There was a time when cancer mostly struck people in their sunset years. These days, more people in their 30s and even 20s are getting the Big C, and not even those living healthy lives can be spared from its grip.
In 2022, April Perreras was at her fittest when she received news that would change her life forever: she was diagnosed with stage 2B invasive lobular carcinoma, a form of breast cancer that starts in the breast milk-producing glands or lobules. She was just a few days shy of her 39th birthday. Later on, she would undergo a double mastectomy after doctors told her they could no longer save her right breast.
Thriving and Fighting
Despite the changes in her appearance, April found strength within her to embrace these and to soldier on.
“They’re imperfect, they’re scarred,” she recalls upon seeing her new breasts, which she calls “foobs” (fake boobs). “They have silicone inside, but I’m alive. That’s what I wanted to really put my mindset in, that I am alive and these are my new breasts and these will carry me. This body will carry me throughout survivorship.”
“In terms of self-confidence, I didn’t have much of a problem with that, to be honest, because maybe it’s the acceptance that came before everything happened,” April adds. “I mean, it’s just my breasts that were removed. My face is still the same. I can still do exercise, I can still walk. I’m still the same mom. My daughters are looking at a new body that is actually thriving and fighting.”
Instead of feeling insecure about how she looked, April was even prouder of her battle scars. Following her mastectomy and 22 rounds of radiation therapy, results showed there was no longer evidence of the disease.
“I’m so proud of all these imperfections—ridges, dimples, and tattoos from radiation. I have so many marks. Even the discolorations don’t matter anymore.”
“What [my daughters] see is what the strength in me is reflecting because of how I truly love myself beyond all the physical things.”
Medicinal Movement
With ironclad determination, April vowed to fight cancer with exercise as her weapon. She longed to return to her fitness routine, but it would take time. It was going to be a long and arduous process.
“The good thing about my mentality towards fitness, I didn’t take no for an answer because I know that movement is necessary, no matter what you have gone through, especially the breast surgery,” she says.
More than the physical benefits of movement, April also utilized discipline and exercise as a means to stay positive and motivated. During her recovery period, she would walk at least 5,000 steps around the house. Every day, she would do a range of motions until she felt better and could lift her arms again.
“There are so many times that you can literally just fall into that rabbit hole of depression, anxiety,” she notes. “I used exercise to get me to a calm state, or feel more mindful and [stimulate] happy hormones, endorphins. It really, really helped ease a lot of my anxieties; it kept my energy levels really good and my recovery really, really fast.”
After a few weeks of restricted movement, she slowly started incorporating more variation into her daily workouts. By the end of 2022, April was back to lifting 25-pound dumbbells. In 2023, she devoted her workouts to rebuilding her body. Today, she says she’s even stronger and fitter than she was before she had cancer.
Filling the Gap
As a former ER nurse and an avid fitness enthusiast, April knew how crucial moving was for her recovery. But she also soon realized just how much information was lacking about appropriate exercises for cancer survivors like herself.
“The hard thing is, no one tells you exactly what to do,” she points out. “There’s such a big gap in the healthcare system, and I had to find resources for myself. I had to find supporting evidence of what are the safe movements that I can do as a person who had a mastectomy. I had to find people like me online, meet fellow breast cancer thrivers.”
When a friend in the U.S. posted about reviewing for a cancer specialist program, April was instantly intrigued and learned there was only one certified in the Philippines. With her background as a nurse and as a breast cancer survivor, her friend encouraged her to apply. She had also received so many inquiries about how she had defined her personal fitness program during and after her cancer treatments.
But there was one problem: The live classes were so expensive that April only enrolled in the self-study program. “I just had cancer. I just [spent] like literally almost all our money in our life,” she recalls thinking.
As luck would have it, the Cancer Training Institute opened a scholarship program later that month and April got a full scholarship. She was able to train in the U.S., attend all the live classes for months, and passed the certification in September 2023.
Redefining Patient Care
So, what exactly is a cancer exercise specialist, and what do they do?
“It’s a very meticulous specialization that is for cancer patients in all aspects of their journey, from diagnosis all the way to survivorship,” April explains. “We are the ones who help create targeted and personalized exercise programs that are suited to whatever they have been through because of their cancer journey.”
April’s work as a cancer exercise specialist involves helping breast cancer patients regain their strength and range of motion. This can be through easing patients who were once active back into exercise, aiding them during chemo, or prepping them for surgery. She also helps rehabilitate her clients dealing with the side effects of treatments such as the usual cancer-related fatigue, breast cancer-related lymphedema, and joint pains, among other problems.
In her line of work, April notes how so many people have fear-related issues when it comes to exercise. Many worry that movement might hurt or that their lymph nodes might get inflamed if they lift weights.
“They’re very, very scared to exercise just because they had surgery, because they’re in pain, definitely,” she shares. “It’s really more of a lack of awareness that there are safe movements that are actually recommended for every stage of your cancer journey.”
As a breast cancer survivor herself, April is familiar with the side effects of chemo and how exercise is an excellent way to counter cancer-related fatigue or chemotherapy-induced fatigue.
