in hospital settings, with an understandable priority focus on cancer diagnosis as well as on the acute cancer treatments, and in primary care settings, with an understandable challenge of addressing multiple additional health and related issues. In this context, the presence of the Cancer Fatigue Services clinic is an important supportive and complementary intervention to help address this gap.

At Cancer Fatigue Services, I’m deeply appreciative of the time we are able to offer to facilitate a dedicated evidence-based comprehensive assessment of cancer-related fatigue which is OHIP-funded. This includes the self-reported fatigue questionnaires completed at their own pace by individuals accessing services at CFS. It also includes a multidisciplinary 60-75 minute comprehensive initial intake assessment appointment and the 45 minute follow-up appointments focusing on empowering individuals to identify and understand the combination of factors contributing to their unique experiences of cancer-related fatigue. Most importantly, it also offers a shared collaborative care plan prioritizing individuals’ own values and priorities.

The Identity Mirror: Who We Become After Cancer

There’s a moment for many survivors as I’ve learned to understand – whether it happens months or years after treatment — when you catch your own reflection and feel a quiet shift. You’re still “you”, but not quite the same. Cancer has a way of nudging itself into our identity, whether we asked it to or not.


The idea of “Survivor Identity” is common, but it isn’t one-size-fits-all. Some people embrace the term. Some prefer “someone who had cancer”. Others cycle through different labels as their relationship with survivorship evolves. Identity after cancer can affect us in a number of ways: well-being, confidence, and how we re-enter the world. It can shape how we view our bodies, our strengths, and our futures.


The mirror reflects both a before and an after — and sometimes, the tension between them.

I’ve felt that myself. After multiple diagnoses, and surgeries, there were days when the reflection looking at me felt like a stranger. Even harder were the times I saw the man before cancer, wanting to warn and protect him from what was coming. Other days, I saw someone rebuilt — quieter in some ways, louder in others, but undeniably changed.


That mix is part of the survivor experience, and it transcends age, gender, orientation, background or diagnosis.


Everyone who’s faced cancer learns that identity becomes something you revisit, not something you leave on autopilot.


But here’s the hopeful part: identity after cancer isn’t only shaped by what happened to you — it can also be shaped by what you choose next.


If you’re in that stage of looking for your own “identity mirror,” here are a few grounding strategies that have worked for me:

  • Name your identity on your terms. Whether you see yourself as a survivor, a thriver, someone who endured, or simply yourself — your definition is valid.
  • Connect with others who get it. Community normalizes what feels isolating. Hearing your own thoughts reflected back helps you feel less alone.
  • Allow evolution. Your identity doesn’t have to stay fixed. It can shift as you heal, as you grow, and as life changes around you.
  • Explore meaning. Creativity, advocacy, leadership, storytelling, caregiving, or restarting something you paused — purpose after cancer can look like many things.
  • Seek support when needed. Mental health professionals familiar with survivorship can help navigate the emotional layers behind identity changes.

Most importantly: Give yourself grace. You are allowed to grow beyond what happened to you. You are allowed to carry parts of the old you and the parts of the new you. You are allowed to be complicated, evolving, unfinished, and still whole.

So the next time you look in the mirror, and ask yourself gently:

“Who am I becoming?”

You may find the answer is richer and more resilient than you expected.


Written by: Peter Laneas
Advocacy & Engagement Lead
Cancer Fatigue Services

My Journey Through Cancer and Finding My Energy Again

By Elvira S.

When I think about how everything started, my mind always returns to October 2021. It had been only six months since my mother passed away when I heard the words that changed my own life: “You have breast cancer.” I was diagnosed with right breast invasive ductal carcinoma, grade 2 with DCIS. My daughter was just 12 years old, and my husband stood beside me, speechless. In that moment, nothing felt certain anymore.

I tried to remind myself that I was lucky it was caught early. But even early cancer brings its own storms. After two lumpectomy attempts that winter, I eventually needed a right breast mastectomy with DIEP flap reconstruction in 2022. Two months later, I went back to work because I thought staying busy would help me stop thinking about the disease. I chose not to take adjuvant therapy, convincing myself I would be fine.

