Sylvester’s science-based programs help cancer patients heal body, mind and spirit
By Mark Gaige, Ph.D.
Illustration by Jacey
he team at Sylvester Comprehensive Cancer Center is dedicated to empowering patients to take charge of their health and well-being at every stage of treatment and recovery. Its Cancer Survivorship and Supportive Care program employs a compassionate, patient-centered approach, bringing together a diverse team of physicians, psychologists, nurses, dietitians, exercise physiologists and therapists to provide comprehensive care that nurtures the body, mind and spirit. Through a range of integrative, whole-person programs, patients gain the tools, strength and support necessary to enhance their well-being, optimize their recovery and lead fuller, healthier lives; this shifts the focus from cancer to the cancer survivors.
From Disease-Centered to Patient-Centered Care
Over the past few decades, oncology has undergone a metamorphosis. Once concentrating almost exclusively on malignancy management — primarily surgery, radiation and chemotherapy — cancer intervention has broadened, becoming more encompassing. Emotional support and quality-of-life considerations, once dismissed as secondary or even outside the field’s scope, have emerged as crucial. This shift reflects a deeper understanding of how physical health and emotional well-being are interconnected, recognizing that effective cancer treatment requires support for the whole person.
“Cancer care has truly become holistic, and it will continue to expand as comprehensive and long-term care,” said Frank J. Penedo, B.S. ’93, M.S. ’99, Ph.D. ’99, professor of psychology and medicine, and director of the Cancer Survivorship and Supportive Care program. “Thirty years ago, the focus was solely on disease activity: Is the cancer back? Do you have a scan scheduled? Which one? Now, we inquire about support systems, emotional well-being and social roles. That’s promising news, because today it is recognized that these psychosocial factors make a difference. Our psychosocial research discoveries are now integrated into our cancer care delivery.”
Sylvester’s program has become a national model because it integrates patient-centered support therapies with top-tier medical care. Researchers have rigorously studied these therapies to ensure patients receive optimal options for overcoming the challenges that cancer presents in their lives. “It’s essential to recognize that there’s a science behind nutrition, exercise and our other support services,” said Tracy Crane, Ph.D., RDN, director of lifestyle medicine, prevention and digital health at Sylvester. “We would never prescribe a new medication without it being evaluated, and support programs are no different. Research, including our own, demonstrates that individuals who engage in interventions that target health behaviors experience clinically significant improvements, along with reduced stress and anxiety, and enhanced functional capacity.”
“After completing primary treatment, Sylvester’s patients receive personalized survivorship care plans developed by clinicians and members of the supportive care team,” Dr. Penedo said. “Patients are then referred to survivorship wellness clinics. Based on those clinic encounters and on responses to My Wellness Check, a patient portal–based questionnaire that evaluates pain, emotional well-being, nutrition, practical needs and physical activity, the supportive care teams provide targeted care customized to each patient’s unique necessities.”
Here’s an overview of some supportive care options at Sylvester, where more than 18,000 patient-support encounters occurred in 2024, representing more than 20% of all cancer-related appointments.
Frank J. Penedo, Ph.D., M.S., B.S.
“Cancer care has truly become holistic, and it will continue to expand as comprehensive and long-term care.”
From Disease-Centered to Patient-Centered Care
Tracy Crane, Ph.D.
“It’s essential to recognize that there’s a science behind nutrition, exercise and our other support services.”
The Foundation of Holistic Care
A cancer diagnosis is a life-changing event that sparks a range of emotional and psychological responses, including fear, anxiety, anger and depression. Studies indicate that unresolved emotional distress can hinder treatment outcomes and recovery while also negatively impacting quality of life.
“It’s crucial to educate patients that mental health support is not an optional add-on; it’s a vital part of comprehensive cancer care,” said Ingrid Barrera, Psy.D., director of clinical operations for cancer supportive services. “By treating the whole person, including the mind, we ensure that every patient receives care that addresses the disease itself and also supports overall well-being.”
Sylvester’s psychoncology team uses a variety of tools — including cognitive behavioral therapy, dialectical behavior therapy and relaxation exercises, such as deep breathing — to help patients manage fear, reframe catastrophic thinking and develop coping strategies.
Cognitive behavioral therapy teaches people to control unwanted thoughts, feelings and behaviors. Dialectical behavior therapy expands on this approach by helping patients accept reality as it is rather than resisting or avoiding it. Dr. Barrera said, “We use dialectical behavior therapy to help patients better manage intense emotions and stay present in their healing journey, ultimately improving their quality of life. It equips patients with skills for navigating the uncertainty of cancer treatment with greater emotional resilience.”
Nutrition: You Are What You Eat
Decades ago, nutritional advice for cancer patients was limited, often focused on managing treatment side effects like nausea and loss of appetite. However, good nutrition also provides additional benefits for cancer patients.
“Nutrition also supports healing, strengthens the body and reduces stress,” said Paola Rossi, M.D., M.S.Ed., clinical program director of lifestyle medicine at Sylvester. “Evidence shows that adhering to a healthy eating plan, including whole grains, less-processed foods, and plenty of fruits and vegetables, along with being active, lowers the risk of cancer recurrence and the emergence of new cancers.”
