Frequently Asked Questions

Frequently Asked Questions on CETI’s Courses

What is the difference between CETI’s courses and other similar courses?

Because our focus is ONLY on cancer, we are able to maintain the highest standards and provide the most current information on exercise oncology in the industry. We have been providing education on cancer recovery since 1995; longer than any other organization in the world. Our coursework is hands-down the most comprehensive and “hands-on” available. We also help you to become more visible, in an effort to help you build your business, by listing you on our International CES directory and providing you with a one year membership to the Medical Fitness Network.


What is the difference between the CES and BCRBS course?

The CES course covers 25 types of cancer, as well as pediatrics, and is perfect for all health and fitness professionals and their modalities (Pilates, Yoga, Personal Trainer, Group Fitness, Aquatics, etc.). It is not limited to any one piece of equipment or apparatus, ie; BOSU(R) Balance Trainer. The BCRBS course ONLY focuses on breast cancer and ONLY uses the BOSU(R) Balance Trainer as a modality.


How long are the Advanced Qualifications good for?

They are good for two years. The information is updated regularly because oncology is an ever-changing field and the information becomes outdated quickly.


Why do I have to re-test or take CETI CEU courses to keep my Advanced Qualification current?

As previously stated, the information is changing daily. In order to ensure the qualifications of our Cancer Exercise Specialists, we must be able to ensure that they are up-to-date on the most current information in the world of exercise oncology. This can be done by providing applicants with the most current edition of the handbook (updated every two years), or requiring them to take CETI’s cancer-specific CEU courses.


What is the cost for re-qualification?

The cost is $200 for either the new handbooks and exam or the equivalent CETI CEU courses.


Is the CES Mat Pilates course also an Advanced Qualification?

No. It is a continuing education course that will provide you with a certificate of completion. This course will not qualify you as a Cancer Exercise Specialist.


What certifying bodies do you offer CEU’s for and how how many credit hours are they?
CES – ACE 1.7, AFAA 15, ISSA 22, NASM 1.9, NSCA 1.8 (until 12/31/2017), PMA (for live courses taught by PMA instructor), Yoga Alliance 22 non-contact hours

BCRBS – ACE 2.2 and NASM 1.9



Frequently Asked Questions on Cancer Recovery

Frequently Asked Question Cancer Recovery from Cancer Exercise Training Institute Will I be able to do abdominal (stomach) exercises after TRAM reconstruction?

What you will be able to do following reconstruction will depend greatly on your fitness level prior to surgery. If you had strong abdominal muscles and a strong lower back prior to surgery, your recovery and subsequent return to your previous fitness level will be much easier. If you did not have a strong “core” to begin with, the TRAM procedure will leave you weakened even more and subject to low back pain and possibly even hernia.

Another consideration is whether you had a single or bi-lateral reconstruction; in other words, did they use part or all of your rectus abdominis to create one, or two new breasts? For obvious reasons, having both parts of your rectus used will leave your core tremendously weakened and can lead to postural deviations (swayback) and low back pain. It is highly unlikely that you will be able to do “crunches” or Pilates if you have had bi-lateral reconstruction. It will be very important, however, to work your obliques, intercostals, and erector muscles of the lower back to reinforce your core stability.

It is essential to address the weakened core muscles and postural deviations that arise following the TRAM. Most if not all of these issues can be corrected with the proper combination of stretching and strength training. Please consult a Cancer Exercise Specialist® (CES) in your area for safe and effective guidance and programming.


Can I lift more than 8-10 pounds following an axillary node dissection?

The National Lymphedema Network recommends that you avoid lifting objects over 8 lbs. following an axillary lymph node dissection to prevent the onset of lymphedema. My recommendation is this; avoid lifting excessive weight whenever possible. What this means is if you don’t have to take out the trash, carry your luggage with the affected arm, or carry your twenty pound child on the affected side, DON’T! On the other hand, if you take proper precautions to avoid lymphedema, including measuring your arm and not overheating, you can gradually begin to increase your weights at the gym.

Following your surgery, you will need to begin with the lightest weight and just a few exercises/repetitions, regardless of how much you were lifting prior to surgery. As your arm tolerates it (no visible swelling), gradually begin to add a few more repetitions and then a few more exercises. Other than not letting yourself over heat, there are no limitations for your lower body (unless you have a pre-existing issue). The bottom line is: be safe; start and progress slowly and realize that you may have to take two steps backward before you can take one step forward. For those of you who did not lift weight prior to surgery, you will need to take it even more slowly. I strongly recommend that anyone who has undergone lymph node surgery contact a Cancer Exercise Specialist® prior to beginning or resuming a weight training program.