But life had other plans.
Two years later—again with no symptoms and found only through routine checks—I faced a second diagnosis: left breast DCIS, intermediate to high grade with central necrosis and macrocalcifications. One lumpectomy led to another mastectomy and reconstruction in 2024. It felt like my body kept surprising me in ways I never asked for.

When the Fatigue Took Over

In February 2025, after all the surgeries, I tried once again to return to work. What I didn’t expect was how deeply fatigue would hit me. Not regular tiredness—this was something heavier, something that swallowed up my focus, my energy, even my confidence. Just a few weeks in, I had to go back on sick leave. I couldn’t explain to my family doctor what I was feeling. All I knew was that something was off. I was exhausted in a way that didn’t make sense.

That’s when I started searching “cancer fatigue,” hoping to understand what was happening to me. I came across Cancer Fatigue Services Toronto and instantly noticed their logo: one person reaching out a hand to lift another up. It made me feel seen before I even clicked. I took their Fatigue Analyzer test, and the results confirmed what my body already knew—my fatigue levels were high.

After talking to friends who had heard positive things, I booked an appointment.

Feeling Heard for the First Time

In my first visit, I completed a physical CPET exam and then spent almost an hour talking with Dr. Bain. At the end of that conversation, I said something I didn’t expect: “I feel better because someone actually listened to me for an hour.” That moment alone felt like a turning point.

As I continued with the clinic, I met specialists who helped me understand what was happening in my body—why fatigue can be so intense after cancer, and what can be done about it. Scott shared research on mitochondria and how they “get happier” with the right kind of exercise. For the first time, I felt empowered. I learned that I wasn’t powerless—I had some control. And that gave me the motivation I needed.

Learning to Live with Energy Again

I committed to the program. Phase by phase, over six months, something began to change. My afternoons didn’t automatically end in naps anymore. I could do more around the house. I started feeling…like myself again. Not the same as before cancer—but a version of myself who understood her body better, who knew how to protect her energy instead of burning it all at once.

The support I received made a difference. The Fatigue Peer Support Group showed me I wasn’t alone. The Cognitive Rehabilitation Program with Luana and Peter helped me navigate the mental side of fatigue. Matthew and Amy guided me through exercises, checked my form, and helped explore chronic pain I had been ignoring. And Tim—who had to patiently deal with me in the early days when I wouldn’t even share my birth date until I felt comfortable—thank you.

Each staff member at the clinic played a part in helping me make it through all four phases of the program.

Looking Back — and Forward

Cancer changed my life twice. Fatigue changed it again. But learning how to manage it, how to understand it, and how to honor my limits has changed me in the best way.

I’ve learned that it’s okay to rest.
It’s okay to ask for help.
And it’s possible to find energy again, even when it feels lost.

To anyone else facing cancer-related fatigue:
You’re not weak. You’re not imagining it. And you don’t have to go through it alone.

Kudos to everyone who has helped me on this journey.
I am deeply grateful.
I love you all.

— Elvira S.

Clinic’s Perspective: Applying Technology to Healthcare – Passion With A Purpose

Written by: Leo Flor BMATH, Director of Technology & Information Services

Not into reading? Try out the TikTok version of this article!

My education and experience to date has led me to a career in an often misunderstood and mischaracterized role in technology companies called Product Management. Essentially, a technical product manager’s job is to support the organization at different levels, influencing product-building, strategy and operations. We leverage different techniques and methods for embracing innovation to tackle problems and come up with solutions that solve for unaddressed needs, both for the customer or internal teams.

You might be wondering, what is a tech product manager doing working for a medical clinic?

This would be a completely valid question, if Cancer Fatigue Services (CFS) was just a medical clinic. It is more accurate to describe CFS as a ground-breaking healthcare startup. Fatigue is arguably the most prevalent, burdensome and complex non-fatal health issue experienced by people living with and after cancer. CFS is creating solutions for an underserved clinical population whose healthcare needs have been neglected. Identifying opportunities out of unmet needs, that is what product management is all about.

