Beyond the Cancer Diagnosis: Interview with Sami Mansfield, Hosted by Adrian Pogacian

In the current episode of ‘Beyond the Cancer Diagnosis’, Adrian Pogacian highlights the crucial role of Cancer Wellness, both as a concept and a lifestyle, with Sami Mansfield, a visionary leader in Exercise Oncology, Lifestyle Medicine, Metabolic Health Consultant and the Founder of Cancer Wellness for Life and My Lifestyle Shift programs.

Sami (Papacek) Mansfield is the founder of Cancer Wellness for Life. She’s been a certified cancer exercise specialist since 2003 and has dedicated her career to implementing evidence-based lifestyle education, resources, and tools into cancer care for both the patients and the providers.
She is also a Chair of Cancer Member Interest Group, at the American College of Lifestyle Medicine and Breast Cancer Taskforce Co-Chair at Colorado Cancer Coalition.

Adrian Pogacian, MS Psychology, clinical psychologist with executive education in Psycho-oncology, holding a degree in Global Health Diplomacy from Geneva Graduate Institute. Currently, researcher and associate lecturer with focus on Impact of Cancer Diagnosis on Couples and Families, Communication in Cancer Care and Posttraumatic Growth. His expertise is on Coping with Cancer and managing Fear of Recurrence.

Additionally, Founder of INCKA Psycho-oncology Center, Host of Beyond the Cancer Diagnosis Interview Series as well as Writer and Host Content in Psycho-oncology at OncoDaily.com, co-author of the first Romanian Multimodal Care Guideline in Pediatric Onco-hematology, active contributor to the International Psycho-oncology Society, presently IPOS Fear of Cancer Recurrence SIG member and IPOS Early Career Professionals in Psycho-Oncology Committee founder member.

The discussion begins with Sami Mansfield emphasizing the role of lifestyle choices in managing epigenetic changes, which are reversible through proactive efforts. However, they highlight the challenge of accessibility, especially regarding high-quality nutrition, which remains costly globally. Conversely, physical activity is a widely accessible intervention. Sami also stresses the absence of any safe level of alcohol consumption, pointing to its undeniable risks.

Adrian Pogacian introduces the session as part of the “Beyond the Cancer Diagnosis” interview series, welcoming Semi Mansfield, founder of the Cancer Wellness for Life Institute. The focus of the discussion shifts to the psychosocial aspects of cancer care, particularly through the lens of well-being and lifestyle. Semi Mansfield expresses gratitude for the opportunity to expand on this essential topic, linking it to broader patient and clinician care.

When prompted to elaborate on the mission of Cancer Wellness for Life, Sami recounts their professional journey. Starting in 2003 as a cancer exercise specialist in Kansas City, they worked during a period when exercise’s safety and benefits for cancer patients were still under preliminary study. Despite early skepticism, many patients showed interest in exercise but faced barriers, including fatigue, joint pain, anxiety, depression, and logistical challenges.

These experiences led to the realization that exercise alone could not address the comprehensive needs of cancer patients. Over time, Mansfield transitioned from community-based work to academic and research roles, contributing to early studies on exercise in post-menopausal breast cancer patients.

Mansfield observed that many programs globally excelled in clinical care but struggled to integrate lifestyle interventions holistically. This gap inspired the creation of the Cancer Wellness for Life Institute, a consulting organization aimed at offering tools and fostering conversations around lifestyle as an integral part of cancer care. The mission centers on empowering individuals to live optimally by combining clinical and patient-facing approaches.

Adrian shifts the conversation to modern advancements in cancer care, acknowledging both opportunities and challenges posed by contemporary lifestyles. Statistics reveal that while only 10-12% of cancers stem from genetic mutations, 40% are linked to lifestyle factors, particularly smoking and obesity. The discussion explores epigenetics, emphasizing the influence of environmental factors like microplastics, water, air quality, and stress on DNA. Mansfield underscores that lifestyle-driven epigenetic changes are reversible, offering tangible benefits such as improved mood, reduced blood pressure, and enhanced cellular health within weeks of adopting healthier habits.

