Clare Delmar: Hello and welcome to On Focus brought to you by The Focal Therapy Clinic, where we connect you with issues facing men diagnosed with prostate cancer that are little known, less understood and often avoided or even ignored. Prostate cancer is now the most commonly diagnosed cancer in the UK, and with this sombre fact comes a multitude of challenges and opportunities. I'm Clare Delmar. Joining me today is Tony Collier, ambassador and awareness speaker and fundraiser for Prostate Cancer UK. Tony is a dedicated runner and a passionate believer in the transformative benefits of physical exercise. He's here to share his views on exercise for men with a prostate cancer diagnosis born out of his personal experience and that of his many supporters and followers on social media. Tony, welcome. Thank you so much for joining me today. Tony Collier Great to be with you today as well. Glorious blue sky and sunshine, it's fantastic. Clare Delmar: Well, not so much where I am, but I know we both had our morning runs and we see each other on Twitter to compare notes on our respective daily runs. And I find that incredibly uplifting. Tony Collier Absolutely. Absolutely. Clare Delmar: So you have been incredibly motivational for lots of people and you're also a master on social media. And I wanted to just tap into that today and get you to share some of your insights, both that you've gained from yourself and from your experience with all the people you know. And I think we just start off by commenting on your running, because that seems to be your main form of exercise. And, you know, you've been a very keen runner. You're an inspiration to many men with prostate cancer on exercise and fitness. So were you always a runner or was it something you took up after your diagnosis? Tony Collier Actually, I started quite late in life before my diagnosis. When I was forty five, I had a medical problem company and it turned out that they said I was borderline clinically obese and my blood pressure was so high that I'd be on drugs the rest of my life if I didn't do something about it naturally. So I chose to do something naturally. And the gym where I played a bit of social squash had a very informal running club and I decided to join them. And then two years later, we became a properly affiliated running club and a love of running was born. So that was forty five. I ran my first marathon when I was 50 and said never again. Clare Delmar: Where was that? Tony Collier It was in Amsterdam in 2007 and Amsterdam has become a place that's very much part of our life because my brother-In-law lives there and I've actually since run the marathon again before my diagnosis and then before I think back in 2019, my entire running club went over to take part in the Amsterdam marathon festival, but I just run the 8k because marathons are a bit of a challenge nowadays, but absolutely adored running and really became quite proficient at it and got down to a PB for the marathon of 3:23. Clare Delmar: Wow. Tony Collier Which I set when I was about fifty four and I was still running competitively. I was still running in the three thirties when I was 58,59 before my diagnosis at age 60. Clare Delmar: Wow. That is impressive. So how is your experience with prostate cancer affected your attitude if not so much your performance but your attitude towards fitness and running? Tony Collier My first question when I got my diagnosis to the oncologist was... Most people would say, how long have we got to live? And that was actually in the back of my mind. But my first question was: will still be able to run? And the oncologist said, yeah, you'll be able to run, but you'll be a lot slower, because hormone therapy is going to cause you to slow down and you won't be able to run as far because of issues with bone density. So my attitude to it was I wanted to carry on running for as long as possible. And it was a really massively important part of my life. I do lot of things with my running club, we go abroad every year in normal years. And so it was really important for me to keep going. But I have to say that it was really tough for the first probably 18 months, two years. I sort of lost the plot a bit because from being one of the faster runners at the running club to suddenly being one of the slower runners through no fault of my own, I found really difficult. It was mentally quite challenging. I'm sort of over that now. I still sort of mourn the old days of being a 22min 5k runner. And, you know, I had a best of 19:53 for 5k and now I'm lucky if I go 26. But you know some people would be really happy with twenty six so I don't complain too much. I'm still running and that's the most important thing. And it's just so important in my life. Clare Delmar: No indeed. I mean obviously because you've been competitive that's kind of your benchmark. But the fact is you're still doing it. Tony Collier Yeah, I think it's just a change of mindset. I'm sort of in a better place with it now. My friends in the running club, who I would consider it to be comparators, the benchmark and I see what times they're doing and I'm thinking I should be faster than that. But I can't, and hey ho, I think the most important thing from my viewpoint was staying involved with the running club, staying involved with running. But actually, I think the most important part was that running was really good for my mental and physical well-being. Some days you come back from the running. You feel absolutely amazing, don't you?Like this morning, this incredible runner's high because you're running great, the skies are blue, the sun shining. And you can't ask for anything