A better question might be to ask WHY would this product manager work for a clinic?

Earlier in my career, I worked at OntarioMD, an organization focused on helping primary care physicians transition from paper to electronic medical records. During that time, I saw first-hand how challenging data exchange between health systems would be. I recognized many opportunities to apply my computer science background to the benefit of both patients and clinicians. I am proud to have contributed to the early stages of integrated healthcare, though disappointed by the limited progress since then.

I LOVED working for a company that served doctors. My mom was a surgeon, she was an overall amazing human being and she was my hero. Ovarian cancer robbed the world of this wonderful person and I saw the work that I did to support doctors as a way to honour my mom’s memory. This newest venture into the healthcare space has an even deeper connection to my memory of her. Every patient we support and all of the clinicians I work with at Cancer Fatigue Services are a reminder of Mama.

It is hard to be mad at cancer. It has no face. But it does leave a person who is diagnosed and the people that care about them devastated, whether they survive the diagnosis and treatments or not. I want to transform the feelings of anger and fear into courage and hope. My personal experience fuels my desire to help those affected by cancer. I contribute by empowering our team to deliver the best possible healthcare experience for those we serve, through the technology and operational processes I played a role in developing.

— — —
A technology and product management background compliments the medical and scientific experts at Cancer Fatigue Services. All of the different technologies CFS has implemented and continues to employ have a similar origin story. We view every unmet need as an opportunity for exploration, using an agile approach to discover and deliver solutions. Throughout the process, we remain simultaneously focused on addressing the need, achieving business objectives, delivering value to users and optimizing patient experience.

Cancer Fatigue Services always looks for ways to leverage technology to further our mission to support anyone who has developed or experienced worsening fatigue at any point following a cancer diagnosis. Pictured here, I am helping our clinical team test and iterate on our cardiopulmonary exercise test (CPET) data collection.

This role at CFS is an amazing opportunity for any technologist. The culture of high-trust, curiosity, experimentation, embracing innovation and making data-driven decisions has been present at CFS since day one. It is exhilarating and fulfilling to work daily with doctors, scientists and other clinicians solving problems I was already keen to solve. I have found truly meaningful work that impacts countless lives, being able to use all of the skills and experience I’ve accumulated throughout my career.

I have found my ikigai.

Finding Your Tribe: Community, Comedy, and the Power of Purpose

If there’s one thing I’ve learned in five years with the Health eMatters Conference, it’s that community doesn’t just happen – it’s built, intentionally, by people who show up again and again. I’ve had the privilege of being part of this event since its very beginning, serving as both co-emcee and as one of the original steering committee members. Each year, I’m reminded why it matters so deeply.

Peter Laneas: Selfie at Health eMatters Conference


The 2025 Health eMatters weekend was another powerful chapter in that story. From the moment the doors opened, you could feel the mix of anticipation and familiarity. The kind that only exists when survivors, caregivers and advocates come together not just to share information, but to share themselves. The sessions were insightful, the panels brave, and the energy? Electric. In one attendee’s terms, “It’s like coming back to cancer summer camp”, where every year we come back to see our friends and do the work.

Peter emceeing at Health eMatters Conference 2025


For me, emceeing this event has never been about being on stage; it’s about helping others step into the spotlight. Giving them room to tell their stories, ask their questions, and find connection in the faces around them. That’s the magic of community: it reminds us that survivorship doesn’t end with remission. It evolves. It deepens.


Finding your tribe in survivorship isn’t just about swapping medical war stories … although feeling understood among your peers “who get it” does feel incredible. It’s about laughing again, creating again, and realizing that life after cancer can have purpose. Whatever that looks like for you. Maybe it’s advocacy. Maybe it’s art. Maybe it’s mentoring another patient through the first hard steps. There’s no single definition of purpose, only the courage to look for it.

