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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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Move Over, Aches and Pains: 11 Best Yoga Stretches For Easing Tightness, Tension, and Stiffness

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Move Over, Aches and Pains: 11 Best Yoga Stretches For Easing Tightness, Tension, and Stiffness

I’m getting old.

Well, I’m not, not really. But as I creep further into my late twenties, the aches and pains are starting to feel worthy of someone beyond my years. They’ve even become a running dinner table topic amongst my friends. Each of us seems to have acquired a niggle, a dodgy joint or a pulled muscle we can compare over pasta, right alongside our new obsessions with homeware and the unexpected thrill of a good vacuum cleaner.

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Fitness Experts Share Their Number-1 Aerobic Exercise Tip for Longevity

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Fitness Experts Share Their Number-1 Aerobic Exercise Tip for Longevity

As strength-training after the age of 50 has been steadily rising in popularity in recent years, love for traditional cardiovascular or aerobic exercise has been on the decline. Still, making this form of exercise a regular part of your routine is just as important to maintaining your vitality as you age—and following the below aerobic exercise tips for 50 plus can help you get the most out of every session.

According to the Cleveland Clinic, aerobic exercise is any activity that you do continuously that increases your heart rate, such as walking, jogging, cycling, swimming, or dancing. “Regular aerobic activity helps mitigate risks like cardiovascular disease, insulin resistance, and bone density loss by improving heart health, managing body composition, enhancing insulin sensitivity, and reducing systemic inflammation,” said Mark Kovacs, Ph.D., C.S.C.S., a human performance scientist and longevity expert.

These benefits become especially important during and after menopause, when your risk of developing osteoporosis and heart disease go up. “Estrogen helps keep blood vessels flexible and cholesterol levels in check,” explained Brooke Bussard, M.D., a certified personal trainer and owner of Brooke’s Balanced Blueprint, a lifestyle medicine health coaching practice in Baltimore, MD. “When estrogen drops, regular aerobic exercise helps pick up the slack by keeping your circulatory system healthy.”

In fact, adults at 50 with ideal cardiovascular health are expected to live an additional 36.2 years, on average, while adults with poor cardiovascular health were only expected to live an additional 27.3 years, according to a 2023 study in the journal Circulation.

Meet the experts: Mark Kovacs, Ph.D., C.S.C.S., is a human performance scientist and longevity expert. Brooke Bussard, M.D., is a certified personal trainer and owner of Brooke’s Balanced Blueprint, a lifestyle medicine health coaching practice in Baltimore, MD.

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The best part? You don’t need to run marathons or swim hundreds of laps to get the benefits. You don’t need to be an experienced exerciser either. So whether you’re just getting started or looking for ways to mix up your exercise regimen, these expert-backed tips will help you feel better and healthier for years to come.

Just be sure to check with your doctor before starting a new fitness routine, especially if you have high blood pressure or any heart problems, including heart disease. And if you feel off while exercising, get medical help right away.

How to get the most out of aerobic exercise at 50 plus

1. Aim for 150 minutes a week—but break it into small chunks.

    The CDC recommends 150 minutes of moderate-intensity aerobic activity per week. But “this is a minimum recommendation,” said Kovacs: People who worked out two to four times above the moderate physical activity recommendations (about 300 to 599 minutes each week) saw the most benefit in a 2022 study published in Circulation.

    Still, something is better than nothing. “The best plan is the one you can stick with,” said Dr. Bussard, who recommends walking for about 30 minutes five times a week. If three 10-minute dance breaks a day works better for you, that’s cool, too. It all adds up—and workouts of less than 10 minutes still count toward recommended weekly activity goals, according to the CDC.

    2. Use the talk test to measure your intensity.

    Not sure if you’re working hard enough for your activity to count as a workout? Try talking. “For heart-healthy aerobic exercise, you should be slightly breathless but still able to hold a conversation,” said Dr. Bussard.

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    You can also determine intensity using a scale from 1 to 10. “Moderate intensity (like a brisk walk or steady cycling) typically corresponds to a five or six out of 10 on the effort scale,” said Kovacs, “while vigorous aerobic exercise (fast walking uphill or jogging) should feel like a seven to eight out of 10, where talking becomes difficult.”

    3. Don’t count out low-impact activities.

    Cycling, elliptical training, swimming, or walking on an incline are all joint-friendly ways to raise your heart rate. “These options reduce joint stress, which is critical as cartilage, tendons, and ligaments may become less resilient with age,” said Kovacs.

    But “low-impact doesn’t mean low-intensity,” said Dr. Bussard. “You can absolutely work up a sweat and challenge your heart and lungs without pounding your joints.” Just pay attention to the effort you’re exerting in the moment and aim to hit that five out of 10.

