Robin Daly: Hello, welcome to the Yes To Life show on UK Health Radio. I’m Robin Daly, the founder of the UK charity Yes To Life and also the host for this show. Yes To Life is all about highlighting the many benefits of integrated medicine in cancer care and helping people learn about it and use it to support their recovery. My guest on the show today is one of the amazing line-up of speakers who appeared in ‘Your Life and Cancer 2020’, talking about the complex world of testing which has opened up to people with cancer in recent years. Dr Nina Fuller-Shavel has developed a new online course for women with breast cancer, which she’s calling ‘Nourish Support Connect’. This looks set to be a valuable resource for women, so I wanted to find out more. I’m talking to Nina over the internet at her clinic in Hampshire. Hello Nina, thanks for coming on the show again.

Dr Nina Fuller-Shavel: Hi Robin, lovely to speak to you again.

Robin Daly: Many people listening would have heard your brilliant discussion with Joe Gamble about testing at last week’s ‘Your Life and Cancer’ online event and I’m sure they’re going to be very keen to hear more from you as a result. But for those who maybe haven’t heard about you before can I ask you to introduce yourself, what you do, why you do it and how you got where you are today? What sort of training you’ve done.

Dr Nina Fuller-Shavel: My name is Dr Nina Fuller-Shavel, or my patients usually call me Dr Nina because I’ve got quite a long surname, and I’m an integrative and functional medicine doctor. I run Synthesis Clinic, and this is an integrative medicine practice in Hampshire where we specialize in women’s health, gut health, and mental health and wellbeing. My main specialty is in terms of cancer work is really breast cancer and that forms about 80% of the practice in terms of cancers, and I take on about 20% of gynaecological cancers as well. So it’s very much women’s health based. In terms of training, I was originally a scientist, so I did natural sciences at Cambridge first and that’s really how I got into whole person physiology, and how the body can sustain health and also create disease. After that, because I went on to do some nutrition training while I was writing some medical education programs for doctors, I then went on to do medicine back in Cambridge again. Throughout all of this, I was doing nutrition and functional medicine in the background, but I had to combine it quite a bit with my NHS work, so it was a bit of a tumble pool for quite a few years really.

Robin Daly: I can imagine.

Dr Nina Fuller-Shavel: But last year, I really thought I want to dedicate my life and my time to the business of function medicine being the standard of care, particularly within women’s health, and that’s how I paved the Synthesis Clinic, where I’m very lucky to be joined by my amazing clinical psychologist, my fantastic health coach and a women’s health physiotherapist.

Robin Daly: Right, so a real clinic set up – that’s fantastic. One bit that I’d like you to fill out a little bit is your motivation. Why did you get into doing all of this in the first place?

Dr Nina Fuller-Shavel: Well, I think how I got into this, I first got interested in nutrition per se, back when I was doing natural sciences, because I could see how supportive it was to the physiology that I was learning and I was interested in it as more of a sports nutrition thing, because I was doing long distance running at the time.

Robin Daly: Aha Aha, yes.

Dr Nina Fuller-Shavel: And then I had my own health crash in my early twenties, and I went through a period of time where I was quite severely fatigued, and that got me into training with these two nutritionists to do nutritional therapy. And I was doing that part-time alongside working. After completing the course, I was thinking, this is great, but I really want to get a fantastic handle on pathology and that’s where I went on to do medicine. Following medicine, I went into my junior doctors job and I was doing various other courses in terms of herbalism and some of the other training that I do, and I got diagnosed with breast cancer, which I have to say was not particularly surprising given the shift work and the stress I was under at that particular point. And then I threw the book at it, I really put into practice what I had learned, about what I then continued to learn, and really took a big, deep dive into cancer. Specifically, I actually had my first encounter with cancer research at the age of 19 when I did a project on cell death back at Cambridge, but it was a really fantastic opportunity for me to dive back into the biology, but very well supported by all the other things I was doing – nutrition, mindfulness, yoga, all of the toolkits that are available for my own disease. And I could see how it works.

