Letter to the Editor: The development of knights cabin cancer retreats: a community program to engage cancer survivors’ proactive health behaviors
Applied Cancer Research volume 39, Article number: 14 (2019)
Cancer survivors often lack the knowledge and skills to return to positive health behaviors following a cancer diagnosis. The use of retreats may be an ideal environment for cancer survivors to learn about health behaviours while receiving social support from other survivors.
Knights Cabin Cancer Retreats was created as a charitable organization in 2014 and is at no cost to participants or their supporters. Elements of the retreat include guided hikes, yoga, classes on nutrition, stress, mindfulness and sleep management techniques, all with a focus on the evidence based theories of behavioral change.
Ten retreats have been hosted across Canada to date with 137 cancer survivors and their supporters. Survivors reported that their top learning outcomes from the retreat were physical activity/nutrition and behavioral change/habit development.
Knight’s Cabin Cancer retreats are unique in their programming with a format of health education that allows for emotional support and engagement with other cancer survivors in a therapeutically natural environment.
Due to increased prevalence of cancer, alongside medical advances in screening and treatment, cancer survivorship is on the rise . Given the physical, psychological and social concerns of surviving cancer , cancer survivor programming needs to be multidimensional in focus and theoretically grounded in order to increase adoption and maintenance of health behaviors .
In 2014, Knight’s Cabin (KC) was created with the purpose of supporting cancer survivors and their supporters in their transition from being a cancer patient to living a life of wellness post cancer diagnosis. To attain this goal, survivors and their supporters engage in tailored weekend education retreats across Canada focused on evidence-based health behaviours. The retreat begins with an introduction to behavioural change utilizing the theory of planned behavior due to greater motivation for physical activity and adoption of physical activity among cancer survivors . Physical activity recommendations for cancer survivors are discussed in detail and a hiking activity in nearby trails is used to incorporate physical activity in an outdoor environment. Yoga classes taught bey a certified yoga instructor and focusing on restorative poses are included at two points throughout the weekend retreat as yoga is effective in enhancing quality of life in cancer survivors . Due to the positive impact of mindfulness and mindful meditation in cancer populations on anxiety and depression  guided meditation is used to improve coping. A sleep session on the importance of sleep and principles of sleep hygiene is used due to the high prevalence of sleep disruption in cancer survivors . An educational session on healthy eating for cancer survivors is delivered by a local registered dietician. At the end of the retreat a habit development worksheet  is used to guide behavior change and habit development.
There is a positive relationship between social support and physical activity engagement in cancer survivors , and therefore both the cancer survivor and their supporter are invited to the retreat. The goal of supporter engagement is to support the survivor throughout the retreat, as well as to assist the supporter in their own health behaviours due to the high reports of compassion fatigue.
Since the inception of the KC charitable foundation in 2014, ten retreats have been hosted across Canada, from British Columbia to Newfoundland, all in beautiful natural settings. Through these cancer retreats, 137 cancer survivors and their supporters have participated, receiving access to evidence based health behavior education at no cost to participants or their supporters. Of those participants who were registered for a KC, one supporter was sent to the hospital due to gallstones. No other adverse events were reported. All participants who were registered completed the weekend programming except for one individual who left before programming commenced due to a family emergency.
The majority of participants at a KC are female and the average reported age was 52. The most common location of cancer is in the breast and one third of participants were diagnosed with Stage 2 cancer. The majority of participants had surgery, radiation or chemotherapy in their cancer treatment and 23% of participants were still receiving treatment at the time they attended a retreat (Table 1). A typical retreat schedule is provided in Table 2. At the end of the retreat survivors and supporters are asked to complete a program feedback form. All survivors and supporters said they would recommend the program to a friend. Survivors reported that their top learning outcomes from the retreat were physical activity/nutrition (31%) and behavioral change/habit development (24%). It is likely that this focus was due to the emphasis places on the benefits of physical activity and nutrition on health in educational sessions. In addition, only survivors report learning about self-care, likely due to the relatability of this behavior.
Knight’s Cabin Cancer Retreats have been successfully run across Canada and have been well received by participants and supporters. Of greatest benefit may be the format of health education in the retreat environment which allows for emotional support, engagement with other cancer survivors in a therapeutically natural environment, which may remove the feeling of isolation that is noted in traditional cancer treatment . This is something that appears to be lacking in much of the community-based programming. It is apparent from program evaluation responses that this breadth of programming is resulting in learning outcomes that survivors and their supporters can bring to their lives after a retreat.
Availability of data and materials
Knights Cabin Cancer retreat data and material are available upon request.
Knights Cabin Cancer Retreats
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We wish to acknowledge all of the volunteers that allow Knights Cabin Cancer retreats to operate.
There was no funding allotted for this research. Knights Cabin Cancer retreat is a national registered charity in Canada.
Ethics approval and consent to participate
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Ethics approval was obtained from the University of the Fraser Valley Human Research Ethics board (1085 K-18).
Consent for publication
Data was originally collected by Knights Cabin Cancer Retreats with participant knowledge with a specific statement that survey data would be used for program evaluation purposes. University of the Fraser Valley was asked as an independent investigator to complete a program evaluation at this time a letter of information was sent to all participants explaining the further use of data for academic publication.
The authors declare that they have no competing interests.
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Lesser, I., McGowan, E. & Belanger, L. Letter to the Editor: The development of knights cabin cancer retreats: a community program to engage cancer survivors’ proactive health behaviors. Appl Cancer Res 39, 14 (2019). https://doi.org/10.1186/s41241-019-0083-2