“Exercise is actually now treated as important as prescribed, meaning it is now prescribed to be part of the patient care for cancer,” she emphasizes.
A Golden Opportunity
Another life-changing opportunity would present itself when the Vodder School of Lymphatics brought lymphedema care to the Philippines in February 2025. Knowing the debilitating effects of breast cancer lymphedema (or chronic swelling—usually in the arm, breast, or trunk—caused by the buildup of lymph fluid), April trained to become a lymphedema therapist as it would work hand-in-hand with her work as a cancer exercise specialist. At the moment, there are fewer than a hundred lymphedema therapists in the Philippines.
Breast cancer patients typically undergo lymph node removal, which compromises lymph fluid flow. But lymphedema can happen to anyone, not just to people with breast cancer, April clarifies.
“The lymphatic system is in charge of so many things. They help the body clear out toxins, waste products, and support our immune function,” she explains. “And when your lymphatic system is removed or damaged, parts of the lymphatic flow will be affected.”
“When the capacity of your lymphatic system can no longer handle the amount of lymph fluid in your body, then it overflows,” says April. Simply put, when the body can no longer properly drain lymph fluid, it manifests as edema. “The body swells up because it can no longer drain. We will always keep producing lymph, like around two to three liters of lymph per day.”
As a lymphedema therapist, April performs complete decongestive therapy, or CDT, which has four pillars. One is manual lymphatic drainage, where she redirects lymph fluid to the body’s healthier side for drainage at the proper lymphatic channels. Another is bandaging techniques, which help contain the lymph fluid and manage the edema. The third pillar involves teaching exercises, which April is already certified for, and lastly, providing patient education on self-care, skincare, and what to watch out for.
Pausing and Positivity
April’s story as a breast cancer survivor shines a spotlight on the restorative and transformative power of movement and exercise, as well as on self-care.
“For me, self-care is really prioritizing what is good for my body, what is good for my mental health,” she shares. “Also, saying yes to things that would not just bring me joy, but would also be good for me. So, I stopped saying yes to all.”
Exercise is a non-negotiable for April, and so is me-time. It could be as simple as savoring a cup of coffee in a café, working on exercise programs for her patients, taking quiet walks, going out with friends, practicing skincare, or spending time to make herself feel beautiful. “No matter what you’ve been through, what was removed, how different you look, when you feel good, it radiates,” she shares.
She also stopped worrying about the future and strives to find a silver lining in everything—her secrets to staying motivated.
“Pay attention to the little things,” she advises. “Even if it’s just a tiny positive thing—that’s what you focus your energy on.” As for those dealing with their own battles? “Please do not ever think that you can’t do this,” she says, explaining that once your mind thinks you can’t fight it, it’s really going to be hard.
“You are not too young or too healthy for cancer. So prepare your body and treat your body so well so that whatever comes your way, you are ready—your body is ready to fight.”
—April Perreras, cancer exercise specialist
Beauty in Purpose
If there’s anything that April wants people to take away from her story, it’s that cancer does not discriminate—which means everyone should really take care of their bodies. More importantly, April’s daughters now know the importance of good health so that they will not live in fear.
“You are not too young or too healthy for cancer,” she cautions. “So prepare your body and treat your body so well so that whatever comes your way, you are ready—your body is ready to fight.”
Cancer may change how a person looks, but April believes that true beauty comes from contributing to the community and becoming a better person.“I focused on my strengths and made my experience purposeful,” shares April. “Now, I’m helping the cancer community see that there can be life after cancer; that there can be strength after cancer. And despite everything—even after every scar—you can still live a beautiful life.”
Everyday Rituals for Long-Term Health
April shares small, daily choices that support longevity and overall well-being.
Keep your blood moving.
The American Cancer Society recommends 150 minutes of exercise in a week, which can be broken down into three days of strength training in a week or 75 minutes of rigorous activities. “Make it really simple: do something that will help your blood circulate every day. If you like to do the 10,000 steps, go for it! If you can’t do 10, 000 steps, that’s totally fine. You can dance, you can walk around, you can climb up a flight of stairs, and go back and forth.”
Build muscle.
“Muscle is now treated as one of the organs of longevity,” she explains. “It’s one of the biggest endocrine organs in our body, and it has so many functions and so many ways to fight not just disease, but also cancer recurrence. It can directly tell you your prognosis if you’re going to be living long or not by just the amount of muscle that you have in your body.” This is especially crucial for women, especially those going through perimenopause or menopause.
Choose clean brands.
April’s entire beauty routine has changed since having cancer—shifting to products free of SLS, sulfates, and parabens. She currently loves Pure Culture’s serums and bar soap, Pro Age Beauty’s facial wash and moisturizer, Pili Ani’s Ageless Concentrate, and Anessa’s sunscreen. Meanwhile, she opts for Davines hair coloring products, which are free of ammonia and bleach.
Use plant-based products.
April is currently obsessed with sea moss, which supports gut health and promotes clear skin. She also takes Manuka honey for its antibacterial, antiviral, anti-inflammatory, and antioxidant benefits. For muscle building, she takes creatine supplements and plant-based protein powders.
PHOTOGRAPH COURTESY OF APRIL PERRERAS/BY AVRAIN.