My oncologist and my surgeon were kind of laughing at me, joking and going, you know, you’re only with us for about five seconds and you bounce out of here. Because the fact was, I knew how to support myself and what I could see out there was the information was really bland in terms of what was given to patients. You know, eat a balanced diet. I was like, well, that’s really non-advice.

Robin Daly: Absolutely.

Dr Nina Fuller-Shavel: Some person’s balanced diet is a chocolate in each hand. It was frustrating, being on that end of the spectrum. I am lucky, I am not only a medical doctor, but I’m a scientist and I am a nutritionist and I’ve got other training and I still have to sift through a mountain of information. How does a person feel on the other end who does not have the benefit of the same background as me? And that’s really, it’s just bewildering. I could see it. I could see it in other fellow breast cancer groups, in terms of people finding it overwhelming. They either give up and just kind of hand the power over and go, okay, well fix me. Which by necessity is encouraged in a way. Or the other way, they do a deep dive and get hopelessly confused because there is so much conflicting information.

So that’s when I, after my own treatment was completed, did some further training and I set up Synthesis Clinic, and more recently the ‘Nourish Support Connect’ program with the vision of wading through this, with a vision of providing a partnership, providing something that can go through the various conflicting information, give people some idea of what the evidence and what the clinical practice actually says and give them a roadmap to help themselves.

Robin Daly: Excellent. Well that’s what we’re going to look into. Amazing how you were uniquely well-equipped to meet the challenges of breast cancer. Most people are completely empty-handed when something like that happens, but you had just been training yourself up ready for the day in a way, extraordinary to find yourself in that position.

Dr Nina Fuller-Shavel: I think I was lucky in a way, I am grateful that this happened because I think that I wasn’t going to get off the conventional medicine treadmill unless something really big happened like this. And I was tearing myself apart in terms of my two heads, I had to leave half of my head at home when I came into my NHS job. So I’m now integrated, I’m now actually delivering care the way I think care should be done. I’m referring to people when it’s appropriate and I’m creating plans outside of what can be possible with just medication. Yes, medication is great, I’m very grateful for every single bit of therapy I’ve ever received. But I can see that if we only rely on medications and not supporting our bodies and not changing anything within our bodies, no lifestyle changes to our time course and our terrain, then actually we’re doing a pretty rubbish job at it.

Robin Daly: One thing I’d like to ask you, quite a few people over the event we’ve just had have made comments about interacting with their medical team. Particularly one of the panelists last night, who was somebody who’d had cancer, actually said that they sort of naively bounced in wanting to share with them the great information that they’d got and how much it had helped them and were sorely disappointed by the lack of interest. Did you find that you, as a trained doctor, were able to win any hearts and minds in amongst your oncology team with your approach?

Dr Nina Fuller-Shavel: I did, but I was very lucky. I had an amazingly open-minded team and I think because they could see the impact it was making on me, I was a kind of a case happening before their eyes, if that makes sense. The other thing to say is I think we’ve got to be careful about how we approach medical teams. I think it’s very important that we have integration, but it’s also very important not to expect your doctor or your oncologist to know any of this stuff, because I can tell you in all of my years of medical training I got two hours of nutrition training.

Robin Daly: Well, that’s right. And I think some people do expect them to know, but the thing that you experienced, which is open-mindedness, that would be gold dust. That’s what we’d love to see, more interest in the fact there are things people can do to help themselves, which are extremely important.