Sylvester’s oncology-trained registered dietitians work with patients and their caregivers to develop customized nutrition plans during and after cancer treatment. The goal is to promote lifelong healthy eating patterns.
Ingrid Barrera, Psy.D.
“It’s crucial to educate patients that mental health support is not an optional add-on; it’s a vital part of comprehensive cancer care.”
From Disease-Centered to Patient-Centered Care
Paola Rossi, M.D., M.S.Ed.
“Nutrition also supports healing, strengthens the body and reduces stress.”
Exercise Oncology: Keep It Moving!
Exercise oncology builds on the documented role of physical activity in helping prevent and manage various illnesses and ailments. Once thought of as counterproductive for patients with demanding diseases such as cancer, exercise is now recognized as a powerful, evidence-based intervention that reduces fatigue, improves mood and lowers the risk of recurrence for certain malignancies.
Through its extensive exercise-oncology programming, Sylvester helps patients develop a healthier, more active lifestyle during and after treatment. Exercise trainers provide personalized strengthening and cardio exercises, mobility-enhancing stretches and behavior-change strategies to encourage lifelong healthy movement.
“By integrating physical activity and exercise into treatment plans, we help patients take greater control of their health and enhance survivorship,” Dr. Rossi said. “This fosters hope and empowerment in facing one of life’s greatest challenges.” One of the initiatives she oversees is Believe in You, a four-month training program that prepares cancer survivors for walks, runs and bike rides in the annual Dolphins Cancer Challenge, a fundraising event in partnership with the Miami Dolphins that supports research at Sylvester.
How East and West Come Together
Integrating evidence-based Western medical treatments with research-supported Eastern healing practices, such as acupuncture and yoga, creates a powerful one-two punch for exceptional supportive cancer care.
Acupuncture
Chemotherapy and radiation effectively target cancer cells but may also lead to side effects such as fatigue, pain and emotional distress. Acupuncture can help alleviate these negative reactions. Oncology-trained Sylvester care team members use needles, heat or pressure on specific locations of the skin known as acupuncture points. This improves blood circulation, strengthens the immune system and releases endorphins, the body’s natural pain relievers. Acupuncture also helps reduce nausea and vomiting induced by chemotherapy.
Yoga
Yoga therapy combines movement, breathwork and mindfulness to nurture both body and spirit. Physically, it enhances flexibility, restores balance and strengthens muscles, which can be weakened by long-term treatments. Furthermore, yoga aids in alleviating the stress, fear and depression that often arise with a cancer diagnosis. Practicing in a group setting also cultivates a sense of community and support, helping to reduce feelings of isolation.
Art Therapy
Art therapy allows patients to express emotions beyond words through painting, drawing and sculpture. Whether engaging with watercolors and acrylics, sculpting with clay or weaving with textiles, participants tap into hidden aspects of themselves — insights that can be explored further in counseling sessions.
Research and self-reporting show that creative expression reduces stress, induces deep relaxation and enhances overall well-being, providing uplift throughout the treatment regimen. Art therapy at Sylvester includes one-on-one and group sessions, all led by certified art therapists.
Music Therapy
At Sylvester, certified music therapists tailor therapy sessions to align with each patient’s goals and musical preferences. Active interventions include playing instruments, singing, dancing and songwriting, while receptive approaches, such as music-assisted relaxation and music association, help evoke positive memories and promote comfort and connection. No musical experience is necessary, and sessions are available individually or in groups, both in-person and through telehealth. However, there is more to Sylvester’s music therapy than just listening enjoyment. In an ongoing study with the University of Miami’s Frost School of Music, researchers are investigating the potential healing effects of music on stem cell transplant patients.
Massage Therapy
Massage, one of Sylvester’s most popular support offerings, is a therapy superhero. Gentle, oncology-focused massage alleviates pain, improves circulation and enhances range of motion, promoting overall well-being. It also calms the nervous system by lowering stress hormones and increasing serotonin and dopamine, which are crucial for relaxation and better sleep. Mild lymphatic massage assists in managing lymphedema, swelling associated with breast cancer. All Sylvester massage therapists possess advanced training and certification in oncology massage, manual lymphatic drainage and related therapeutic techniques.
Looking Ahead
The number of cancer survivors is increasing. In the U.S., there were 18 million in 2022, up from 16.9 million in 2019, with projections of 22.5 million by 2032 and 26 million by 2040. This growth is driven by early detection; improved treatments, such as immunotherapy and precision medicine; and heightened prevention efforts, including smoking cessation and HPV vaccinations. It’s a fortunate dilemma, but the challenge lies in providing the support resources that these increasing numbers of survivors require.
“At Sylvester, we’re leading the way with our extensive support and survivorship program,” said Jessica MacIntyre, D.N.P., M.B.A. ARNP, AOCNP, assistant vice president for the Oncology Service Line. “We’re fortunate to offer supportive care that many cancer centers cannot provide. We’re dedicated to reaching more patients by raising awareness of our current services and expanding to meet future needs.” 
Jessica MacIntyre, D.N.P., M.B.A.
“At Sylvester, we’re leading the way with our extensive support and survivorship program.”
