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What an Oncology APP Should Know About Exercise in Cancer Care | Oncology Nursing News

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What an Oncology APP Should Know About Exercise in Cancer Care | Oncology Nursing News

Oncology advanced practice providers (APPs) should be aware of the transformative potential of exercise in cancer care and how to get patients started with a feasible exercise plan, said Daniel Glidden, MS, PA-C.

Ahead of his presentation at JADPRO Live 2025 on evidence-based diet and exercise tactics for patients with cancer, Glidden spoke with Oncology Nursing News about the key evidence APPs should be aware of, as well as actionable changes that can be made to incorporate exercise in patients’ care plans.

What data supports exercise as an essential part of cancer care?

For the longest time, we’ve had observational data that associates exercise and proper nutrition with improved survival, but it’s always been observational data. Now we have the first randomized, controlled trial—the phase 3 CHALLENGE trial (NCT00819208)—that shows us the true overall survival and disease-free survival benefit of a structured exercise program after adjuvant chemotherapy for colorectal cancer.

This was a phase 3 randomized controlled trial that randomized patients into either receiving health education materials alone or receiving health education materials plus a structured exercise program where they would go in for a supervised exercise and also have either in-person or virtual visits to talk about behavioral change to increase their exercise. What they found, of course, was that people in that exercise group had increased physical fitness in terms of their VO2 max and their 6-minute walk test and so on, but also that their disease-free survival was significantly improved. Around the 8-year mark, there was a [7%] improvement in disease-free survival in the patients in the intervention group. There was also an overall survival benefit.

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Do the CHALLENGE data set a standard for all types of cancer care?

This is the first randomized control trial to show the true survival benefit that exercise can confer, at least in this patient population. We can’t extrapolate those data to all different cancers, but we have some good observational data that tells us that that there’s improved survival in many different cancers with exercise. As more of these studies come out, we’ll see more that exercise truly can be helpful for survival in cancer.

What level of exercise should patients with cancer be told to follow?

The general guidelines for people with cancer to start seeing health benefits from exercise are to get between 150 and 300 minutes of moderate-intensity aerobic exercise per week. Moderate-intensity aerobic exercise is a brisk walk where, if you’re walking with a friend, you can have a good conversation with them, but if you tried to sing a song, you’d get out of breath. That’s a good “talk test” for moderate intensity exercise. We recommend that [routine], plus 2 to 3 days per week, getting resistance training of the major muscle groups for about a half hour at a time.

How can exercise plans be personalized for each patient?

The first step is finding out what people are doing. Are they exercising regularly? Are they exercising somewhat or completely sedentary? If they’re completely sedentary, I wouldn’t tell them to just go right off and exercise to those guidelines. We would want to start off slow and do a stepwise approach. …For many of our patients, cancer is not their only chronic condition, and there may be other safety issues like their neuropathy or bone [metastases] or poor bone health in general that we must take into consideration when we’re creating an exercise prescription.

What should all oncology APPs know about exercise in cancer care?

Exercise counseling is something that [oncology APPs] can integrate into their clinical visits. I want them to know that the true benefit of exercise is not just something that we can do, it’s something that we should be doing, all of us. If exercise was a medicine in a pill form, it would be something that we would all be lining up around the corner at our doctor’s offices to get a prescription for. Really, exercise truly is medicine.

What is integrative oncology, and what made you choose this field?

Integrative oncology is a patient-centered approach to cancer care that looks at the whole patient and combines their conventional cancer care with other treatment modalities like exercise; nutrition; stress management; and mind-body therapies like yoga, tai chi, and meditation to take care of the whole person.

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I started off my career working first in emergency medicine, then in medical oncology. While I was working in medical oncology, I saw that we were doing a great job treating the cancer. We were winning the battle more and more, but there’s still a person there who needs to be taken care of, and that person was undoubtedly cared for by their cancer team. But there is certainly more that can be done.

I made the transition into integrative oncology at Dana-Farber so I could spend my entire clinical practice emphasizing and optimizing health, wellness, and quality of life. I will see people for consults and people come to me for different reasons. Sometimes it’s for treatment-related adverse effects. In those cases, we talk about how can acupuncture be helpful? For hot flashes, joint pains, or neuropathy, how can exercise, proper nutrition, and stress management be helpful?

This transcript has been edited for clarity and conciseness.

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Fitness

Jennifer Aniston “doesn’t always want to work out” but her fitness app’s new four-week mindset and movement challenge makes exercise fun not punishing

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Jennifer Aniston “doesn’t always want to work out” but her fitness app’s new four-week mindset and movement challenge makes exercise fun not punishing

Actress Jennifer Aniston has launched a new four-week challenge with fitness app Pvolve to help people get into the right mindset to exercise.

The Worth It Everytime campaign, created in collaboration with mental wellness app Headspace, encourages people to view exercise as something that energizes them rather than punishes them.

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A trainer says returning to exercise in your 40s and 50s should look different to what you did in your 20s—here’s how to get started again

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A trainer says returning to exercise in your 40s and 50s should look different to what you did in your 20s—here’s how to get started again

After a period of inactivity, getting your fitness back can feel like a tough slog.

Jason Smith, a personal trainer, nutritional advisor and founder of Fit in Midlife, knows this from personal experience. He got fit again at 50 after years of inactivity, then started training people of a similar age, helping them to do the same.

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Enter 2026 stronger than ever with these expert-approved fitness tips

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Enter 2026 stronger than ever with these expert-approved fitness tips
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Whether you’re focused on building muscle, improving your balance or working on your ability to complete longer, sustained workouts, one thing’s for sure: you’ll need to take small, actionable steps to reach your fitness goals.