Dr Nina Fuller-Shavel: I think the best thing that we can do on all sides is be open-minded, because the whole point of having integrated care is to help the person in the middle of it. And that’s really where everybody’s got to leave their egos and opinions behind and really just treat the person in front of them, and I think hopefully the communication should be held. If we can create this two-way talk between the integrative doctors or functional medicine practitioners, whoever’s looking after the patient from a nutritional perspective or holistic perspective, speaking, not necessarily in person, of course, but maybe writing to them or talking to the hospital, pharmacists, making sure they’re aware of what the patient might be taking on the other front, making sure you check the interactions really, really carefully. I think what we’ve got to be aware of is that quite often, oncologists also operate quite protectively of their patients. Some of them might be close-minded, but some of them are just protective and want to make sure that the patient is safe. If we can demonstrate that we are safety-minded, and that we check all the interactions, and we make sure that we’ve thought our way through cases – hopefully we will find the attitudes will change.

Robin Daly: Thank you for that. So, like a number of fantastic practitioners who are coming on stream in the UK now, you’ve got these impressive and wide-ranging qualifications, enormous passion, focus, and drive behind your work. We’ve spoken before about your work, but today I want to home in particularly on what you’ve already mentioned, this new initiative for your chosen patient group of women with breast cancer which you call ‘Nourish Support Connect’ – a breast cancer support course. An eight-week course for women in active treatment for breast cancer and early survivors. So the first thing, can we just be quite clear, who is eligible to register?

Dr Nina Fuller-Shavel: Anyone who’s had a diagnosis of breast cancer, or who are just about to start active treatment, or are on chemotherapy, radiotherapy or any hormone therapy and any of their nursing and surgery, of course, as well. So that’s what we mean by active treatment, is that you are in one of those, kind of four streams. We also look after early survivors, early survivors are really within the first two to three years of completing activities. That’s the patient who we’re aiming this at because quite often, when you’ve come out of treatments, you get hit with the whole implication of what just happened and you might still also be on some hormone medication and you might still be struggling with the side effects of the therapy you’ve just had. And I think it’s really important that we talk about this at that point, because quite often conventional care is at that point withdrawn.

Robin Daly: Okay, that’s nice and clear. So to get the techie bits out of the way, it’s an online course, what do the people who want to join need in the way of equipment or software?

Dr Nina Fuller-Shavel: They just need to have a computer that’s probably less than 7 years old I would say, because usually technology moves on relatively fast. They need to have a Zoom program, which is easy to download off the internet. Now, we’ll send the link to anybody who signs up. So just like where we are talking right now, it’s a pretty easy program and it’s a video conferencing app that you can just see people’s faces. I’ll be able to present slides and I’ll be able to take questions and it’s of course the same platform that you use for the Yes To Life conference.

Robin Daly: Okay, good. So, most people got pretty used to living on Zoom these days, so it’s not so scary as it used to be. So now the interesting stuff, what people will learn. It’s an eight-week course, and I imagine it’s all very structured. Have you got a title for each session that tells you, kind of what’s in the tin?

Dr Nina Fuller-Shavel: Yes, we start off with week one, which is all around nutrition. To me that’s the base, whatever you put on top of that, you need to have a good, solid nutrition background. And we talk about everything from the point view of nutrition during treatment and what the implications are. Also nutrition in terms of recurrence and risk minimization, so having a look at what the evidence says around that. But then we go on to week two, which is around movement, so we think about physical activity and how we carefully incorporate physical activity within our lifestyle. For example, what particular restrictions there might be if someone’s got lymphedema – it’s really important to understand what you can do or what you should be cautious doing if you’ve got issues about the surgery you might’ve had, and then we move on to treatment support. Week three is all around the various treatment options that people might have gone through. We also talk a little bit about treatment monitoring, so that’s how it plugs into the testing talk and that idea of you guys over the weekend. We talk a little bit about how we monitor treatment, how we monitor for recurrence, as well as things that you can do to help yourself in recovery post treatment.

Robin Daly: Okay.