    4. Work in short, quick bursts.

    “Adding short bursts of faster-paced intervals to your aerobic routine boosts the benefits,” said Dr. Bussard, as long as you’re cleared by your doctor to work harder. Recent research in the journal Lipids in Health and Disease shows that high-intensity interval training (HIIT) can improve insulin sensitivity, blood pressure, and overall fitness—“all areas that can decline during menopause,” she added.

    This kind of training is considered vigorous activity, so you don’t need as much of it: Just two HIIT sessions per week (with a total training time of 20 minutes per workout) improved working memory and lower-body muscle function more than moderate-intensity continuous cycling, and boosted cardiorespiratory fitness just as much, according to a 2023 study published in The Journals of Gerontology.

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    5. Mix up your workouts.

    Boredom is the enemy of consistency. Try different types of cardio—like hiking, aqua aerobics, Zumba, or even pickleball. “Varying modalities challenges different muscle groups, reduces overuse injury risk, and improves neuromuscular coordination,” said Kovacs. “It also helps sustain motivation and supports functional aging by preparing the body for a wider range of physical challenges.”

    6. Let your body recover.

    As you age, your body may take longer to bounce back. “Recovery between workouts often takes longer due to a combination of physiological changes,” said Kovacs. “These include slower muscle protein synthesis, reduced hormone levels (like estrogen and growth hormone), and less efficient mitochondrial function—all of which contribute to slower tissue repair and reduced energy availability.”

    Make sure to allow 48 to 72 hours of muscle recovery between higher-intensity sessions, and prioritize adequate sleep, sufficient nutrition, and active recovery, like gentle walking or mobility work. And listen to your body; if you feel wiped out for days, scale back and allow more rest between sessions.

    7. Take the time to warm up.

    Older muscles and joints need more prep. “As estrogen drops, tendons and ligaments get stiffer, so warming up is more important than ever to prevent injuries,” said Dr. Bussard. “A good warm-up should move your joints through a full range of motion and activate your major muscles.” Try inchworms, bodyweight squats with overhead reaches, and side-to-side lunges—just five to 10 minutes can prime your body for exercise.

    8. Pair cardio with strength-training.

    Women over 50 benefit most when they combine cardio and strength-training, as both play essential but distinct roles in healthy aging. “Aerobic exercise keeps your heart healthy, but you need strength training to keep your muscles and bones strong,” said Dr. Bussard. Putting them together is the real key. “Combined, they form the foundation of long-term healthspan and mobility,” said Kovacs.

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Runners share their wellness journeys on KSAT Connect ahead of the San Antonio Marathon

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Runners share their wellness journeys on KSAT Connect ahead of the San Antonio Marathon

Full and half-marathons will take place Dec. 7

Runners, joggers and walkers shared their health and fitness experiences on KSAT Connect in anticipation of the San Antonio Marathon weekend. (KSAT Connect)

SAN ANTONIO – Runners, joggers and walkers shared their health and fitness experiences on KSAT Connect in anticipation of the San Antonio Marathon this weekend.

Ahead of the inaugural SATX Marathon on Dec. 7, KSAT invites you to share photos, short videos and personal stories about why you are running, who you’re running for and what the race means to them.

>> What to know about the San Antonio Marathon: Street closures, routes, expo

Check out these photos and videos uploaded to KSAT Connect:

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Raul

Running the SA Rock and Roll Marathon, 2yrs. With my dog Cannoli. We ran 26.2 miles. This year, I will be running solo, 26.2 miles. With my dog Cannoli, running the last 3 miles. Crosssing the finish line together.

Jam1230

–My running journey started many years ago with a prayer for discipline to exercise consistently and from my first run to my current exercise activity I thank God for the ability to do so. As many of my immediate family members battle diabetes, I strive to exercise diligently keeping them in mind and believing for them to remain courageous in their fight. Endurance running has shown me enhanced health, physical growth and increased faith. I’m so glad to participate in the first San Antonio Half Marathon this weekend. Good luck and God bless all participants.

Julian

How to participate:

  • Open the KSAT News app, KSAT Weather app, or visit the KSAT Connect web page. We recommend using the KSAT News app for regular access to KSAT Connect!
  • If you’re on the KSAT News app, click KSAT Connect in the navigation bar at the bottom of your screen. If you’re in the KSAT Weather Authority app, open the navigation bar at the top left of your screen and click KSAT Connect.

  • Sign in or sign up for a FREE KSAT Insider (member) account by clicking the orange button with the text “Log in to Upload a Pin.”

  • Once you’re signed in, you’ll click the orange button that now reads “Upload a Pin.”

  • Click the blue button at the top to choose the photo or video you’d like to share.

  • Select “Outdoors” as the channel and “Activities” as the category.

  • Tell us about your photo or video by including a description.

  • Click the orange button at the bottom to upload.

KSAT may select submissions to feature on air and online. KSAT encourages entrants to respect privacy and only post media they own or have permission to share.

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Share your training, your triumphs and the reasons you run — KSAT wants to tell your story.


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