Physical activity is positioned as a universally accessible and impactful tool for improving health, especially amidst rising financial and time constraints in healthcare. Mansfield critiques the sedentary behaviors exacerbated by the COVID-19 pandemic and technological advancements, which have increased dependency on delivery services and remote work. This shift, while convenient, has inadvertently contributed to inactivity.

[Speaker 2] introduces the concept of the “five A’s of behavior change”—ask, advise, assess, assist, and arrange—as a framework for clinicians to gauge a person’s readiness for lifestyle modifications. Mansfield elaborates on how to apply these steps in practice, beginning with understanding individual circumstances and gradually building towards tailored interventions.

The key to successful behavior change lies in addressing readiness and avoiding overwhelming individuals with excessive information or demands. Mansfield emphasizes the importance of patience and the need for healthcare providers themselves to model healthy behaviors, which can enhance their credibility and reduce burnout.

The conversation concludes with a reflection on the importance of addressing one issue at a time, especially for cancer patients who often feel overwhelmed by the urgency to make comprehensive life changes. Mansfield advocates for incremental progress, such as incorporating short, manageable exercise sessions to achieve tangible mental and physical benefits.

By focusing on practical, achievable goals, patients can gradually adopt healthier lifestyles without feeling burdened by unrealistic expectations.

The discussion continued with Sami  explaining how health recommendations, particularly regarding exercise, need to be tailored to individual needs and capabilities. She pointed out that suggesting 150 minutes of weekly exercise to someone who is entirely sedentary can feel overwhelming.

Instead, focusing on smaller, achievable steps and ensuring the activity aligns with the person’s interests—such as yoga or Tai Chi—can make behavior change more sustainable. Sami stressed that it’s important to remember that progress doesn’t have to be perfect and that every small step counts.

Adrian then asked Sami to elaborate on the “six pillars of lifestyle medicine.” Sami described these pillars as essential components of a healthy lifestyle: exercise (aerobic and strength training), nutrition (focusing on plant-predominant diets), stress management, sleep health, social connections, and avoiding unhealthy habits (such as smoking, excessive alcohol consumption, inactivity, and sugar-sweetened beverages).

She emphasized that these are about making habit changes rather than achieving perfection, highlighting that wellness and lifestyle improvements should be individualized to each person’s situation.

The conversation shifted to the cultural factors that influence the acceptance of wellness practices. Sami explained that cultural and community factors, including language barriers, ethnic backgrounds, and historical experiences, play a significant role in shaping how people perceive and adopt wellness strategies.

She gave the example of Denver, Colorado, where there is a large Mexican and South American immigrant population. For this group, cultural differences—like unfamiliarity with certain foods, such as tofu—might hinder the adoption of plant-based eating habits. Sami stressed the importance of cultural competence in wellness practices, suggesting that healthcare professionals should adapt their approach based on the community’s cultural background.

When Adrian asked about the myth of red meat and cancer, Sami clarified that the science connecting red meat to cancer is primarily associated with colorectal cancer. For other cancers, moderate consumption of red meat is generally safe, with a recommendation of no more than two to three servings per week. She emphasized the importance of consuming high-quality, minimally processed red meat and avoiding processed meats like bacon or deli meats, which are more problematic. Sami also noted that nutrition science often targets specific cancer types, so the context and individual factors matter when considering dietary recommendations.

Finally, Adrian inquired about red wine, a topic of much debate. Sami stated that there is no amount of alcohol that is considered completely risk-free for cancer patients. However, she acknowledged that the choice to drink is ultimately a personal one. While some cultures, like the Mediterranean, include moderate red wine consumption in their diets, Sami cautioned that individuals need to be aware of the risks and make informed decisions. She reiterated that moderation and being educated about the health impacts are key when making such choices.