PICC Lines & PunchLines Comedy Show Banner

One of my favourite moments this year was hosting and performing in “Picc Lines & Punchlines”, a comedy show featuring an incredible lineup of fellow cancer survivor comics. Each performer brought their own story, their own scars, and their own punchlines. Together, we proved that laughter truly is part of healing. There was pride in the room, yes, but also release. Comedy became connection.

Peter Laneas, on-stage delivering comedy


That’s what Health eMatters community is all about. Whether it’s through a microphone, a conference session, or a shared laugh over dinner, the weekend reminds us that we’re not alone. The space we create together has a ripple effect far beyond the hotel conference room.



If you’re still searching for “your tribe”, keep looking. They’re out there – at conferences, in support groups, in late-night messages from people who “get it”. When you find them, you’ll know: healing gets lighter when it’s shared.


Written by: Peter Laneas
Advocacy & Outreach Communications Manager
Cancer Fatigue Services

From Skeptic to Believer: How a 6-Week Plan Got My Energy Back

As a childhood cancer survivor of over 20 years and as someone who currently works in paediatric oncology, I feel as though I am able to navigate the system relatively well. I’ve seen first-hand the incredible resources that exist for survivors of childhood cancer. At the same time, I’m also aware of the gaps that still need to be addressed.


For a long time, I didn’t even realize I was dealing with fatigue – I just thought feeling tired and sleeping poorly was my “normal” after cancer, a long-term effect of all the treatment. Looking back, I can see how much it was actually affecting me.


I am a bit skeptical of psychosocial resources in Ontario, especially as a childhood and AYA (adolescent & young adult) cancer survivor. I have tried a number of them and many are just education, cost a lot of money or put the responsibility solely on the patient to continue to follow through with the action.


I met Scott (Dr. Adams) MANY years ago and we had crossed paths over the years. So when Scott reached out I was a bit skeptical of this new service. I walked everyday between 2-5km, had no issues with my daily living and felt pretty healthy but there were moments when I was tired. I didn’t think I needed these services. We had a meeting and I asked A LOT of questions, many repeatedly and I still was like BUT WHY?


The bike was the hardest part for me to grasp – I walk, I get done what I need to get done I don’t understand, why does it have to be the bike. I asked this like a broken record.


Nevertheless, I gave it a shot. I did the assessment and the CPET (cardiopulmonary exercise test) and I didn’t realize how unhealthy I was when I received my initial testing numbers.

Cancer Fatigue Services - Assessment Room - Cardiopulmonary Exercise Test and Metabolic Cart


So I did the 6 week plan. When I went in to do my repeat CPET and talked with Matt and Scott and I had to eat my words. I don’t understand it but it worked, I got energy back. I don’t get why I had to use the bike but something about it was different and it worked.

Real People. Real Relief
Aggregate data of our early adopters after completing a six-week exercise therapy program.

No one does anything about fatigue in the cancer community. We all hear about it as a possible side effect but what happens when you are done treatment and you need additional assistance, there is no one to help walk you through the process aside from just go exercise. Cancer Fatigue Services helped me – I have the numbers to prove it – and they also did it with me so I didn’t feel like I had to solve the problem alone.

Bladder Cancer Canada: Building Awareness & Community

Bladder Cancer Canada (BCC) is the first and only national organization dedicated solely to supporting those affected by bladder cancer. Through education, advocacy, and connection, BCC is changing how Canadians understand and respond to one of the country’s most underrecognized cancers.

Their mission is simple but vital — to provide patients, caregivers, and families with credible information, peer support, and a sense of community from diagnosis through recovery. From their One2One Peer Support Program and national support groups to public awareness campaigns like “See Red? See Your Doctor,” BCC ensures that no one faces this journey alone.

At Cancer Fatigue Services, we’re proud to spotlight organizations like Bladder Cancer Canada that are reshaping the landscape of survivorship care. Their work reminds us that awareness and advocacy are as critical as treatment — because early detection saves lives, and connection restores hope.

