Fitness
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
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.
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.
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.
Fitness
Fitness coach debunks 8 ‘crazy’ exercise myths women still believe: From periods and workouts to weightlifting
Despite growing awareness around fitness and women’s health, several outdated exercise myths continue to persist. From misconceptions about strength training to beliefs surrounding periods, pregnancy and weight loss, many women still receive advice that isn’t backed by science. These myths can not only slow progress but also discourage women from prioritising their health and fitness. (Also read: Can eating too much protein be harmful? Experts explain why excess intake may do more harm than good )
Fitness coach Zoe recently addressed some of the most common misconceptions women continue to hear in a June 12 Instagram post titled, “craziest exercise myths women still hear.” Here’s what she had to say:
1. Periods mean complete bed rest
According to Zoe, menstruation does not mean you need to stop exercising altogether. “No. You can train. Just adjust intensity if needed,” she wrote, explaining that while energy levels may fluctuate during different phases of the menstrual cycle, movement and exercise can still be beneficial.
2. After marriage or kids, fitness is not important
Many women are often made to feel that fitness should take a back seat after major life changes such as marriage or motherhood. Zoe strongly disagrees. “That is exactly when it becomes more important,” she said, highlighting the need to maintain strength, mobility and overall health while navigating increased responsibilities.
3. A C-section means your core is gone forever
Recovering from a Caesarean delivery can be challenging, but Zoe says it doesn’t mean women should give up on rebuilding strength. “Wrong. It means you need rebuilding, not giving up,” she wrote, emphasising that gradual rehabilitation and proper training can help restore core function.
4. Walking around the house is enough exercise
While daily movement is important, Zoe points out that it isn’t the same as a structured workout. “No. That is movement, not full training,” she explained, noting that a balanced fitness routine should include strength, mobility and cardiovascular exercises.
5. Sweating more means more fat loss
Many people associate excessive sweating with effective fat burning, but Zoe says that’s a common misunderstanding. “No. It means you are hot,” she wrote. Sweat is the body’s cooling mechanism and does not necessarily reflect the number of calories burned or fat lost.
6. Running will ruin your uterus, boobs or joints
This long-standing myth often discourages women from running or high-impact activities. “No. Poor preparation and weak support is the issue,” Zoe said, stressing the importance of proper training, supportive gear and gradually building endurance.
7. Women should only do yoga, not weights
Strength training is still viewed by some as a male-dominated form of exercise, but Zoe believes women benefit greatly from lifting weights. “Women need strength too,” she wrote, highlighting how resistance training supports muscle mass, bone health, metabolism and overall fitness.
8. Carbs at night make you fat
Carbohydrates often get unfairly blamed for weight gain, especially when eaten in the evening. “No. Overeating does,” Zoe explained, pointing out that overall calorie intake and dietary patterns matter far more than the timing of carbohydrate consumption.
Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.
This report is based on user-generated content from social media. HT.com has not independently verified the claims and does not endorse them.
For Hobart teacher Mary Holton, health means everything.
She started feeling the squeeze from cost-of-living pressures when fuel prices spiked again.
“Going out for just fitness alone was a bit much,”
she said.
Mary Holton says since joining the group, her fitness across the board has improved. (ABC News: Jake Grant)
Many Tasmanians are feeling cost-of-living pressures in a very physical way, with locals saying exercise routines are being dropped, health appointments delayed and wellbeing pushed to the bottom of the list as budgets tighten.
Ms Holton relies on multiple physiotherapy sessions each week, but says paid fitness classes simply are not an option.
“That costs … so to actually go to other classes as well, it’s out of my budget really.“
Ollie Mathewson conducts a free workout session. (ABC News: Jake Grant)
National data shows that almost half of Australians already fall short of minimum physical activity guidelines, and rising prices are making even basic care unaffordable for many.
Consultant clinical psychologist academic Kimberley Norris says this is exactly how unhealthy patterns begin.
“We tend to focus on the most stressful thing first … and health is one of those things we don’t think about until things go wrong,”
Professor Norris said.