Dr Nina Fuller-Shavel: Then we move on to the emotional side of things. So really in the next couple of weeks, we do emotions and connection, and that’s connection to yourself and connection to others. I think that’s such an important part of going through cancer treatment and recovery afterwards, it’s a huge part of making sense of what happened and also connecting to like-minded people. And people can understand what you might be going through. I’ve got a big population of women who are younger with breast cancer, so they’re under 40 and women in their age group, their fellow friends, just don’t have counsel. They don’t understand what it’s like, having to go through treatment. Trying to connect people of any age together so that you’re not the only one, you’re not the only person within your immediate group who’s having to go through this. Let’s connect you, let’s get you to support each other because that’s I think where the power of all of this comes from, the power of the group, the power of the support that people can give to each other as peers.

Then we move on to sleep and mindfulness, so that’s week six and week seven. We talk about the benefits of mindfulness and breath work, and mind, body techniques on anything from calming down the stress response to also improving quality of life. Cancer and chemo-related fatigue, and a number of other measures that we could use. Finally, we bring it all together in week eight and we talk about self-care and an integrated plan – making your own effectively. How do you take all the building blocks of the previous seven weeks and make it into a practical, livable plan that you can take away?

Robin Daly: Sounds like a very important session, that one. That’s great. And it’s interesting that you’ve got three out of eight of your sessions are in the realm of emotions, the relationship between the mind and the body, all of that area, the psychological – which are a huge part of the event we just held which also focused on the same thing, because this is probably the biggest single underrated area of health care which gets almost no attention. For people with cancer, it is just seen very much as a practical problem that they have in their body. And of course the other side of it is massive and it’s going to have a massive implication on the trajectory of their treatment success and the quality of their life from then on.

Dr Nina Fuller-Shavel: Absolutely, and I think it’s crucial to link everything up. The program aims to address the whole person, because we’re not just our cancers, let’s just forget that bit. The whole tumor focus, I don’t really want to have that within the program. I want to try and focus on the whole person’s wellbeing because that’s how we change something in the long term for people. That’s how we help them recover. It’s not about patient X with breast cancer, grade three, stage three, blah, blah. It’s not about that. It’s about how we help you as a person have the best time through treatment, because that’s the most important destination during active treatment. And people can retreat into themselves and think, ‘Nothing can help me, I’m meant to be feeling this rubbish and I’m just meant to be soldiering on through this’. My saying to that is no, you don’t. Okay, chemotherapy is hard work for example, so is radiotherapy sometimes, but there are always things we can do to improve – to improve the quality of life, to improve your sleep. If your sleep goes off, if your digestion goes off, a number of side effects you’re suffering from, there are things that we can do and people don’t have to suffer needlessly, that’s I think a really important point.

Robin Daly: Very much so. I’m just interested in practitioners who are helping patients with this kind of stuff day-to-day anyway, but you’ve made a particular decision to create this course and to construct it in this way. What made you decide on that?

Dr Nina Fuller-Shavel: The first thing is accessibility. I’m very lucky to have a busy clinic and a long waiting list, but I want people to have something that was really accessible for them to go through before they even get to see me, or maybe another practitioner who is experienced in cancer management. I wanted them to be able to access it from the comfort of their own home. So if you’re exhausted from chemotherapy, if you are self-isolating in the current day and age, it’s important to have this tool that you can just access for yourself and you don’t have to go anywhere and it’s convenient and you can take it in bite-sized chunks.

Robin Daly: Well, that makes complete sense. Maybe you could tell us a little bit about the format of the sessions, are these like lectures?

Dr Nina Fuller-Shavel: They’re a mixed bag. What I tend to do is to put a few bits of resource and information with a little bit of pre-reading before we get going with a group session. Then on a weekly basis we meet up and we do a 90-minute Zoom session, out of which about 45 to 60 minutes is me talking over a presentation effectively. Talking through potentially some of the very anonymized cases and how things were helpful to me in clinic. Then the other 30 to 45 minutes, it’s Q&A really, so that the people on the program are able to ask things that are not clear, able to bring to the table anything they might have read or heard about, and we can discuss it as a group.

Robin Daly: You’ve just answered one of my questions about the opportunities to interact. When you say that you’re able to ask questions, this is going to be onscreen in person or through the chat, how’s it going to work?

