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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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Reward yourself by exercising regularly at One to One Fitness | CWRU Newsroom | Case Western Reserve University

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Reward yourself by exercising regularly at One to One Fitness | CWRU Newsroom | Case Western Reserve University

Now is the time to recommit to your health in time to feel your best for all your summer activities! One to One Fitness Center offers several ways to save in March.

Members of the Case Western Reserve University community can take advantage of sign-up specials designed to reward themselves for creating healthy habits.

Individuals can get 50% off the initiation fee (regularly $50 plus tax) and earn back what they do pay by exercising eight or more days in both April and May. Learn more online about this deal on initiation fees.

Students also can get additional savings:

  • Graduate students who are enrolled for the spring semester receive summer membership free.
  • With Spartan Shape Up memberships, affiliate students pay just $40 per month for membership from now through May, and no initiation fee or security deposit is required.
  • Students also can pay $44 plus tax per month with a month-to-month, ongoing plan. No initiation fee or security deposit required.

One to One Fitness Center, owned and operated by CWRU, is known for offering personal, professional, friendly and clean services. Memberships include full access to the 28,000-square-foot fitness center, group exercise classes, validated parking in Lot 53, towel and locker service, and member discounts on programs and services.

Members also can add their spouse or partner to their account for $30 plus tax per month. The center also offers personal training, Pilates Reformer, massage therapy and sound bath therapy, swim lessons, and more.

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Visit the One to One Fitness Center website, email onetoone@case.edu or call 216.368.1121 for more information.

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A 3-Step Plan to Give Your Diet, Fitness Routine and Mindset a Reset for Spring

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A 3-Step Plan to Give Your Diet, Fitness Routine and Mindset a Reset for Spring

To help you do this, we’ve tapped our Start TODAY experts for simple tips to lighten up meals, move in ways that boost metabolism and and refocus our mindset to get motivated to keep working toward your goals. Apply their strategies and finish the month feeling lighter, more energized and motivated to move forward. Here’s the plan to make it happen:

>>Download the 31-day calendar here

31-Day HIIT & Walking Challenge

This month’s workout plan is focused on short workouts that pack a punch. “HIIT workouts give you a bigger bang for your workout buck! They provide a more efficient workout because you’re alternating the pace and intensity rather than sticking to a steady, moderate pace,” says Mansour. “Changing things up with HIIT prevents boredom and keeps your muscles guessing. This is how we can get the body to change — whether that change is speeding up your metabolism, burning more calories, building muscle, losing weight, or just improving overall health — keeping your body guessing is the magic ticket to seeing results!”

Active recovery days include stretching to improve flexibility and walking for a cardiovascular workout that aids muscle recovery. When weather permits, Mansour encourages people to get outside on walking days. “Walking outdoors isn’t just a workout, it’s a chance to breathe in fresh air and get out of the house to change your environment,” she says. “Each time you go outside on a walk, even if you go on the same path, you’ll see or feel something different. Maybe it’s a change in weather, plants or flowers, people or things. Prioritizing taking your walk outside can hugely benefit your mental health. Getting out of your regular environment and into nature can be a form of meditation, too.”

Get the full 31-day workout plan with unique workouts sent to you daily — plus, walking podcasts, healthy spring recipes and mindfulness tools — in the Start TODAY app!

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Start TODAY Spring Asparagus Pasta recipe
Lighten up comfort food favorites by adding seasonal ingredients, like in this Spring Asparagus Pasta.