more in your life and then another day you go out and try and do it a run and it's just a complete miserable failure. I've reached the point where the failures stop mattering anymore and you live for the good runs. Clare Delmar: I mean, the other thing about running as a form of exercise, of course, is that it's been the least, if at all, affected by lockdowns. So you're lucky that that's kind of your sport of choice. Tony Collier I think the most amazing thing that we've noticed during lockdown and this is something that my running club wants to capitalise on, is the fact that there are so many more people out running than ever before. I've never seen so many people, it's fantastic. Clare Delmar: Well, there's not much else to do. Tony Collier Well there is that. Clare Delmar: So, I mean, your work as an advocate for men with prostate cancer has connected you with hundreds, I mean, correct me, maybe it's thousands of people affected by and living with this disease. So what are you hearing from them about exercise and what messages do you want to send to them? Tony Collier I think we just sort of park the prostate cancer a little and just think about cancer in general. There is a whole conversation happening now with health care professionals about the benefits of exercise with people living with and beyond cancer. It's very clear that some people were massively unfit before they had their cancer diagnosis, and that limits what they can do post cancer diagnosis. But I think it's one of those things that's really difficult. The message really is that there is something that everybody can do. Now, not everyone... Last year I climbed Ben Nevis, since my diagnosis I've run the London Marathon. And this year I'm taking on a 100 km ultramarathon, which I'm going to do as a walk with a little bit of running. Well, not everybody can do that. You know, I'm living with terminal prostate cancer, but there is something for everybody. And this is the most important message I try to get across to people. There are even chair based exercises that people can do. And I think that's a really important thing that people need to get in the mind, that, you know, not everybody can climb a mountain, not everybody can run a marathon, but everybody can do some form of exercise. And I think the most important thing is get the heart rate elevated, even if it's just literally sit to stand from a chair, do that 20 times and see if it elevates your heart rate. That's a great exercise. And so there's loads and loads of chair based exercises. And I really trying to encourage people to do something that works for them and to look for areas where they can get support. And I've been really blessed to be a patient representative Prehab for Cancer in Greater Manchester. Clare Delmar: What is that? Tony Collier Prehab was originally an initiative set up in 2019 and the idea was for three particular tumour groups - they didn't go for the big tumour groups for obvious reasons, it was only a pilot scheme. Immediately somebody gets a diagnosis of cancer, they go into a prehab programme to get them fitter for surgery, and then when they come out of surgery, they go into the sort of post op phase and then they go into rehab. And what we were trying to do was trying to prove that basically, even with only a six week window between diagnosis and surgery, you can make a massive difference to people's fitness levels. And that's what we set out to achieve. And I think we, so far, are doing a pretty good job of it. Clare Delmar: So can you give us some examples? I mean, is it conclusive or is it simply encouraging, which again, would be a good thing? What are some examples of how it would be encouraging? Tony Collier The idea basically is that people see as part of their treatment plan and it's not compulsory. People don't have to take part or they are actively encouraged to take part. It's all the leisure trusts in Greater Manchester are part of it. They have specialist cancer rehab trained personal trainers in all leisure trusts in Greater Manchester. And basically people go straight into the programme. They're given a referral, they're contacted by one of the PTs - personal trainers. And they were doing this face to face in the gyms, in groups or individually in the gyms. And it's basically they've proven to be a massive success. Myself and one of the other patient reps did some focus groups for the patients who had been through the programme. And I remember vividly one 72 year old guy, he said, I've never been in a flipping gym before in my life, he said, but I can't see me ever not going to the gym. Clare Delmar: Wow. Tony Collier And what we've seen are some outstanding results. So what the guys do is either an incremental shuttle test or a six minute walking test to assess people's baseline fitness. And then over the six week period prior to surgery, they basically do a programme that's specifically designed for that individual that fits in with what they're capable of. Clare Delmar: OK Tony Collier ...And they then do those tests again just before surgery. And what we've seen is the baseline level is increased significantly preop, and obviously when they come out of surgery, they drop back down below baseline, but then go into rehab once they recover from surgery. And what we're finding is their recovery is much quicker and they get back above the pre surgery levels very quickly. Clare Delmar: Wow. Tony Collier The most amazing outcome of this, of course, is that patients are getting out of hospital more quickly, which is wonderful for the NHS. And that's actually part of what we're trying to prove to the NHS commissioners, that