👉 Learn more or get involved at bladdercancercanada.org

Men and Fatigue: Breaking the Silence

If there’s one thing I’ve learned in fifteen years of survivorship and advocacy, it’s this: men are really good at pretending they’re fine. We’re taught from a young age to “push through it,” to “man up,” and to keep going even when our bodies and minds are begging for a break. It’s a cultural script that prizes endurance over honesty—and when it comes to cancer-related fatigue, it’s hurting us more than we realize.


Fatigue isn’t just feeling tired. It’s the kind of exhaustion that sits deep in your bones and makes everyday life feel like climbing a mountain. And yet, I’ve lost count of how many men I’ve met—survivors, patients, caregivers—who downplay it. They don’t want to admit they’re struggling. They fear being seen as weak.


I’ve lived this myself. As a two-time testicular cancer survivor, I know what it’s like to smile through the exhaustion, to host events, to sit on panels, to crack a joke when inside your body feels like it’s running on fumes. Ignoring fatigue doesn’t make it go away. It just makes it lonelier.


That’s why this isn’t just a health issue—it’s an advocacy issue. If men continue to underreport fatigue, we miss the chance to normalize conversations that could lead to proper support. We risk leaving half the survivor population in silence. And silence, in survivorship, can be dangerous.


So how do we start breaking it?

  • Normalize honesty. Men need permission—from themselves and each other—to say, “I’m exhausted, and it’s affecting me.”
  • Challenge the stigma. Pushing through isn’t a badge of honour if it leaves you burnt out or disconnected from your own recovery.
  • Advocate for gender-sensitive care. Fatigue management shouldn’t be one-size-fits-all. Health professionals need to recognize how stigma shapes male reporting and adapt their approaches accordingly.

To me, advocacy has never been about grand gestures. It’s about being the other guy in the room who admits, “Yeah, I’ve been there too.” That simple honesty can open a floodgate for someone else.


Men don’t need to suffer in silence. Fatigue is common, but it’s not normal—and it is treatable. The first step is giving ourselves permission to stop pushing through and start speaking up.


Written by: Peter Laneas
Advocacy & Outreach Communications Manager
Cancer Fatigue Services

Life is __________.

Written by Robert

Everyone has their own answer for this phrase based on their own experiences, and everyone is right because it is their experience. Many years ago, I heard someone complete this phrase by explaining that life is not just what you plan and work out using a formula, good career decisions, having the right connections, etc…. But, life is the interruptions. In other words, some of the biggest tests and outcomes in life occur when they happen without plan or expectation, and when they come seemingly out of nowhere.


Prior to my diagnosis, life was good. Of course it had it’s challenges, but I was prepared to face them. I had relatively good health, a good career, a loving family…in many ways my life was very stable and obstacles were just meant to be worked through and overcome.


When I received my diagnosis of Non-Hodgkin’s Lymphoma in early 2021, we were all learning how to get through the Covid existence. Although a surprising diagnosis, as I was feeling fine and had no ailments other than a lump that appeared on my neck, it was just going to be another challenge to overcome. I remember talking with my hematologist, saying that I had intended on living a long life. After all, I had plans! Life was busy, but I was in control. This was just another obstacle, right? Life keeps you busy.


The process of diagnosis, treatment and gaining information about my newfound illness was all so quick. Given that it was an aggressive lymphoma, I was in an appointment with my hematologist/oncologist within 2 days and had begun treatment within a few weeks. It was a new challenge, a new experience. I’ve had challenges before… I figured them out. I tripped up at times, sure, like everyone else, but I managed to always be successful and come out on top. Sure, there was a lot more at stake this time, but I was game. Life is a game.

Patient receiving chemotherapy


Chemotherapy treatments over the next few months were tough, but they were bearable. I slept a lot, relied more on family and friends, tried to work, but my mind and body wouldn’t cooperate. As a result, I had to go on a medical leave. But this was going to be a short interruption… it was going to be manageable. Life was still waiting to be lived.

