Hey Everyone,
So by now I think everyone is aware that we are creating a huge cancer wellness programme and we are 90% there.
Over the next 2 emails, I’m going to include the evidence for exercise whilst undergoing treatment and how it can help.
1) What the guidelines say
- International roundtable guidance (ACSM) concludes exercise training is generally safe during and after cancer therapy and recommends structured aerobic and resistance exercise to improve fatigue, mood, physical function and quality of life. Typical prescriptions: moderate-intensity aerobic exercise 3x/week (≥30 min) plus resistance training 2x/week. PMC
- UK guidance similarly advises people with cancer to be active during treatment, aiming for 150–300 minutes/week of moderate activity (as tolerable), personalised to diagnosis and side-effects. Cancer Research UK
Clinical takeaway: For most patients, tailored exercise during treatment is beneficial and encouraged; discuss specifics with the oncology team, especially if you have bone metastases, severe anaemia, infection/fever, or post-operative restrictions. PMC Cancer Research UK
2) Evidence that exercise can support treatment efficacy
2.1 Drug delivery & tumour microenvironment (mechanisms)
- Vascular normalisation & perfusion: In mouse models, adding moderate aerobic exercise to chemotherapy reduced tumour growth more than chemotherapy alone by normalising tumour vessels and improving drug delivery. Systematic reviews synthesise that aerobic exercise can increase tumour blood flow and reduce hypoxia, theoretically boosting treatment sensitivity. PMC+2PMC+2PubMed
- Immune mobilisation: Exercise acutely mobilises NK cells and cytotoxic T cells (seen in cancer patients), and in preclinical models this is epinephrine/IL-6 dependent and slows tumour growth. PMC Cell
What this means: These biologic changes (better perfusion, less hypoxia, more effector immune cells) are plausible pathways by which exercise can sensitise tumours to systemic therapies.
2.2 Human clinical endpoints
- Chemotherapy delivery (dose intensity/completion):
- A 2024/2025 secondary analysis (phase 2, n=144) found exercise therapy was associated with higher 100% relative dose intensity overall and significantly higher 100% RDI in those receiving anthracyclines. PubMed
- The PACES randomised clinical trial (JCO 2015) reported that moderate- to high-intensity supervised exercise during adjuvant chemo improved fitness, reduced fatigue, and reduced dose adjustments compared with usual care or low-intensity home activity. PubMed ASCO Publications
- A systematic review concluded exercise does not impede chemo delivery and may improve completion or RDI in some trials (mixed results across studies). PubMed
- Tumour response: In the randomised LEANer trial (JCO 2023), a home-based exercise plus nutrition intervention did not change RDI, but among patients receiving neoadjuvant therapy, PCr was higher with the intervention (53% vs 28%). The ASCO Post
Bottom line: Human data increasingly suggest exercise can help patients stay on treatment and, in some settings, may be associated with better tumour response—though effects vary by regimen/subtype and more definitive trials are underway.
All of the research and guidance point towards exercise being a truly powerful ally on the cancer journey, not to mention being able to help prevent recurrence by up to 33%.
Join me for part 2 next week!
Until next time stay awesome!
Vanessa x