Kimberley Norris says humans tend to focus on alleviating stress first and foremost, and warns de-prioritising health can become a cycle. (ABC News: Jake Grant)
For Ms Holton, going to a free workout group in her local community was a game-changer.
“Came down and absolutely loved it. It’s really nice to have a group and it just keeps growing,” she said.
Finding a free exercise group has drastically improved her health, as noted by her GP, and she is part of a growing trend.
Free exercise classes become a lifeline
At a community exercise class in South Arm, south-east of Hobart, the mood is upbeat, with laughter, movement, and a sense of relief.
Participation has more than doubled in the past year, with more than 100 Tasmanians now involved.
Trainer Ollie Mathewson said the surge was unmistakable.
“It’s free of charge for everybody … and over the last 12 months I’ve noticed a lot more people starting to come along,”
he said.
Ollie Mathewson says attendance at his classes has almost doubled over the past year. (ABC News: Jake Grant)
Across greater Hobart, free and low-cost alternatives are multiplying and include walking groups, community-run circuits, and morning and afternoon fitness meet-ups.
Tasmanians are increasingly organising their own solutions.
Mr Mathewson said connections drive outcomes.
“A lot of people talk about weight and strength, which are obviously insanely important, having other people there to push you single every week makes it a hundred times easier.“
Professor Norris said one’s health can be prioritised for free.
“What we know about health is, it’s more about sustainable wellbeing, it’s about quality of life,” she said.
“So rather than focusing on how much you can deadlift, how far you can run, it’s about how your life has improved and how close your life is to the way you want to live it.”
She said free options were vital because once people stop moving, it becomes harder to start again.
“If we develop routines in which health is not a priority, then we almost get stuck in this cycle of health always being last.“
Health appointments being delayed or dropped
For some Tasmanians, the financial pressure is forcing even tougher choices.
Amy Dakin says she can’t even think about getting a gym membership with all the other costs of living on her mind. (ABC News: Jake Grant)
Amy Dakin, who lives with a compromised immune system, often has no choice but to delay essential care.
“My health needs to be prioritised, but your bills come first, really,” she said.
Jordyn Rowbottom says she’s not the only one changing her hobbies to save on costs. (ABC News: Jake Grant)
Jordyn Rowbottom has seen the same pattern around her.
“People are being forced to cut what they can access,”
she said.
Professor Norris warns that these short-term decisions can create long-term harm, not just for individuals, but for the broader health system.
She said the combination of financial pressure and reduced physical activity would create a public health challenge.
Trainers adapting to shrinking budgets
Personal trainer Nickola Orr works with clients across different income levels, ages and needs.
She said affordability now shapes almost every program she designs.
“You want to make sure they can get as much help as they can within their price range,”
she said.
Nickola Orr is concerned about access to fitness and health services in the face of rising cost pressures. (ABC News: Jake Grant)
With the median individual spend on fitness in Tasmania sitting at almost $600 last year, Ms Orr said the warning signs were already visible.
“We’re going to see more results of long-term neglect; higher injuries, more need for mental health assistance. It’s going to snowball.”
Her concerns echo Professor Norris’s academic findings that once healthy routines break down, the consequences ripple for years.
“The changes are very small … while they add up over time, there is no immediate impact,”
Ms Orr said.
Calls for more free and low-cost options
Mr Mathewson hopes the success of free community classes will inspire governments and private operators to expand accessible fitness programs.
“More free options would be a great thing. There are a few now, but there should be more,” he said.
The Tasmanian government has said it will release its 20-year preventive health strategy this month, titled The Health Revolution.
A Department of Health spokesperson said the strategy “will address the broader social, economic, and environmental factors that influence health and wellbeing”.
“Specific issues about access to health services and programs are being considered through the Access to Health Services project, a Commonwealth-State partnership.
“The Health Revolution will complement that project by addressing the root causes of poor health and the underlying conditions to make it easier for Tasmanians to live well.“
If you’ve been faithfully logging your 30 minutes of moderate exercise most days of the week, you’re getting the recommended weekly about of cardio. But a new study1 suggests that for women in midlife, that standard benchmark may not be moving the needle on cardiovascular fitness as much as we’ve assumed. Here’s what you need to know.
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