A diagnosis of breast cancer in 2010 hit Susan Rossman pretty hard. A year later, a pioneering study at the University of Alabama at Birmingham helped her reclaim her life from cancer's grasp.
"I think that cancer can be the worst thing that ever happened to you or it can be a life-changing event — one that you do something with rather than letting it do something to you," she said.
For Rossman, the key was Harvest for Health, a UAB study that paired cancer survivors and master gardeners from the Alabama Cooperative Extension System. The idea was to see if gardening would help survivors eat a more nutritious diet and improve physical activity.
Wendy Demark-Wahnefried, Ph.D., R.D., is the associate director for cancer prevention and control in the UAB Comprehensive Cancer Center. She is also a registered dietitian and a professor in the Department of Nutrition Sciences. She is intrigued by the link between cancer and diet. There is powerful evidence, she says, that a diet high in fruits and vegetables is especially beneficial for cancer survivors.
"We asked the question: If cancer survivors started a vegetable garden, would they eat more vegetables? We found they not only ate more vegetables, they also got more exercise. And their physical functioning improved dramatically," she said.
Harvest for Health began with a pilot study in Jefferson County, Alabama, in 2011. Funded by the Women's Breast Health Fund of the Community Foundation of Greater Birmingham, the original study showed survivors had improved strength — especially in the hands — improved mobility, and an increased ability to get up and down. The study has since been expanded to many counties surrounding Birmingham, along with the Cullman, Montgomery, Mobile and Dothan areas, with support from the National Cancer Institute.
UAB provides tools and seedlings and will either prepare a raised bed in the yard of a survivor's home or provide EarthBoxes® — large gardening containers on wheels — that can be kept on a porch or patio. Master gardeners visit with the survivors monthly for one year, offering advice and answering the questions new gardeners have.
Mary Beth Shaddix is the master gardener who worked with Susan Rossman in 2011. They mapped out a strategy that Rossman still follows: growing tomatoes, kale, lettuce, spinach and a variety of herbs. Rossman has since added another raised bed, has planted strawberries and blueberries, and has begun keeping bees for honey.
"I liked the idea of growing something because it represented the whole circle of life," Rossman said. "Plus it helped me take better care of myself and have some fresh vegetables. It prompted me to spend a little more time thinking about what I was putting in my mouth and what I was buying and cooking for myself and my husband."
Shaddix, one of more than 100 master gardeners in Alabama who have volunteered for Harvest for Health, is something of a fresh food crusader.
"I love to grow my own food, and I want to tell as many people as I can how fun, rewarding and tasty it is," she said. "Because, I promise, if you thought you didn't like it but you grow it yourself, the fresh, homegrown one may just change your mind."
Demark-Wahnefried says better diet and increased physical function are means to an end — to keep cancer survivors living independently for as long as possible.
"Loss of physical function in cancer survivors, especially older survivors, is a downward spiral, so that many times survivors lose the ability to live on their own," she said. "Improving that ability to live independently is a big outcome for us."
Another outcome from the project is an overall improvement in the survivor's outlook on life.
"As scientists, it is difficult to measure intangible benefits; but this program seems to be contributing to improved quality of life and self-esteem — helping to produce a sense of peace in the survivors who participate," Demark-Wahnefried said.
"I'm feeling more empowered by what I'm doing here," Rossman said. "When I started gardening, it really brought to my consciousness that this was something I could focus on. It was something I could control so that I didn't think about cancer every day."
Shaddix, of Maple Valley Nursery, is a gardener, not a psychologist; but she knows firsthand that gardening's benefits extend beyond the harvest.
"I think gardening improves your mental well-being tremendously," she said. "Just being outdoors for an hour each day to tend to your plants improves your mental and physical well-being. I think there is room for gardening in everyone's life, and I also think there is room on your kitchen table for what you grow no matter what you are faced with in life."
Demark-Wahnefried wants Harvest for Health to continue to grow. She hopes to launch a trial on a national level within the next five years.
"Then in 10 years, I'd like to see a program in place that is sustainable on a national level," she said. "Two-thirds of the states in this country have at least two growing seasons. We could really make this a national program. And that would fulfill the dream."