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The Honolulu Advertiser
Posted on: Thursday, November 10, 2005

Rebuilding strength lost to cancer

By Catherine E. Toth
Advertiser Staff Writer

Roz Makaula, diagnosed with breast cancer less than a year ago, works out at the Honolulu Club with fitness expert Karen Merrill.

GREGORY YAMAMOTO | The Honolulu Advertiser

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ROZ MAKAULA

Age: 32

Profession: AM producer at KHNL and freelance writer

Home: Kailua

Health status: Diagnosed with breast cancer in December 2004

Stays in shape by: Working out twice a week at the Ho'ola Cancer Exercise Wellness Program at the Honolulu Club

Book she's reading: "The Purpose-Driven Life: What on Earth Am I Here For?" by Rick Warren

Interesting fact: Makaula, who's more than half Native Hawaiian, was born with platinum blond hair.

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Roz Makaula

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FACTS ABOUT BREAST CANCER

  • Breast cancer is the most common cancer among women, except for non-melanoma skin cancers. It is the second leading cause of cancer death in women, exceeded only by lung cancer.

  • An estimated 211,000 new cases of breast cancer will be diagnosed in American women in 2005. About 43,000 patients will die from the disease this year.

  • The chance of developing invasive breast cancer at some time in a woman's life is about 1 in 8. It happens to 13 percent of women.

  • There are slightly more than 2 million breast cancer survivors in the United States.

  • Women living in North America have the highest rate of breast cancer in the world.

  • Breast cancer does not exclusively afflict women. For every 100 women with breast cancer, 1 man will develop the disease. An estimated 1,600 men will develop breast cancer this year.

  • About 50 percent of breast cancer is diagnosed in women older than 65.

    SOURCE: American Cancer Society, Susan G. Komen Breast Cancer Foundation, National Breast Cancer Foundation, National Cancer Institute

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    Roz Makaula, right, and other cancer patients at the Honolulu Club learn about strength training and cardio exercises from Karen Merrill. Exercise programs are tailored to individual abilities and progress.

    GREGORY YAMAMOTO | The Honolulu Advertiser

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    RETURNING TO HEALTH

    Ho'ola Cancer Exercise Wellness Program

    Exercise program designed for cancer patients and survivors

    Honolulu Club, 932 Ward Ave.

    543-3937

    www.honoluluclub.com

    To help with the program:

    Karen Merrill, 284-5150, karenmerrill@hawaii.rr.com

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    EXERCISE AND CANCER

    Studies show that exercise accelerates recovery after chemotherapy and improves survival rates.

    But before cancer patients or survivors jump into a fitness program, here are some things to consider, according to Karen Merrill, certified cancer-exercise specialist and founder of the Ho'ola Cancer Exercise Wellness Program:

  • Ask your doctor. You need to get medical clearance before starting any fitness routine. Your doctor will know best what you can and cannot do.

  • Be realistic. Set appropriate short- and long-term goals. Walking to the mailbox may be your goal today, and that's OK. Don't push yourself to do too much too fast. Take it slowly.

  • Forgive yourself. Some days you'll feel better than others. That's normal. "You have to realize you're starting from ground zero," Merrill said. "You might feel great in the morning, then at 5 p.m. you feel horrible. I'm a huge advocate of taking small steps."

  • Feel proud. Celebrate the small victories. "Realize that a lot of (cancer) isn't in your control," Merrill said. "So focus on the positive. Don't focus on the stuff you can't control."

    — Catherine E. Toth

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    A year ago, Roz Makaula led a completely different life.

    Always active, Makaula hit the gym five times a week, hiked on the weekends and danced hula. She even had plans to pick up surfing at the end of the year.

    At 31, she was living on her own in Nu'uanu, starting a career in television and keeping herself as busy as humanly possible.

    Life wasn't just good, it was getting better every day.

    Then, in December, she felt it. A lump the size of a half-dollar, firm and obvious, in her right breast.

    The doctor quickly diagnosed her with breast cancer and scheduled a lumpectomy the next month.

    Makaula couldn't believe it.

    "Who thinks about that now, right? We're supposed to be invincible," she said.

    Suddenly, Makaula couldn't run or lift weights or dance hula anymore. She had back-to-back surgeries, then immediately started chemotherapy. Then radiation. Then chemo again.

