The Long View with: Jenny Skoog Mondesir
This week we're handing the newsletter over to Jenny Skoog Mondesir, a personal trainer and cancer exercise specialist who has trained women through pregnancy, menopause, and cancer recovery since 2005, as part of our series The Long View, where leading voices in women's health share what they believe matters most for how we age.
The call usually comes on a weekday afternoon. A client I've trained for years tells me what the biopsy found, and then she asks the same question everyone asks. So I guess we’ll have to take a pause?
Nope. We are not stopping. We are changing the plan.
I’ve been a personal trainer since 2005 and a cancer exercise specialist since 2016. I’ve trained people through thyroid cancer, glioblastoma, and metastatic prostate cancer. Because my specialty is women’s fitness, the most common in my practice is breast cancer, everything from lumpectomy and radiation to double mastectomy with full reconstruction, plus the lymphedema, swelling, and tightness that come after.
The diagnoses vary wildly, but my protocols don’t. I stick to the same three phases with every client.
🧠 The takeaway
Exercising in the weeks before cancer treatment, known as prehabilitation, has been linked to better strength, shorter hospital stays, and better psychological health in a review of more than 30 years of prehabilitation research.
During cancer treatment, the surgeon, oncologist, and physical therapy team set the pace, and cancer exercise specialist Jenny Skoog Mondesir waits for medical clearance before resuming training with a client.
A 2019 international roundtable convened by the American College of Sports Medicine found exercise is generally safe for cancer survivors and set a goal of 30 minutes of moderate activity three times a week plus strength training twice a week.
🤔 In our last Long View with Dr. Caroline Packard, DPT: Why more kegels won’t always fix bladder leaks
Before treatment: use the weeks you’ve got
Between the diagnosis and the first surgery or infusion, there is a stretch of waiting that is rife with anxiety and more questions than answers. It is also the most useful training window a person will ever get.
My client Amy, a breast cancer survivor, put it better than any textbook: “Try to be in the best shape going in. It will help in recovery. Realize and accept that you won't be able to work out for a couple of months, that you'll get back in [the gym] gradually.”
The research agrees with her. A review of more than thirty years of prehabilitation studies found that patients who trained before treatment had better strength, shorter hospital stays, and better psychological health than those who went in cold.
You can’t control your pathology report, but you can control the strength and mindset you walk in with.
So we train. We build what we can in the time we have. We sleep, we eat like athletes, and we go in as strong as possible.
During treatment: the doctors are in charge
This is the phase where a trainer can do real damage. So, I check in periodically and connect with the physical therapy team. They set the pace. Whatever the surgeon says, whatever the oncologist says, that is the program. After about a month, most of my clients are chomping at the bit, but I am in no hurry. Until the doctors give clearance, I am simply another friend bringing flowers.
There are good reasons for that.
Steroids used in brain tumor treatment weaken muscle on their own.
Hormone-suppressing therapy for prostate cancer strips muscle and bone, which makes strength work more urgent later, not less.
Thyroid surgery is followed by months of dialing in a hormone dose, and until it's right, the fatigue is bottomless.
None of that is my call. What I can do is show up. I offer to come to appointments, because personal training is just that: it’s personal. Nobody absorbs a word after they hear “carcinoma,” so sometimes I’m the one taking notes.
After treatment: slower than anybody wants
For most of medical history, cancer patients were told to rest. But scientific research no longer supports sedentary behaviors. Andrea Leonard, who founded the Cancer Exercise Training Institute, says it simply: movement is medicine. Stacey Mann, CES, CPT, writes in the CETI handbook that exercise is “not just safe for individuals with cancer, but essential.” Dr. Robert Bard, in the same book, writes that “exercise is no longer considered optional. It is essential medicine.”
But we’re not talking about spending two hours in the gym.
Two months out of the gym is pretty common, and the way back is gradual. You’d be surprised at how heavy two-pound dumbbells can be!
The 2019 international roundtable convened by the American College of Sports Medicine found that exercise is generally safe for survivors, that survivors should avoid inactivity, and that the goal is thirty minutes of moderate activity three times a week plus strength training twice a week.
Range of motion comes first, usually established with a good physical therapist.
My client Jessie, diagnosed in her thirties, will tell you the stiffness is relentless and that getting movement back took real work. She also points out the part that never makes it onto the pink ribbon merchandise: the shame, the scarring, and the strangeness of looking at a body you don’t recognize yet.
After a hard health season, what has been the toughest part of getting back into your body?
The toughest part of this work is that sometimes there is no after. I have trained people who were never going to recover, but the work is always worth doing. The goal shifts to standing up from a chair without help, getting to the bathroom alone, or walking to the window.
As long as a body can move, movement is still medicine, and dignity is still the point.
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👀 In case you missed it:
Your hormones may be changing how well you hear
How to prepare for surgery for a stronger recovery
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The information provided about wellness and health is for general informational and educational purposes only. We are not licensed medical professionals, and the content here should not be considered medical advice. Talk to a doctor before trying any of these suggestions.
