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Strength, Hope, Courage - PALS for Life Cancer Programs at the Upper Valley Aquatic Center

Mar 24, 2022 02:30PM ● By By Nancy Fontaine. Photography Courtesy of Albert (Beto) Rodriguez.
Fitness trainer Erin Buck is a woman on a mission: to help breast cancer survivors. Her journey started 10 years ago when she was working with a personal training client who was going through breast cancer treatment. That experience has evolved into a suite of programs at the Upper Valley Aquatic Center (UVAC).

Erin K. Buck, ACSM Cancer Specialist, director of PALS for Life Vermont and New Hampshire, and fitness director at the Upper Valley Aquatic Center located in White River Junction, Vermont.

Erin wanted to help her client avoid lymphedema, a common side effect that can occur after breast cancer surgery or radiation treatment. Blockage in the lymphatic system prevents lymph fluid from draining well and, as fluid builds up, swelling occurs. Traditionally women were advised to avoid stressing the affected arm to prevent swelling. Erin started doing research and discovered the University of Pennsylvania Physical Activity and Lymphedema study (PALS), which demonstrated that physical exercise, specifically weight training, not only did not harm patients but reduced the likelihood of arm swelling.

Intrigued and inspired, Erin reached out to Cathy Bryan, one of the researchers and the founder of PALS for Life, a small-group training program based on the study. Erin then connected with Dartmouth-Hitchcock, speaking with the whole circle of providers to figure out how to navigate this kind of program in the Upper Valley. She created a referral network, found a space, and got started.

Programs like PALS need money to run, and Erin was committed to having it be free for her clients. At the time, she was an independent trainer and wasn’t able to secure funding, so she gave her time in kind, to the tune of 15 to 20 hours a week. “It was time well spent. I felt called.”

The Program

Erin Buck cues Katherine Babbott of Thetford, Vermont, in a “triple threat,” a compound exercise consisting of ball hip extensions, ball leg curls, and ball hip thrusts. Stability is the first foundation focused on in the PALS for Life protocol.

The PALS for Life program creates groups of three to six individuals receiving treatment for breast cancer that meet twice a week for 12 weeks. Erin says, “It’s different when they are out of treatment and they’ve had physical therapy. During treatment there are many highs and lows.”

In addition to increasing fitness and improving prognosis—cancer recurrence is much less likely for those who are active—the training has emotional benefits as well. “Patients are going through a traumatic experience. They have no confidence and they feel their body turned against them. Strength training changes that.”

Katy Driscoll (Thetford, Vermont), Deb Steele (Lebanon, New Hampshire), Katherine Babbott (Thetford, Vermont), and Erin Buck (Lebanon, New Hampshire) perform elevated single-leg glute bridges.

Erin’s philosophy is simple: “Having empathy is a huge part of coaching any population. You have to allow them to work at their pace, so I make things achievable to inspire them.” She is always asking, “How can I help you make good choices for you, your family, and your cancer diagnosis? The goal is to build their toolbox,” which is why the program includes nutritional counseling as well. “I leave them with an arsenal of things to go and do on their own. I want them to increase physical strength and emotional strength so they can move into any realm.”

Expansion and UVAC

Erin found that 12 weeks was good for a start, but her clients could use more, and she needed more support. She had done classic fundraising activities, like cyclothons, but to expand the program, she needed a home base. So joined the staff at UVAC, where she is now fitness director, and brought PALS for Life with her.

The June 2021 PALS for Life women attended the Lyme Wellness Fair on September 25, 2021, where PALS for Life held a booth educating the public on lymphatic stretching. A big emphasis is placed on social gatherings outside of class time.


Being at UVAC, a nonprofit organization, gave Erin what she needed to secure grants from organizations like the Couch Foundation. Such support allowed her to expand with the PALS for Life Bridge Program, affordably priced small-group training for those who have completed the PALS protocol and want to do additional training based upon the Strength and Courage exercise program. She also created the Living Beyond Cancer program, another affordably priced group training open to anyone who has had breast cancer.

“These programs find people at very different times of their lives. From the time they were told they had breast cancer, their lives changed, the way they related to their bodies changed. We never turn anybody away, and we welcome back ‘graduates’ when they need to return.”

The Future

The pandemic brought challenges for PALS, but Erin found ways to make it work. She currently offers the program in hybrid format, combining in-person and Zoom, which has made her think of ways of expanding beyond the Upper Valley. “I’m striving to receive funding to offer it remotely across all of Vermont and New Hampshire,” she says. She’s also interested in expanding to other forms of cancer. “I’m always trying to find what we can do,” she says.

The program’s motto is “Courage, strength, hope.” Erin Buck’s persistence in bringing training to breast cancer survivors is the perfect example.

For more information
Email Erin at [email protected]
or call (802) 296-2850 ext. 112.


I am so grateful for having been able to participate in the PALS program. Over the weeks, I gained confidence in exercise, learning how to safely build strength while living with lymphedema. Sharing the experience with other survivors was amazing. These women were inspiring, motivating, and supportive, and the class was both emotionally and physically therapeutic. I feel privileged to have benefited from Erin’s dedication to and  the UVAC’s support of this important program and thoroughly enjoyed the welcoming and relaxed atmosphere of  the class and facility. Thank you!
Nicole Azze, October 2021

I joined because of the PALS program and needed a jumpstart to rehab after surgery for breast cancer. I’m continuing because I got incredible support from both Erin and Carrie, physically and emotionally. It’s easy to get into a funk due to stresses in life, whether it is life, work, or health related. Starting an exercise program was the best way for me to feel as though I had some sort of control over my life. Erin, Carrie, and the other women in the group gave  me that sense of control.
Catherine Driscoll, January 2022

Erin and Carrie both nurture and nudge us. Sticklers for correct form so we get stronger without hurting ourselves, they keep us moving throughout the hour-long workouts. Because there are two trainers, one is free to offer individual support as she moves around the room, while the other leads the exercises. The workouts are varied and fun. It’s true. Trust me! We record our exercises and progress as we increase our weights and repetitions. During these 12 weeks we have grown physically and emotionally stronger and morphed into a group of supportive and connected women brought together by a common diagnosis that changed all our lives.
Katherine Babbott, October 2021

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