Remember, you don’t need to drastically overhaul your life on January 1. In fact, before making any major changes to your dietary pattern and exercise routine, it’s best to have a conversation with your doctor first, especially if you live with any chronic conditions. In the long run, you’ll most benefit from taking small, actionable steps to help achieve your fitness and nutrition goals, the experts say.

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We asked fitness experts to break down their top tips to help you kick off 2026 stronger than ever.

How to fit exercise into a busy schedule

If you’re hitting the reset button on your fitness routine, start small and choose an exercise you enjoy, says Dr. Kimberly Burbank, a primary care sports medicine fellow and team physician at UCLA Athletics. You don’t necessarily need to do the movements traditionally associated with exercise to get a good workout in, either. “I really encourage people to choose (a movement) they actually enjoy doing, because they will probably stick with it more,” she says.

To help set attainable fitness goals, one route is to use the SMART framework of goal setting, recommends Dr. Brandee L. Waite, a professor and vice chair of Wellness & Community Engagement Department of Physical Medicine & Rehabilitation at UC Davis School of Medicine, the medical director of the UC Davis Health Sports Medicine Clinic and the director of Lifestyle & Longevity Medicine Innovation.

The SMART acronym stands for goals that are specific, measurable, attainable, realistic and time bound, and what’s great about using this framework in an exercise context is that you’re able to approach fitness as you would any other appointment — if it’s scheduled on your calendar, there’s a greater likelihood you’ll honor it, Waite says.

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When it comes to fitting exercise into a busy schedule, “I try to encourage consistency over perfection,” Burbank says. Often, her patients will express frustration that they’ve missed a week of exercise — and therefore their entire workout schedule has been thrown off. While it’s important to “be as consistent as you can, (understand) that you don’t have to be perfect to still make a meaningful difference,” she says.

If you’re someone who prefers to exercise in the morning, try to make it easy for yourself when you wake up. “It’s so easy when that alarm goes off to just ignore it and move on. But if you have laid out your clothes the night before, have your coffee prepped (and) have your bag packed, then there’s so many (fewer) variables and barriers,” Burbank says.

How often should you exercise?

There’s no perfect cadence as to how often you should exercise. “What works really well for one person, will not work at all for another person. So, it does need to be personalized and realistic,” says Waite. However, there is something to be said about shorter, more frequent workouts. There’s a lower risk of injury, and they’re faster to complete and generally easier to stay consistent with, Burbank says.

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Ultimately, what’s most important is to meet a certain number of goal minutes every week, says Dr. Julia L. Iafrate, a sports medicine physician at NYU Langone Health and a team physician for the U.S. Ski Team. The Physical Activity Guidelines for Americans and the American College of Sports Medicine recommend adults participate in 150-to-300 minutes of moderate-intensity exercise a week. While this might sound intimidating, that breaks down to only 30 minutes of exercise a day over the course of five days, and could consist of a mix of pilates, yoga or brisk walking.

If you prefer vigorous-intensity aerobic exercises (like HIIT or running), it’s recommended you complete at least 75 minutes a week, which evens out to a little more than 20 minutes of exercise a day over the course of three days. On top of these exercises, the organizations suggest adults should partake in muscle-strengthening workouts at least two days a week.

What are the most beginner-friendly exercises?

There are a few forms of exercise that should be a central focus of your workouts: cardio, muscle strengthening and balance work. Practicing each type of exercise can help improve your ability to do the others and also reduce your risk of injury, Iafrate says.

  • Cardio. Incorporating aerobic exercises that get your heart rate up (such as running, swimming or cycling) is key to improving endurance, supports heart and lung health, and lowers your risk for a number of chronic diseases, Iafrate says. 
  • Muscle strengthening. Resistance training with weights stimulates two types of muscle contractions: eccentric loading and concentric loading. When you perform a bicep curl with a dumbbell in hand, that’s considered a concentric motion. As you lower the dumbbell and your arm straightens, that is an eccentric motion, Iafrate says. Both movements are important for strength building, tendon health and bone mineral density, she explains. 
  • Balance work. Functional movement training, including tai chi and yoga, is especially beneficial for maintaining flexibility, stabilizing your body and limiting the likelihood of falls down the line, Iafrate says. 
  • Weight-bearing exercise. “Walking, especially for beginners, is super underrated,” Burbank says. Getting your step count up to 7,000 steps a day offers immense benefits for health, including lowering your risk for cardiovascular diseases and type 2 diabetes, according to a 2025 study published in Lancet Public Health.

If you’re relatively new to exercise and don’t know what is helpful or harmful, Waite recommends having at least two-to-three sessions with a physical therapist to develop the right type of exercise program. For instance, if someone has a medical condition like hip arthritis, a professional can provide “modifications for a regular fitness training program that won’t further exacerbate the problem that is currently bothering them,” Waite says.

How can nutrition support fitness goals? 

“Nutrition and exercise have such a symbiotic relationship,” Burbank says. Throughout your week, prioritize whole, fiber-rich foods, including fruits, vegetables and whole grains. Americans aren’t consuming nearly enough protein, which is essential to muscle building, muscle recovery and satiety, Burbank notes. Your minimum daily intake of protein should hover between 0.8 grams to 1.2 grams of protein per kilogram of body weight. To increase your protein intake, the Dietary Guidelines for Americans 2020-2025 recommends incorporating more lean meats, poultry, eggs, seafood, legumes, nuts, seeds and soy into your diet.

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Hydration is particularly important, especially prior to working out. “When you’re dehydrated, (it will) increase your likelihood for fatigue and poor peak performance,” Iafrate says. Ideally, we should be drinking between 2.5 to 3 liters of water a day, Burbank says. 

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