3 Simple Spring Diet Tips

In addition to mixing up your workout routine, use spring as an opportunity to start lightening up your meals by packing them with seasonal ingredients. Start TODAY dietitian Natalie Rizzo shares her top tips:

  1. Incorporate more seasonal foods. After a long winter of eating the same foods, your palate is ready for a change! Aim to add at least one spring fruit or vegetable to your meals each day, like asparagus, peas, spinach, radishes, citrus or strawberries. This Spring Asparagus Pasta is a simple weeknight dinner that feels both light and comforting. Seasonal produce is fresher, more flavorful, and an easy way to naturally boost vitamins and fiber. Plus, seasonal produce is more affordable than other items in the produce section.
  2. Use fresh herbs to brighten up your dishes. Fresh herbs like basil, cilantro, parsley, mint, or dill can instantly upgrade simple meals without extra salt or heavy sauces. Sprinkle them on salads, roasted veggies, eggs, soups, or grain bowls for a burst of spring flavor. Cilantro is the perfect finish to this Mexican Stuffed Sweet Potato, while herbs are blended into cottage cheese in this Herby Cottage Cheese Toast with Tomato recipe for a pop of fresh flavor.
  3. Shift from heavy comfort meals to balanced plates. As the weather warms up, it’s time to move away from heavy comfort foods and embrace lightened up spring dishes. Build plates with a mix of lean protein, whole grains or starchy veggies, and plenty of colorful produce. Think roasted veggie grain bowls, hearty salads like this BBQ Chicken Quinoa Salad, or simple stir-fries instead of creamy casseroles or heavy stews.
Start TODAY Mexican Stuffed Sweet Potato
A sprinkle of fresh cilantro is the perfect finish to this Mexican Stuffed Sweet Potato.

Spring Clean Your Mindset with This Mental Health Exercise

Yes, we are working to propel ourselves forward toward our health goals, but an important part of that process is slowing down and reflecting.

Getting permission not to rush in a world that feels like it’s moving faster than we can keep up is a reminder that most of us need.

Yasmine Cheyenne, start TODAY mindfulness expert

“Getting permission not to rush in a world that feels like it’s moving faster than we can keep up is a reminder that most of us need, but how often would we admit that?” says Cheyenne. “ When the to-do list feels long, and we’re trying to get everything done, we often say the opposite, disregarding how we feel, and push ourselves. Yes, we all have deadlines and things that need to be done. But we also need the reminder to take care while handling our responsibilities.”

This can be easier said than done. So Cheyenne offers up a simple exercise to help: Write down the words you need to hear each day to make yourself a priority and work toward your goals. Put them somewhere you see often, like your fridge or bathroom mirror, and recite them out loud daily.

“This is a perfect example of a reminder that seems small, but can come at the perfect time and help us care for ourselves,” she explains. “One of my favorite examples is: Take it slow and don’t rush, your nervous system deserves peace.”

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“When you tell yourself the thing you’ve been needing to hear, it allows you to admit the quiet rumbling within you and take the steps you need. It might be admitting ‘I’m tired and will give myself an early night this week.’ Or you’re saying ‘I’m so proud of the way I’ve committed to moving my body everyday.’ Whether you’re cheering yourself on or reminding yourself of what you need, we don’t always slow down enough to hear what we need from ourselves, and this practice is a great way to start.”

Talking out loud to yourself may feel strange at first, but Cheyenne says over time it will help shift your mindset and translate those words into action. “When we hear ourselves recite these words, it’s like we’re planting positive seeds within us. The more we say what we need, the more we remember it, and we’re more likely to follow through and care for ourselves,” she says. “Our actions really start with the words we say to ourselves. Reading them out loud helps us rewire the way we talk to ourselves and that inner shift is exactly what opens the door to transformation.”

Join our live “Spring Reset Workshop” on March 22 to get one-on-one coaching from Yasmine Cheyenne and connect with other Start TODAY members. Sign up here!

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Exercise scientist says ‘eating more’ is key to losing weight in perimenopause – here’s why

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Exercise scientist says ‘eating more’ is key to losing weight in perimenopause – here’s why

If you’ve ever wanted to lose weight, you’ve probably heard the phrase ‘calories in versus calories out’. While it’s true to a degree, losing weight in menopause isn’t about eating less, but rather eating differently.

Speaking to fitness coach Loretta Hogg, Dr Stacy Sims says: “One of the first things that women often do, because we grew up in an era of calories in, calories out, less calories means fat loss. That is not true because if you are not eating enough, your body holds on to fat.”

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