Dr Nina Fuller-Shavel: Both ways, it depends on how shy you are, because I’m happy to take either. I would love to interact with people by video because it’s always lovely to have that connection, but equally if people don’t feel comfortable having their video on I’m more than happy to take questions via audio, via chat. So whatever format suits the person.

Robin Daly: I can imagine that some people will start off feeling something like this, some people are quite private about their health and this will be a major step out to suddenly start being public about it, if you like. The opportunity to come in, in a fairly understated or even anonymous way, some people might appreciate. So that’s going to be an opportunity that you will be able to do that.

Dr Nina Fuller-Shavel: Absolutely. I think we always aim to meet people where they’re at. They can sit there quietly for the first couple of weeks if they like, that’s absolutely fine, and then really engage in a topic that’s particularly close to their heart, whatever suits the group is really important. That’s another reason why we’re keeping groups really small. I don’t take on more than 15 people at a time, and I try and keep them even smaller than that at the moment because I want to be able to give people the individual attention as well. I want to make sure that everybody has a voice, so it’s not an anonymized group of, you know, 50 people and then you never get to ask your own questions.

Robin Daly: Yes, well that’s important. Obviously, we just had a big event where people are asking lots of questions, but obviously there was no opportunity to start answering any kind of personal questions – that just wasn’t the right forum. So this is a forum in which people will be able to ask things that are very particular to them and get an answer.

Dr Nina Fuller-Shavel: Yes, although I have to say that the key thing is that I’ll be able to talk about it in general, but this isn’t something like a one-to-one medical consultation. I will not be able to provide individual medical advice. It is an educational program and treated as such. There is the reason there’s a one-to-one medical duty of care relationship within that, because it’s impossible to provide that within a group setting like that.

Robin Daly: That makes sense. But what you’re going to do is, you’re going to just kind of take somebody’s personal question and draw out as much as you can and generalize to the group about that.

Dr Nina Fuller-Shavel: Absolutely, and I might be able to point someone to some resources, some papers to read as well, so that I can effectively teach people to find stuff for their own specific type and stage and where they’re at in cancer treatment to maybe take to their oncologist or to discuss it with them. But I won’t be able to provide that kind of the one-to-one.

Robin Daly: No, that’s understandable. When are these going to take place, evenings or weekends or what?

Dr Nina Fuller-Shavel: At the moment we are aiming for 7:30pm to 9:00pm on every second Monday, starting on 12th October – so the second Monday of the month. We are going to be carrying that on for eight weeks and then we have a second cohort starting in January. So we’re starting that on the second Monday of January as well.

Robin Daly: What happens if you are unable to attend one of the sessions, is there some way of keeping up to speed?

Dr Nina Fuller-Shavel: We will record the sessions and what I will do is split the recording in two, I record the presentation separately and then we do the Q&A separately as well. I will always give people the options, of course, of turning their video off, and making sure there are no names on screen when recording is done. So again, when we post this, people can choose to interact from that perspective.

Robin Daly: It’s becoming increasingly recognized that cancer can be highly isolating, and also having some leaning towards integrative medicine can be isolating. We often hear of people who are surrounded by frightened family and friends who are just desperate for you to get on with the surgery or the chemo right now, and they’re frankly terrified by any thought of you taking your time to make decisions, to build your team, to look at your options, that sort of thing. One thing that can often be hugely valuable about in-person training is the way you get to meet others in a similar position – this is what you’ve already alluded to – and with similar interests and attitudes to you. Something that, for some, it can be very hard to come by. So I’m interested to know the ways in which you’re looking to replicate this if you’re not having in-person, either you can’t or it’s online. That’s got its advantages, but in this area, you’re not going to get to meet people. What efforts are you making to try and replicate this kind of community building?