    Her bones ached. She felt nauseated all the time. Her silky blond hair fell out.

    After moving back in with her parents in Kailua, she had to take a leave from her job. And she had to accept the new reality that she couldn't do everything herself anymore.

    "I was so used to being very, very active, having all this energy, and now I was tired all the time," Makaula said. "I was really upset about it. It was frustrating and humiliating at the same time.

    "But those feelings have been replaced with realizing how fortunate I am."

    Makaula was among the nearly 5,000 people diagnosed with cancer — 680 with breast cancer — in Hawai'i last year, according to the American Cancer Society. That number reflects only new cases of cancer.

    Makaula's diagnosis was life-changing but not defeating.

    Though she could barely walk around her neighborhood, Makaula knew she needed to stay in shape, to keep her body healthy. And it didn't help that she was putting on extra pounds.

    "I was fine with going bald," she said, laughing, "but not with gaining weight."

    She searched the Internet for exercise programs in Hawai'i tailored for cancer patients.

    Nothing.

    Then a news release came across her desk at KHNL, where she works as a producer. It was about the new Ho'ola Cancer Exercise Wellness Program at the Honolulu Club, which started last month.

    The program is designed specifically for cancer patients who are deconditioned or chronically fatigued from their treatment or disease. Its goal is to help patients build muscle mass and strength, increase flexibility and endurance, improve functional agility and improve their energy levels and self-esteem.

    And it's free.

    "It was a godsend," she said.

    Until a few years ago, exercise was not an integral part of cancer patients' treatment. There were not enough certified instructors to work with cancer patients, and the research about benefits was insufficient.

    But that's changing, said Karen Merrill, the cancer-exercise specialist who designed the new program.

    "Cancer is out of your control, so this program gives patients the opportunity to take charge of something," Merrill said. "They feel so drained and tired and sick and nauseous ... But they can maintain some level of cardiovascular fitness and strength that can help in every aspect of daily living, to just get through the day."

    Makaula, who is still undergoing chemotherapy, sees Merrill twice a week. In a class with other cancer patients, Makaula learns strength-training and cardio exercises tailored to her needs and abilities.

    After two weeks in the program, she is up to nearly 20 minutes of cardio while gaining strength in her upper body.

    "Roz is an amazing individual," Merrill raved. "She works hard, she's smart and she processes everything you tell her. You know she's putting it in long-term memory. She's very upbeat."

    She may be tired, her bones may hurt and her once-straight blond hair is now curly and brown.

    But Makaula knows she has a lot to be thankful for: family, friends and new perspective on life.

    "I feel like I've been given a new set of eyes," Makaula said. "Everything looks so different, so clear ... I feel so blessed."

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    ROZ MAKAULA'S FITNESS PROGRAM

    Workout habits: Makaula participates in the Ho'ola Cancer Exercise Wellness Program at the Honolulu Club, doing cardio and/or strength training for about an hour twice a week. Though she still undergoes chemotherapy, she also hits the gym twice a week, getting in at least 15 minutes of cardio either on the elliptical or treadmill.

    When and why I started working out: Fitness runs in the Makaula family. She started playing softball at age 5, and enjoyed a short collegiate stint at Chaminade University.

    My good foods/bad foods: Makaula loves salads, particularly Waldorf salads. And she's partial to vegetables. "I eat anything green," she said, laughing. Her vice? Dove dark chocolate. "I gotta have that on the side somewhere," she said.

    My biggest motivator: "The faster I can get healthy, the faster I can help other people in my situation get healthy, too," Makaula said. She wants to spread the word about the importance of exercise wellness programs for cancer patients and survivors, while raising awareness that breast cancer can happen to anyone.

    What saves my sanity: Makaula writes in a journal just about every day. "I can just write without thinking," she said. "It helps me, not so much the day I'm writing, but when I go back and read what I wrote months ago. It's enlightening." Exercise and lots of laughter also help.

    My next challenge: Her short-term goal is to get her strength back, to lose the 20 pounds she put on since undergoing treatment and lower her body fat. In the future, though, she's thinking about conquering a triathlon.

    Advice for those in the same boat: "Talk about it," Makaula said. "Find someone you can confide in and lean on. And when people say they want to help you, let them."

    Reach Catherine E. Toth at ctoth@honoluluadvertiser.com.