The staff at Princess Margaret Hospital were incredible to say the least. Like a clock, they seemed to function meticulously, accurately and oh so organized, in spite of the fact that there were so many people to manage: faces that were filled with fear, resignation, hope, concern. But I was going to get through this…. just show me the path and I’ll be back to a normal life in no time. I just had to show up, spend a day every three weeks hooked up to an IV pumping those chemotherapy drugs in me that were going to make everything better, learn to live with the (hopefully) short-term nausea and fatigue, and then move on with life. Life is like clockwork.


Towards the end of treatment, scans were completed. Yay, the cancer was gone and I did not have to go through the last treatment session. I was so glad…I didn’t want to share with those around me that I didn’t think I had it in me to do one more treatment…chemo was taking everything out of me and I almost felt I had nothing left. Physically, I felt I was at rock-bottom… I truly felt my body and my soul were broken. I was weak, constantly tired, at times unable to finish sentences because it took too much energy. All I needed now was to get back to normal and life will be good. Life is about hope.


The next stage…. recovery. I asked my hematologist “how long will it take before I’m back to normal, before I can go back to work and a regular life?” The answer was along the lines of “hmmm, ahem, well, everyone is different and everyone recovers differently… some people go back to work after 3 months, and some people never go back.” I only heard the part that “some people go back to work after 3 months”… this was going to be me.


Friends, family and acquaintances were all mostly supportive, to the point that they could understand (can anyone really understand without going through something?). I was grateful for the support. The regular and constant question was “when are you going back to work?”, to which I answered regularly “hopefully in 2-3 months.” 2-3 months later, I was in no shape to go back to work. Although the fatigue improved somewhat, there were still some issues with stamina, cognitive challenges and even confusion. I was surprised at myself that I did not have the energy to be patient and understanding of those around me, which was uncharacteristic. “2 or 3 more months and I should be back at work” I would continue to tell my employer and those around me. And the cycle began, in that every 2-3 months I was not ready to go back. I had learned about the term cancer fatigue and brain fog – I was beginning to think I was the poster child. The cycle of expecting to go back to work soon but not being able to, continued, over and over. After awhile I wondered if it were just me… was it all in my head? Am I just out of practice? Do I just need to force myself to work harder at things? Life can sometimes be wearisome.


I engaged with various health practitioners, trying various supplements and treatments hoping it would make a difference with my fatigue levels. And after months and months of interventions, nothing was different. It was becoming clear to me in comparison to our vast understanding of cancer and how to treat it, the understanding of recovery from chemotherapy treatment seemingly paled in comparison. There was no clear, quick path… at least it did not seem so. Treatments varied. Maybe they worked for some…. they weren’t working for me. One practitioner encouraged me to eat 3 dark chocolate bars every day as there was research that showed dark chocolate can help with energy and fatigue levels. Life can be confusing.


I began the cycle of trying something new, seeing little to no change, going into a bit of a depression, and then trying something new again. I searched and searched for something different, something evidence-based, some intervention that truly understood cancer fatigue and related challenges. I sought out numerous interventions and informed my medical team and insurance company of them, to which they pretty much said “sure, sounds great.” Everything was a shot in the dark with the hope that it would facilitate positive results, but these results were not happening. Often practitioners in these fields were using interventions that they used for other maladies, hoping that there would be some benefit for me. But they were not. It began to feel like no one seemed to truly understand what I was going through and that the fatigue issues related to cancer treatment was obscure and not within the scope of treatment. The idea of going back to work did not even seem like a goal anymore. I stopped answering the question of when I was going back, and people stopped asking. It felt like I finally needed to come to the difficult conclusion that life will never be the same, and that I would need to learn to live my life differently than I had, with fatigue and cognitive and physical challenges. Life can be humbling.


As I continued my own research and exploration of how to deal with cancer fatigue, I came across an ad for Cancer Fatigue Services (CFS). Was this just another clickbait ad with empty promises? I quickly went to the webpage with cautious optimism. It looked promising, and so I decided to try one more intervention. After an assessment and discussion with members of the CFS team, I began to feel that finally there was some understanding of what I was going through and that it wasn’t just in my head. I decided to commit to the program not knowing what to expect. Life is about taking risks.