Dr Nina Fuller-Shavel: We will give people the option of a group. I will very much make that on a group by group decision, but the number of platforms we can use to create a group setting is anything from Facebook groups, to WhatsApp groups – there are a number of ways in which we can do it. It really depends on what people are most comfortable with in terms of technology, in terms of what other platforms they might already be using. But we are absolutely going to have a group for each cohort that they’re able to link up with, and we will also very much in general talk about what mix of people we’ve got in the group. So people understand who their other fellow cohort people are and what background they might be coming from, where they’re at in terms of their treatment.

Robin Daly: It’s tempting to want to dive into all these different sessions and find out more about them, but of course we haven’t got time. There is one particular one I’d like to explore a little bit. The reason I want to explore it is because more and more is coming out about the immense importance of this particular area to human beings, health and wellbeing generally – let alone with cancer. And that is the connection with yourself and others – week number four, in the middle of your program. Do you want to say some more about why you have a whole session dedicated to this and why it’s important?

Dr Nina Fuller-Shavel: For me it’s important for a number of reasons. One of them is the fact that having cancer or having had treatment for cancer can be incredibly disconnecting from yourself. Particularly as a woman who has breast cancer might have undergone mastectomy or lumpectomy or reconstruction, and your body is just not what it used to be. Your body feels different, it is different, it looks different. Some women even feel like their body’s betrayed them in terms of having generated the breast cancer in the first place. So it’s about reconnecting to that, reconnecting to you, and reconnecting to who you are right now and empowering you to be able to make decisions out of a place of connection and ground. It is not out of a place of fear.

Robin Daly: And more generally the research is coming out these days which talks about the fact that one of the biggest factors affecting how long and how well people live is how well embedded they are in a good social circle, and how comfortable they are within themselves as to who they are within that. Can you talk about that a little in the context of cancer, particularly?

Dr Nina Fuller-Shavel: I think, like you said, it’s about finding community and tribe, and I think it’s depending on where you’re at and whether you’ve got a community that might have other members who may be going through it. When you’re in your sixties or seventies, for example, you might know, I don’t know, your friend’s husband or someone else might be going through cancer and it’s a little bit more accepted and you might be able to find some more common ground.

I find that the younger the patient with cancer is, the younger the ladies are, the harder it is to find a community, because actually it’s not the same. People are getting on with careers, babies, you know, children’s schools etcetera. They’re not having treatment, they’re not having their whole life interrupted and put on hold by the fact they’ve got, six, nine or twelve months of treatment ahead of them. So having that community, like we said, in a group setting, both being able to engage with an open house, get providers such as myself, but we will probably end up having guest speakers in the program as well at some point, but also engaging within themselves and forming that support group, whatever form that takes. Whether we do a Facebook group, whether we do a WhatsApp group and to be able to say, ‘Hi, I’m here and I’m struggling with this,’ and, ‘What do other people find to be helpful and is there anyone else who struggled with this?’ Having that sense of community and understanding and empathy, and a bit of a preselected group who is interested in supporting themselves through cancer, not just hammering on with active treatment and kind of going hell for leather with that.

So I’m hoping that this, particularly because we’re keeping group size small, is going to really help us foster that sense of community and belonging and help people thrive – not just survive – but actually thrive through this and beyond the cancer diagnosis.

Robin Daly: The thing I like about what you’re talking about is that of course you can lecture somebody on the fact they ought to have a good social circle and all the rest of it, and somebody who’s sitting there and hasn’t got one won’t be very impressed by being told that. They’d probably liked one, but they possibly have no idea how to go about getting one. So, you’re actually offering them a solution at the same time as you’re talking about it, because you’re creating a group.

Dr Nina Fuller-Shavel: And I’m hoping that what we will do at the end of each cohort is give people the option to join a wider group. They’ll obviously be very carefully held within the small groups for the eight weeks, but as cohorts build up from there then we’ll also have the option of joining the wider group. In a year or so we can have up to a 100, 150 women within that group who are able to support each other and able to engage and disengage as well. Sometimes it’s good to disengage as much as they wish to. It’s about giving people options and giving people access without having to say, okay, you must do this.

