In the early 1990s when Bernardine Pinto launched one of the first post-treatment exercise studies for breast cancer patients, she had no idea it would shift her research focus and influence a new paradigm within cancer survivorship.
Long before yellow silicone bracelets launched a fashion fad and a movement, attitudes about post-treatment quality of life were summed up by one physician who questioned the need for her study, quipping, “Why bother?”
But Pinto persevered, designing a moderate-intensity exercise program for breast cancer patients that improved their fitness, mood, body image and fatigue levels, highlighting the importance of exercise to cancer recovery.
While refining her intervention model through a series of research studies, she also partnered with other health care professionals and researchers on a national task force sponsored by the American College of Sports Medicine that in 2010 published the first guidelines for exercise for cancer patients, now under revision.
Her latest accolade in a high-profile career spanning more than 20 years was receiving the 2018 Senior Investigator Award from the Society of Behavioral Medicine’s Cancer Special Interest Group.
“This recognition was very self-affirming because it’s based on your body of work. It felt good because it came from my colleagues.”
Dr. Pinto, professor and associate dean for research
Although a clinical psychologist by training, Pinto has partnered with nurses throughout her research career. She came to the University of South Carolina in 2014 drawn by the opportunity to mentor research faculty and advance the college’s research productivity while continuing to obtain funding, conduct her own studies and work towards improving cancer survivorship.
Her work motivating breast cancer patients to exercise began during her post-doctoral experience at Brown University’s School of Medicine. After designing home-based exercise programs for cardiac patients, Pinto recalled her previous research experience with breast cancer patients. She searched the literature, finding common post-treatment reports of fatigue, loss of confidence and poor body image — all side effects she theorized could be addressed by moderate-intensity exercise, which in other populations had been proven to improve mood, vigor, fitness and cognitive abilities.
At that time, the prevailing medical thought was that cancer patients should rest after treatment because their bodies had been taxed. And because the patients were considered fragile, moderate-intensity exercise was seen as a risky proposition — thus, she began with an on-site supervised, hospital-based program.
Over time, the design of Pinto’s exercise programs has evolved. Based on participant feedback, she developed a home-based program that patients could complete on their own time with telephone check-ins for safety monitoring and support. Recognizing that within the cancer care setting, physicians have limited time with patients to discuss exercise, Pinto has partnered with community organizations such as the American Cancer Society to offer an exercise program for survivors using the Reach to Recovery program’s trained peer counselors, reducing the intervention’s implementation cost while extending its reach to more patients.
The peer counselors, who must be physically active themselves, teach participants how to slowly adopt a program of regular exercise, help them to overcome barriers to exercising and encourage them to set weekly exercise goals, recognizing that in some weeks other obligations may squeeze exercise time.
Pinto also continues to explore how technology can support and motivate participants — for instance, by receiving check-ins by text message instead of by phone and tracking exercise through a mobile app.
And as a five-year breast cancer survivor herself, Pinto not only talks the talk of the important of exercise but walks the walk, daily logging 5 miles of brisk walking.
“I’m hoping that through my research, I’ve helped improve survivors’ lives,” she said. “It’s not about doing research for the sake of research.”