this really works, it's saving money. Clare Delmar: I mean, it's almost a form of social prescribing as it would seem to fit into that agenda, perhaps. Tony Collier It absolutely does. And I think one of the patients said to me, you know, I was out of bed inside of four days, he said, and I was told would probably be 10 days. And the other people around me who hadn't been through the programme were still in bed when I left. Clare Delmar: That's really interesting. I mean, everything depends on evidence before it actually gets instituted. And what evidence of links between exercise and prostate cancer specifically motivates you? I mean, obviously, what you're telling me is one area, but is there anything else that that you can cite that is particularly motivating? Tony Collier Well, I think exercise is obviously really important for prostate cancer, particularly for men who are having prostatectomies, because obviously pelvic floor exercises before surgery are really, really important so that people gain continence more quickly. I think the biggest thing that motivates me to sort of encourage people living with and beyond prostate cancer is about mental wellbeing as much as physical well-being. I think it's just amazing to get out into the fresh air and just get the heart rate elevated, even if it's just a fast walk. And I think when you get back, you always feel better. And that's the message I really try to get across to people who are living with and beyond prostate cancer. The motivation really is that it will make you feel better mentally. From my viewpoint, this is a very personal thing. I was given given a worst case prognosis of two years, and I exercise like I do because I think it will extend my prognosis. And if I believe that, then why shouldn't it? Clare Delmar: Oh, absolutely. I mean, and you're really good at that and inspiring others. I mean, we touched on this a few minutes ago, but the past year has presented so many challenges to engaging in exercise, both obviously on an organised level, but even as individuals and for those who can't go out and take a run or for some reason find that difficult, it's really important that you have a set of other, whether they're chair based, or other. I mean, how have you personally coped with the challenges that the pandemic has brought? And what advice would you give to others based on that? Tony Collier It's really interesting because at the first lockdown, I literally had a real sort of mental meltdown because life was just put on hold. And when you're living with a terminal prognosis, that's the last thing you want. And I had lost my running mojo, and my wife said to me, at the sort of end of April, why don't you try to run 5k every day in May? You need a target, a challenge in life. So I set out to do that and I ran at least 5k every day in May. And at the end of May I thought, well, what on earth do I do now? I need some motivation. So at the moment I'm up to day 306 or something like that of actually running or hiking every single day since 1st May, some days I've done both. Clare Delmar: Yeah. I mean, I noticed that because is it Strava that you use where you share you're running and hiking routes? Tony Collier Yeah. Clare Delmar: I mean that's a very powerful bonder for people, you know? Tony Collier I think now it's become a bit obsessive and so the streak will end. It will end after a year. And then I'm going to go back to doing four or five days a week. But I think the other aspect of lockdown that's been really difficult is I'm one of the two coaches at our running club and the other one is now living in Lanzerote. So I basically took up the cudgels of dealing with all the issues as far as covid was concerned for the club, and I became our covid compliance officer. That has presented lots of challenges because the club is actually split between two particular areas in South Manchester, partly in Trafford and partly which is Greater Manchester, and partly in Cheshire East. We had a problem that we actually couldn't have the two people crossing boundaries. So we had to find a way to keep the club going and active and moving. And that for me, was a massive organisational problem that I had to deal with as the covid compliance officer within the club and the coach. And I'm really proud that we were the first club locally to get back running as a group and we carried on running as a group until this lockdown. And we will be the first back on the 31st of March. Tony Collier You got that date sealed in your mind? Tony Collier Yeah, we know 29th March we'll be allowed. Our next club run is the Tuesday and we are going to go for it and then we'll be back running together in a covid compliant way to start off with, that means small groups. Clare Delmar: Yeah. Tony Collier It means away from other people, but we will be back running as a group, and I do think running as a group is incredibly motivational. Clare Delmar: Indeed, especially after after this time. But well, I will look forward to seeing your Strava updates and maybe I'll be joining you on Strava and sharing my probably rather pathetic runs compared to yours. But listen, Tony, it's been so wonderful speaking with you again. And thank you so much for coming along and sharing your incredibly motivational running tips and exercise tips. Thanks again. Tony Collier
An absolute pleasure- good to speak to you.
A transcript of this interview is available on our website, where you can also access additional interviews and stories from men living with prostate cancer. Visit www.thefocaltherapyclinic.co.uk. Thanks for listening and from me, Clare Delmar, see you next time.