The Health Coach Will See You Now

Sylvester’s health coach program helps individuals lower their risk of cancer.

Most clinicians focus on fixing existing health problems; Bryan Mejia, M.A., is one of the fortunate few who prevent them from happening in the first place. As a Prevention Health Coach at Sylvester Comprehensive Cancer Center, part of the University of Miami Health System, Mejia counsels individuals at high risk for cancer who do not yet have the disease. Meeting one or more of three criteria qualifies someone as high risk:

• Having a genetic mutation that increases the chance of developing cancer
• A family history of the disease
• Lifestyle factors that put them at risk

Any of these criteria qualifies UHealth patients to participate in Sylvester’s complimentary health coaching program. The program has two components: survivorship coaching for patients who have had cancer or are undergoing treatment and cancer prevention coaching, which is Mejia’s forte.

“More than 60% of cancers are attributable to modifiable lifestyle behaviors, including body weight, exercise, alcohol and tobacco use,” Mejia says.

How does coaching work?

Paola Rossi, M.D., clinical director of Sylvester’s Lifestyle Medicine, Prevention, and Digital Health Initiative, says that any UHealth physician can refer a patient to the health coach program. If the physician identifies the patient as high-risk, they can refer the patient to a nurse practitioner at one of Sylvester’s high-risk clinics. The nurses can then determine patients’ eligibility and refer them for genetic testing. “Patients usually see a genetic counselor and health coach on the same day. Even if they don’t have a genetic mutation, they are referred to a health coach if their family history or lifestyle puts them at risk,” Dr. Rossi says.

With the referral complete, Bryan Mejia steps in. “I perform an intake assessment to discuss their medical history and health goals, as well as their dietary, exercise, sleep, stress management and tobacco use. I try to get a grasp on any behaviors that contribute to cancer risks,” Mejia says.

The goal of coaching is “building long-term behaviors,” Dr. Rossi says. “The coach focuses on what works for your life. The first appointment lasts about an hour, and while the average person has three sessions and a six-month follow-up session, others might need more or less depending on their level of motivation and need.”

People are built to move.

One of the program’s primary objectives is getting people to move more. “Our bodies were built to move,” Dr. Rossi says. “Just 15 to 20 minutes of walking per day decreases your risk of developing cancer.”

Weight management and better immunity are two solid arguments for getting off the couch. “Being overweight reduces your ability to break down fat cells, which is where cancer cells thrive. Exercise also helps your immune system function better,” Mejia says.

Mejia and other Sylvester health coaches follow American Cancer Society guidelines for physical exercise. The guidelines recommend:

• 150-300 minutes per week of a moderate intensity exercise such as brisk walking – your heart rate is up, but you can still carry on a conversation

Or

• 75-150 minutes of vigorous-intensity exercise such as running – your heart rate and breathing are up, and you can’t easily carry on a conversation

“For cancer prevention, 300 minutes of moderate exercise per week is best,” Mejia says. Although two to three days of weight resistance training are optimal, you don’t necessarily need to hit the gym every day. “The more you can find activities you enjoy, the easier it is to incorporate them into your life. That might mean gardening, dancing, walking or hiking in parks.”

Dr. Rossi agrees that how we perceive exercise can be a barrier to fit. “We think of physical activity as structured exercise, but science sees it as breaking up periods of sitting or lying down. When you sit for an hour or more, your body functions go into rest mode. Standing up just five minutes for every hour you sit reduces oxidation and inflammation, which reduces your cancer risk. Going from sedentary to increasing your activity by 10% has more benefits toward lowering your cancer risk than increasing your activity if you’re already fit.”

Genetic testing and health coaching aim to empower people to take control of their future health. “Once they know their genetic risk, some people think there is nothing they can do, but there are many things they can do, such as screening more frequently or at an earlier age,” Dr. Rossi says. Recent studies also suggest that eating healthier foods and exercising more frequently can reduce cancer risk, even if a genetic mutation is present. “Knowing your risk can change how you manage your risks,” Dr. Rossi says. Insurance may cover genetic testing if it is medically necessary. Contact your insurance provider to learn more about coverage.

Nancy Moreland is a regular contributor to the UHealth Collective. She has written for several major health care systems and the CDC. Her writing also appears in the Chicago Tribune and U.S. News & World Report.

Tags: Bryan Mejia, cancer prevention, Dr. Paola Rossi, health coach, lifestyle changes, lifestyle medicine, Sylvester Comprehensive Cancer Center