Born to be BOLD

For Dr. Alyson Moadel, it starts with the personal – and it starts at age seven when her single mother was diagnosed with breast cancer, eventually succumbing to the disease 10 years later. While she was thrust into the world of illness before she could even process the ramifications, she also witnessed her mother’s strength in finding supportive care at a time (the 1980s) when this was not readily available to patients living with cancer.

Alyson Moadel, PhD

Alyson Moadel-Robblee, Ph.D.

“What she did during the last two years of her life was pretty remarkable,” says Dr. Moadel, deputy director of community engagement and cancer health equity at the Montefiore Einstein Comprehensive Cancer Center (MECCC) and a professor of epidemiology & population health, of medicine, of radiation oncology, and of psychiatry and behavioral sciences. “My mother sought out all kinds of help, all kinds of integrative care, and found a support group and took me with her.”

This support group was a new type of patient empowerment program called Exceptional Cancer Patients led by a local surgeon at Yale New Haven Hospital, Dr. Bernie Siegel, who was an early advocate of personal empowerment, transformation, and lifestyle changes.

“It had such a big influence on her, and she had tried everything – meditation, a form of deep muscle massage called rolfing, and visual imagery. And it had a big influence on me as well. In the end, her death was jarring but I had many systems of support in place because of what I saw her do on her own with no formal guidance. I also saw how important integrative care was for patients and families.”

In college, Dr. Moadel went back to Dr. Siegel and asked if she could observe him running a group session and do an internship with him. She stayed the course, later learning that there was a field called psycho-oncology. This influenced her to pursue her Ph.D. (at Einstein and Yeshiva University) in health psychology. She returned to Einstein after a postdoctoral fellowship in psycho-oncology at Memorial Sloan-Kettering Cancer Center.

BOLD Party

Becoming BOLD

This knowledge, combined with the limited cancer support resources for people living in the Bronx, inspired her, in 2008, to start BOLD (Bronx Oncology Living Daily), a free program at Montefiore Einstein that offers counseling, education, and support services to Bronx cancer patients. BOLD’s wellness and support services take a holistic approach to meet a patient’s emotional, physical, and spiritual needs. The participants are women and men with all types and stages of cancer as well as their family members. They don’t have to be receiving treatment at Montefiore Einstein – it is available to all Bronx residents who need it.

“The program really developed on its own,” says Dr. Moadel. “The community we serve is culturally diverse and ethnically rich but economically disadvantaged. We assessed what the members of this community living with cancer needed. And what they needed were the same things my mother sought out 40 years ago – mind-body programs like yoga and meditation, nutrition and fitness workshops, and someone to talk to who shared their experiences. This led to the creation of BOLD.”

It started out with pre-med student volunteers from Hunter, Fordham, Columbia, Lehman, and other local colleges. Word got out about the need for those with specialized skills and talents and soon a lot of others wanted to volunteer, including yoga teachers, personal trainers, artists, writers, and Reiki masters – people from all walks of life. To date, there have been approximately 500 volunteers.

From her own experience with her mom and as a psycho-oncologist, Dr. Moadel feels the heart of the program pumps through its Bronx cancer survivors who volunteer as peer counselors known as BOLD Buddies, some in active treatment and some who are long-time survivors, helping patients navigate the many social, physical, and cultural experiences they face. Currently, there are 47 BOLD Buddies.

In addition to BOLD Buddies, there is:

  • BOLD Brothers and Sisters, a peer mentoring program for teens and young adults who have or have had parents or parental figures diagnosed with cancer. In addition to emotional support they receive through their brother/sister mentors, they also receive career and academic guidance.
  • Support Groups (in English and Spanish) that offer a safe place for those interested in sharing their thoughts and feelings, connecting with others, and learning how to cope with day-to-day challenges.
  • Wellness Workshops that provide free nutrition, wellness, and fitness workshops, mind-body programs for patients and caregivers, including yoga, dance, creative arts, meditation, and health education. There are around 10 free workshops per month conducted in person in the Bronx and virtually.
  • Cancer Screening, a program of MECCC BOLD Navigation that offers free assistance in scheduling screenings for breast, cervical, lung, colorectal, and prostate cancers as well as providing follow-up support for understanding screening results.
BOLD Holiday Party

In addition to volunteers, BOLD has a dedicated core staff of 10 that work out of a modest office in Belfer handling the programmatic, scientific, and administrative details on which this program vitally relies to operate. They include Brittany Miller, Ph.D., project director; Johnna Bakalar, M.P.H., project manager; and Sabrina Alvarez, administrative assistant, who have formed the core team with Dr. Moadel for the past three years but extend to several others who bring equal parts compassion, hard work, and dedication to their work every day. In addition, BOLD serves as a formal training and pathway program to pre-med and mental health counseling interns, postdoctoral fellows, as well as a community-based service-learning site for medical students.

BOLD has evolved to include a BOLD Cancer Wellness Center made possible through the vision and support Shalom Kalnicki, M.D., chair of radiation oncology and director of clinical affairs at MECCC, where many of the BOLD events and workshops take place.

Dr. Moadel would love to see BOLD expand further and serve as a model for other institutions to replicate nationwide. In 2019, BOLD was entered into EPIC as part of the cancer care workflow so oncology providers could refer patients for a BOLD Buddy, wellness workshop, or support group through the electronic medical record. Throughout the last four years, referrals increased steadily from, on average, 5 to 60 per month. Program evaluation data reflect a positive impact of this multi-modal cancer wellness program on not only the patients, but the BOLD Buddy volunteers and staff.

A mom’s influence is lifelong, even if you spend the majority of your life without her. BOLD is a wonderful legacy to a mother who died way too young but had a BOLD impact.

Referrals to BOLD can be made from any Montefiore department. For more information, reach out to cancersupport@einsteinmed.edu, (718) 430-2380, or visit the BOLD website.