With CFS, I got the validation that cancer fatigue is indeed real and not just in my head. I was presented with the challenge of a professional exercise plan that was tailored to my circumstances, my physical abilities, and was adjusted as I progressed …something that you hear about that only professional athletes have access to. It was a plan that wasn’t going to break the bank. I now had an intervention that was going in the right direction. I was finally getting answers to questions, answers that were steeped in research. Life can be fortuitous.


As I reflect on my experiences with CFS, I am reminded of the critical impact of working with professionals who are knowledgeable, caring, empowering and compassionate, and how this approach has contributed to overall wellness for me. I continue to experience a true partnership with CFS, as they truly understand what it is like living with cancer fatigue. Although some levels of fatigue still persist, I feel stronger and my stamina has improved.


Life is not the same after a battle with cancer. The hard reality is that this interruption has changed me and requires me to approach life in a new way. Having a powerful intervention like CFS has contributed significantly how I now continue with this journey.


Life is…. life.

Clinician’s Perspective: Dr. Martin Chasen on Cancer-Related Fatigue

If you’ve been through our clinic, you may have had the opportunity to meet Dr. Martin Chasen, an oncologist and palliative medicine physician with a progressive view on cancer rehabilitation, survivorship, and fatigue management.

Recently, Peter Laneas, our Advocacy and Outreach Communications Manager, sat down with Dr. Chasen to learn more about his journey, what drives his work, and his insights on managing cancer-related fatigue.

A Career Spanning Continents

Dr. Chasen’s medical path began in South Africa, where he completed medical school and specialized in internal medicine and medical oncology. Early in his career he was struck by the multi-dimensional challenges faced by people living with and beyond cancer.

In the early 2000s, he pursued additional training in palliative care, recognizing the importance of treating the whole person, not just the disease. In 2004 he moved to Canada, first joining McGill University, where he helped create a comprehensive Cancer Nutrition and Rehabilitation Program. In 2009 he brought this model to Ottawa, expanding access to a truly integrative approach that addresses physical, nutritional, and psychosocial needs.

Why Cancer-Related Fatigue Matters

Throughout his work Dr. Chasen noticed a consistent theme: patients who were profoundly tired—long after treatment ended. “Cancer-related fatigue is still misunderstood,” he explains. “It doesn’t show up on a blood test like anemia. People sometimes dismiss it, even in healthcare. But it’s real, and it can be life-altering.”

He stresses that fatigue isn’t simply a side effect of chemotherapy. It’s multifactorial—linked to treatment, surgery, emotional stress, and the body’s overall response to illness. Left unrecognized, it can impact every part of daily life.

The full video interview will be released soon as part of The Energy Exchange, our educational video series designed to help people living with cancer-related fatigue learn practical strategies.

Evidence-Based Steps to Manage Fatigue

Dr. Chasen emphasizes a whole-person strategy that blends medical oversight with lifestyle habits:

  • Exercise: Start small—“even a minute or two,” he says—and gradually build to about 30 minutes of activity three times a week. Regular movement preserves muscle mass, boosts mood, and reduces fatigue.
  • Nutrition: “Food is fuel. Balanced meals with adequate protein, healthy carbohydrates, and fats help the body recover and maintain energy.”
  • Sleep & Routine: Consistent sleep, social interaction, and maintaining daily rhythms are crucial for restoring energy.

Equally important is validation: “Caregivers and clinicians must listen and believe patients,” Dr. Chasen notes. “Acknowledging that cancer-related fatigue is real is the first step toward meaningful support.”

Supporting the Whole Person

Dr. Chasen champions a team-based model—physicians, nurses, dietitians, physiotherapists, occupational therapists, and social workers working together. This coordinated care helps patients and families understand that fatigue is not a personal failing but a recognized, treatable condition.


Get to know Dr. Chasen and Peter even better in this article welcoming both of them to the team!