Robin Daly: Well you’re one step ahead there, I was just about to ask you about that. I wondered whether you’d thought about sort of gluing all the groups together to make one big one. Can we just now move to the last session that you have? This is bringing all the strategies together in a practical plan and the importance of prioritizing true self-care. As I said, when you’re going through them I think it’s an enormously important session, because that’s one of the things that’s quite clear to anybody who takes a step into the world of integrative medicine for the first time, is how utterly baffling and complex and multifaceted the whole thing is, and finding your own way as to, ‘Well, what am I actually going to do out of all these things I could do? And that all seemed to be so important, and this person told me you have to do this, and this other person says no, you’ve got to do this.’ And there seems to be so many things that we must do in order to stay alive, that actually finding our own way, and even having a method to find our own way, is extraordinarily important.

Dr Nina Fuller-Shavel: Yes, and the way that we’re going to be structuring this is we will take the previous seven weeks and we’ll break that down as a part of our plan, and against each one we’re going to try and set some personal goals and some personal targets in terms of what we’re going to try and work on. So we actually structure around what you’re going to do for your nutrition. For example, ‘I’m going to eat a rainbow every day to support my body and have the healthiest antioxidant status’. Or, for example, we could target movement. We can say, ‘I’m going to do some walking and maybe some yin yoga or I’ll take up a breast cancer specific Pilates group’, something along those lines.

Treatment support, depending on where you’re at with treatment, you can go, ‘Okay, for this phase of treatment it’s really important to plan it.’ Like you said, step-by-step and phase-by-phase, is to say, ‘For this phase of treatment, this is what I can do to support myself.’ And for the connections to emotion we’ll talk about again, ‘How can I connect with myself and others?’ and emotions will be around emotional management and, ‘What techniques can they bring into my toolkit to help me manage what’s coming up for me?’ and I will talk about sleep and the mind-body.

Having this kind of seven-point structure I think is a really good way of going through it and saying, ‘Look, I’m just going to set a goal in each bit, and what I’m going to do is week-by-week after the program finishes, I’m going to ask how I’m going to achieve the first couple’. Again, taking it very much step-by-step, not trying to solve the whole puzzle at the same time. And keeping very, very flexible, because the other key thing that we know is that as you go through treatment the treatment phases change, and where you’re at changes. And what your needs are changes as well. It’s having that framework to always be able to change your mind, be flexible, and to say, ‘What is working and what isn’t working for me right now?’ is going to be very important.

Robin Daly: Well, that sounds extraordinarily helpful. So people are going to leave knowing how to work out their way forward, and they’re also going to be able to work with the others in their group on how it’s going, which is incredibly important, of course, once you’re actually out there on your own doing these things. It’s kind of checking on how you’re doing with it all, which you could never know how you’re going to do with it all, and it’s quite often not what you expect.

Dr Nina Fuller-Shavel: Absolutely. And I think it’s about having a connection point. I’m hoping that people will continue to engage with the group way after they’ve finished the course and still find support and also provide support within that setting. And I’m also hoping that again we’ll be able to take the structure forward with them and even beyond treatment, to be able to say, ‘This is how I take care of myself, this is what’s important. I’m going to keep myself grounded’. Then whatever other people might say, they can go, ‘Okay, well, how does it fit into my plan?’, because actually it’s quite easy to start grabbing at straws and grabbing at various bits and pieces of stuff. But when you have a structure to go back to and say, ‘Okay, where does this fit for me?’ If it fits – great, and if it doesn’t, it’s actually quite nice to be able to see that and to say, ‘You know what, I’m already taking care of that in a different way. I don’t need to have three million things within that section of my plan. I’m okay with the one I’m doing right now’.

Robin Daly: One question, you talk about the ‘importance of prioritizing true self-care’. You could have written it, ‘the importance of prioritizing self-care’. But you didn’t, you said true self-care. Could you just tell us what you mean by that?