Why can’t I raise my arm to the side or over my head anymore after my mastectomy?

Following a mastectomy, lymph node dissection, and/or radiation, the muscles may react by going into painful spasms affecting range of motion and posture. While the pectoral (chest) muscles are not removed, they undergo quite a bit of stress during the process. The incision across the chest, as well as the one under the armpit, may be bound down with scar tissue and adhesions. The skin may also be damaged by radiation. Depending on the degree of limitation, you may need to consult a physical therapist to help you with such modalities as ultrasound, massage, and electric stimulation.

You should have a Cancer Exercise Specialist® assess your range of motion and posture to determine whether or not you need a physical therapist and, if not, what the most effective exercise programming will be to help you regain your range of motion as well as correct postural deviations that may have resulted from the surgery and/or treatment. It is essential that you do not “push through” pain. Listen to your body and take it slowly. The degree of recovery will vary from person to person, but with the proper balance of strengthening/stretching exercises, there should be significant noticeable improvement in a very short time.


How do I lose the weight I’ve gained on steroids and/or hormone therapy?

If you are still taking steroids or hormonal therapy, you may find it quite difficult to lose weight. It can be extremely frustrating because no matter how well you eat, or how much you exercise, you continue to gain weight. For starters, consult with your doctor so that you can eliminate the possibility of diabetes. If he/she gives you the green light, you should consult with a registered dietitian (RD) who specializes in working with cancer patients. Lastly, consult with a Cancer Exercise Specialist® to help you put together a comprehensive and safe exercise program to help you build lean muscle mass and lose body fat.


How can I regain my precancerous strength and energy level?

If you are still undergoing chemotherapy or radiation, your body will not have the same physiological response to exercise as it will when your treatment is completed. All of your energy is currently going towards healing yourself and fighting cancer. If you have been exercising throughout your treatment, your return to your pre-cancerous strength will be much quicker than if you have been sedentary.

You must start slow and realize that there will have been a natural decline in your performance. This is completely normal and expected. Even if you were a triathlete prior to your diagnosis, you will have to start slowly and progress according to how your body tolerates each newly introduced exercise protocol. I urge you to consult with a Cancer Exercise Specialist® to help you reach your goals safely and effectively. Don’t give up, with a bit of will-power and perseverance, you will return to your pre-cancerous strength, and then some!                                     

Frequently Asked questions cancer recovery Cancer Exercise Training Institute


Why is my posture so bad following my mastectomy?                  

Following a mastectomy, there may be scar tissue and adhesions across the mastectomy   site causing tightness and muscle spasm in the chest wall. If the area is not stretched following surgery, it can become spastic and lead to round shoulder syndrome (the rounding forward of one or both shoulders).

Round shoulder syndrome can also be exacerbated by the inherent “guarding” of the area after surgery. Prior to mastectomy, many of us have some degree of round shoulder syndrome as a result of poor posture and weak upper back muscles which seems to be compounded by the surgery. Matters can be made even worse following reconstruction which can cause muscle imbalances as well as additional scar tissue at the mastectomy site. It is essential to address the resulting muscle imbalances following a mastectomy and/or
reconstruction. Most if not all of these issues can be corrected with the proper combination of stretching and strength training. Please consult an Cancer Exercise Specialist in your area for safe and effective guidance and programming.


If a man undergoes a mastectomy will he suffer with the same range of motion and postural distortion issues as a woman would? 

male breast cancerFollowing a mastectomy, whether it be on a man or a woman, there may be scar tissue and adhesions across the mastectomy site causing tightness and muscle spasm in the chest wall. If the area is not stretched following surgery, it can become spastic and lead to round shoulder syndrome (the rounding forward of one or both shoulders).  Postural distortions will vary and may determined, in part, by whether or not any  type of reconstruction was performed. If tissue was removed from another part of the body to fill the “gap” left by the mastectomy, there may be a muscle imbalance in that part of the body that will need to be addressed. Most if not all of these issues can be corrected with the proper combination of stretching and strength training. Please consult an Cancer Exercise Specialist in your area for safe and effective guidance and programming.