Kelly Shires Breast Cancer Snow Run

As part of advocacy and outreach, Peter gets to connect with many different organizations that support the cancer community. In this post, we want to highlight, Kelly Shires Breast Cancer Snow Run, a charity that runs an annual event to raise money for individuals with breast cancer who need financial assistance.

This charity gives directly to people with breast cancer (rather than research) which is fantastic because you know for sure an individual in need will benefit from funds raised by the charity.

Please check out their website for more info: https://breastcancersnowrun.org/

From Patient to Cancer Fatigue Services Clinician

By Norkael (Kael) Limdy, BKin

Cancer changed the course of my life not only as a patient, but now as someone supporting people going through their own cancer journey. I was still in school at Ontario Tech University, studying kinesiology, when I was diagnosed with a rare spinal sarcoma cancer. One moment, I was learning about how the human body functions. And the next moment, I was facing chemotherapy, radiation therapy, and multiple spinal reconstruction surgeries. Everything I thought I knew about health, strength, and recovery suddenly became no longer textbook but, deeply personal.

The treatment journey was long and intense. I spent months going through chemotherapy and radiation, followed by years of rehabilitation as I adapted to life after surgery. I had to relearn how to walk, move, how to manage pain, and how to live in a body that felt very different from the one I was familiar with.

Looking back, I realize I was experiencing cancer-related fatigue, but at the time, I did not have a name for it. I only knew that even basic tasks felt exhausting. Exercise, school, and especially my social life all took a toll. For years, I felt as if I was isolated, not just physically but emotionally too. I was afraid of regression, unsure of how to rebuild and make new relationships, and often felt ashamed of how much my body had changed. It was like life had moved on without me while I was standing (mostly sitting) still.

However, when I found Cancer Fatigue Services (CFS), it truly changed everything.

The CFS team, welcomed me with open arms and built a personalized care plan that helped me regain strength, reduce pain, and slowly return to the things I love doing. Exercise programs were designed to target my core and back muscles, improve my posture, and support my daily movement with precision and care. But it was not just about physical function. It was also about the joy, independence, and feeling like myself again that stood out differently compared to treatments I have received in the past.

As my body got stronger, so did my confidence. This summer, for the first time in years, I felt like I could really live again. I have met new people, travelled, tried new things, and reconnected with the world around me. Not as someone who had cancer, but as someone who is moving forward with my purpose. In fact, this September, I am happy to share I will be running a 10K at the Toronto Zoo. It is more than just a race. For me, it is a celebration of how far I have come both physically and emotionally.

What makes it even more meaningful to me, is that I now work as part of the Cancer Fatigue Services team. Supporting people who have walked a similar path that I have been on, has been incredibly fulfilling. I have had the privilege of assisting with Cardiopulmonary Exercise Testing’s, helping patients with their exercise care plans, and contributing to the patient outreach and advocacy efforts. The involvement has allowed me to support people living with cancer-related fatigue in practical and effective ways. Being able to support people on their journey and see their quality of life improve first-hand has been incredibly rewarding. It is clear to me now that fatigue does not have to define the experience, and with the right care, we can regain energy, confidence, and hope for the future.

My lived experience allows me to care with empathy and understanding. I know how difficult it is to feel exhausted, overwhelmed, fear and unsure about the future. But I also know that with the right support, recovery is within reach.

Before I found Cancer Fatigue Services, I had already begun studying prosthetics and orthotics at George Brown College. Inspired by my own recovery and the spinal orthosis that helped me walk again. Now, with training in both respected fields; rehabilitation and cancer-related fatigue care, I hope to help others regain their mobility, independence, and confidence. Cancer Fatigue Services did not just help me recover. They helped me rediscover who I always was. They reminded me that healing is not only about the body, but about self-identity, connection, and purpose.

We do not just treat, we relieve fatigue and restore hope through rebuilding strength, restoring confidence, and reconnecting with life.

And I am proud to be part of that journey, for myself and for you.