Dr Nina Fuller-Shavel: I read this really great quote once, and it’s really stuck with me and it says true self-care is building a life you don’t need to regularly escape from. It is very powerful. It’s about the fact that when we think of self-care it’s been a bit commercialized as oh, take your bubble bath, you know, go and have some chocolate and have a massage. And that’s lovely, but to me true self-care is that what’s deep and authentic to you as a person. It is about building a life that is not making you sick, and that is a life that you don’t have to escape from.

Robin Daly: Thank you for that, I’m glad I asked. So what else do participants get from the course? Any other resources associated with it?

Dr Nina Fuller-Shavel: Every week we’ll have some handouts to do, and they will usually be on the weeks where we’re doing mindfulness and some of the emotional work, there will be some recordings to go along with it that the participants will get to keep throughout.

Robin Daly: Excellent. So lastly, but importantly, can you give some indication of what this is going to cost? I mean, is it within the reach of most people, would you say?

Dr Nina Fuller-Shavel: The sessions are £30 per session, so the whole cost is £240. I know it’s quite a lot in one go, but I think that’s really reflective of the amount of time and energy and evidence that I put in within this course. I’m hoping in the future this will get funding. There’s a couple of funding applications that I will be putting in, although at the moment, as you are probably aware, anything charity-wise is probably a little bit tricky because of what’s going on globally in the world. I found my usual sources possibly not quite as approachable as they usually would be. I’m hoping within another 6 to 12 months I’ll be able to offer some free-funded spots for some people who are not able to afford the full cost of the course.

Robin Daly: That would be fantastic. You’re right, it’s a tough time for charities and so they’re not being as generous as they normally would be, they just can’t be. But, yes, some free places would obviously be fantastic. But having said that, £30 a session, I’ve got a pretty good insight into the quality of the stuff that people are going to be getting from you and it sounds like pretty much a bargain nonetheless. How do people find out more and what’s the web address they register at?

Dr Nina Fuller-Shavel: The web address is: drninafullershavel.podia.com. Sorry it’s very long, but hopefully we can post a link at the end of this interview so that people can find it. If they come to my Instagram account, again, it’s Dr Nina Fuller-Shavel, they will be able to see the link on there as well.
Robin Daly: Well, thanks so much, Nina. I’m sure your course is going to be an enormous resource and support to women who’ve been unfortunate enough to get breast cancer. Thank you very much for telling us all about it today.

Dr Nina Fuller-Shavel: Thank you for having me Robin.

Robin Daly: Dr. Fuller-Shavel’s course does sound like an amazing resource for women with breast cancer who are looking for help in finding ways to support themselves. As mentioned, you will find the link to the course on the Yes To Life show page of our website, yestolife.org.uk.

But if you want to take a note now it’s: drninafullershavel.podia.com

It was mentioned during our talk today also of ‘Your Life and Cancer 2020’, Yes To Life’s online event. We’re currently in between the two weekends, having completed the ‘Introduction to Integrative Medicine’, and we’re now looking forward to the ‘Expanding Your Knowledge’ weekend from the 10th-12th October. In this we’ll be diving deeper into integrative medicine led by luminaries such as Dr Nasha Winters, Professor Tom Siegfried, Jane McLelland, Dr Keith Block, Dr. Valter Longo and many, many more. The first weekend was a spectacular success, and we’ve been inundated with hugely positive feedback regarding the speakers, the content and the format. In fact, in all aspects of the event it’s gone down a storm.

You can both order recordings of the first weekend and reserve your place at the second weekend starting on the 10th October at: www.yourlifeandcancer.com. Thanks for joining me today in my ongoing exploration of integrative medicine, I’ll be back next week, showcasing more integrative medicine, pioneers, and people who are passionately pushing the boundaries of cancer-care with a determination to significantly improve the lot of people with cancer. So if you can, please do join me for another Yes To Life show here on UK Health Radio. Bye.

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Radio show transcript edited by Kathy Martin, Literary Transcript Editor