It's the side of cancer that the public doesn't see. A few weeks after diagnosis, it begins. First, there is withdrawal from social outings, then pain and fatigue set in, followed by loss of appetite and finally, a nearly-irresistible impulse to give up and stay in bed. Even when treatment is proving successful in combatting the disease, patients can feel as if hours and days are being lost in a listless, foggy-headed fight for survival.

Doctor's orders are pretty straightforward: fresh air, exercise, nutrition, social support, and sheer determination to get out of bed every morning. Clinical evidence leaves no room for debate. When patients do these things, the odds of survival skyrocket.

But a patient can often sabotage those odds with a list of demoralizing excuses: People will stare at you. They'll judge you for not doing much. What if you get sick or have an episode? What if you're alone? Why make all that effort to go to the gym if you'll be done in five minutes? Frozen by indecision, too many end up staying home, beginning a downward spiral into weakness.

The Y, in partnership with Livestrong Foundation, is tearing down this list of sabotaging lies by offering a safe, supportive program for physical wellness to adults with a cancer diagnosis. It's called Livestrong at the Y: an evidence-based program that empowers cancer survivors to exercise effectively, socialize with peers and share helpful tips-all as a free public service. It's an intimate small group (no more than ten or twelve members at a time) that meets twice a week in 90-minute sessions.

Since it began in 2007, Livestrong has helped over 40,000 people across the nation. Presented in a no-pressure environment, the program assesses each person's capabilities and emphasizes those exercises that are doable so that members learn how to move and lift safely. The goal is to provide skills and motivation that can carry survivors through the rest of their treatment and beyond.

Individuals dealing with all types of cancer are welcome in the program, and medical equipment such as colonoscopy bags can be worked around. It's a supportive setting among friends and specially-trained facilitators. Some members get involved immediately after receiving a diagnosis. Others come when they feel themselves slowing down. Others have made it through the most difficult stages of their battle and are ready to rebuild. Regardless of where a survivor is on the journey, Livestrong at the Y is an available resource.

Oncologists have grown particularly fond of the program since witnessing its results first-hand. Treatments are better tolerated, daily life continues with more normalcy, attitudes improve, and opioid prescriptions taper off. Caretaker dependence, common with certain types of cancer, is sometimes avoided. While the program can't replace treatment, its peripheral effects are powerful. In fact, the Livestrong program is so helpful that several major oncology practices in South Hampton Roads now routinely recommend it.

After seeing the program's success in Virginia Beach and Great Bridge, the Y is launching it in Greenbrier. Denise Brown leads the program at Greenbrier Family Y. A survivor herself who beat breast cancer six years ago, she remembers how it felt when the mere thought of getting out of bed was exhausting. After watching other loved ones go through the same thing, she was delighted to hear that Livestrong was coming to Greenbrier.

"Denise brings a special level of compassion to this program. She was the perfect choice for leading it," Executive Director Ryan Henderson says. "She meets survivors exactly where they are, no judgment or unreasonable expectations."

Each 12-week course is tailored to the comfort level of those in the small group. Any adult with a cancer diagnosis may participate at no cost, whether or not they have a Y membership. All that's needed is an exercise clearance from their physician. Members meet with Denise and her team to establish a baseline, assess special needs, and determine which exercises will prove most beneficial. The next 12 weeks are shaped by the group's composite capabilities. Roundtable discussions, informative guest speakers, and thought-provoking worksheets exercise the mind as well as the body.

Denise and her team have gone through extensive program-specific training developed by the Y in conjunction with Livestrong's clinical evidence. Each member receives a handbook with invaluable information.

Early meetings often involve self-conscious, hesitant members stretching their muscles until they've had enough. Facilitators give encouraging smiles for progress that may seem small but is actually highly significant. A month or so later, cheerful participants are dipping in the pool with more gusto. Faces have become familiar and friendships have deepened. Carpools and lunch dates become the norm for many. Since everyone is a cancer survivor, struggles are shared so that what once seemed like a solitary fight, soon feels like a communal effort.

Denise explains that the program's social component is as important as the exercise. Even if a member has a bad day and is too weak to participate, attendance is encouraged. Particularly, following chemo, a member may attend a few meetings only to sit on the sideline and cheer for the group. As long as members commit to regular attendance and a willingness to do what's possible, the program will benefit them.

Caretakers are welcome to bring a good book and watch from afar. The program actively seeks to remove barriers and be as accommodating as possible. Practical matters of balance, mobility, endurance, and lifting, which have the biggest impact on daily living tasks, are given emphasis. At the end of the course, a second assessment shows members how much progress they made.

Most importantly, members connect with a group of peers who hold each other accountable long after the 12-week course. Participants go on to report greater independence, better overall health, and a change in their long-term lifestyle. In some cases, this difference can be the catalyst to save a life.

"The most common thing I hear from cancer survivors is that they want their life back," Denise relates. "I have exactly two words to tell them: take it. Get up, start fighting, and take it back. This program is an excellent way to begin that process."