#099 The Science of Exercise for Cancer | Kerry Courneya, PhD
Mar 3, 2025
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Dr. Kerry Courneya, a Professor and leading figure in exercise oncology, discusses how structured exercise transforms cancer care. He emphasizes that exercise isn't just supportive but a vital therapeutic intervention that can improve survival rates. The conversation covers the importance of pre-diagnosis exercise, the benefits of resistance training, and the concept of 'exercise snacks' to combat sedentarism. Courneya also highlights how physical activity can enhance immune function and mitigate treatment side effects, reshaping cancer treatment strategies.
Exercise is now a fundamental therapeutic intervention in cancer care, reshaping treatment approaches and improving survival outcomes.
Structured exercise mitigates treatment side effects and enhances immune function, proving essential for better recovery during and after cancer treatment.
Regular physical activity significantly lowers cancer risk, with exercise being beneficial even for high-risk individuals, like those who are obese.
Exercise provides vital psychological benefits for cancer patients, helping them cope with stress and improving their overall quality of life.
Deep dives
Exercise as a Therapeutic Intervention
Exercise is now recognized as a critical component of cancer care, shifting from being seen as optional to a fundamental therapeutic intervention. Research shows that structured exercise can recalibrate tumor biology, enhance treatment tolerance, and improve survival outcomes. This intervention includes various forms of exercise such as aerobic, resistance training, and high-intensity interval training, which have been shown to mitigate treatment side effects and enhance immune function. The findings emphasize that exercise is not merely supportive; it is essential for improving patient outcomes in cancer treatment.
Preventive Potential of Exercise
Regular physical activity can significantly lower the risk of developing several cancer types, including colorectal and breast cancer, with evidence suggesting that up to 40% of cancer cases could be preventable through lifestyle changes. Importantly, exercise can reduce cancer risk even in individuals classified as high-risk due to obesity or family history. This provides a strong rationale for integrating physical activity into cancer prevention strategies, emphasizing that it is a powerful intervention accessible to everyone. The protective benefits of exercise extend beyond healthy individuals to those already facing cancer challenges.
Effective Exercise for Treatment and Recovery
The most effective exercise prescriptions during and after cancer treatment involve a combination of aerobic and strength training, with research suggesting that higher intensity exercise provides the greatest benefit. Participants engaging in regular physical activity during treatments experience reduced fatigue, improved sleep quality, and enhanced mental health. Importantly, maintaining muscle mass through resistance training is linked to better recovery and survival outcomes. Therefore, patients are encouraged to develop a tailored exercise routine that suits their physical condition, maximizing the benefits of their treatment.
Psychological Benefits of Exercise
Exercise plays a vital role in managing the psychological effects associated with a cancer diagnosis, including stress, anxiety, and fear of recurrence. Patients report feeling a sense of control over their health when incorporating physical activity into their routine, which enhances their overall well-being. The psychological benefits of exercise often outweigh even the disease-related benefits, significantly improving patients' quality of life during and after treatment. As a coping strategy, engaging in regular exercise can empower individuals to navigate the challenges posed by cancer more effectively.
Challenges in Adoption of Exercise Regimens
Despite evidence supporting the benefits of exercise for cancer patients, many individuals show a decline in physical activity levels during treatment, often due to fatigue and other side effects. Less than 10% of patients adhere to exercise guidelines while undergoing chemotherapy, highlighting the need for structured support systems. Oncology teams can bridge this gap by encouraging patients to engage in physical activity, emphasizing the importance of starting even at low intensity. Establishing community-based exercise programs can create an environment for patients to safely incorporate exercise into their lives, increasing adherence and motivation.
Emerging Research and Future Directions
Ongoing research is investigating the effectiveness of exercise as a monotherapy for early-stage cancers through trials like the PREVENT trial for patients on active surveillance. This exploration seeks to establish whether exercise alone can prevent disease progression, enhance immune function, and ultimately prolong survival. Substantial evidence is emerging that suggests exercise not only supports physical health but may also modulate biological pathways related to cancer. Consequently, the incorporation of exercise into cancer care protocols is likely to continue evolving as evidence mounts.
Comprehensive Cancer Care Approach
Exercise stands out among other supportive care options for cancer patients due to its extensive health benefits, both mental and physical. Many supportive therapies lack evidence for improving survival outcomes, whereas exercise has shown promise in reducing recurrence rates and enhancing overall quality of life. Integrating exercise into standard care practices could significantly shift cancer treatment paradigms, emphasizing that proactive lifestyle choices are essential for patient empowerment. Collaboration among oncologists, exercise specialists, and support staff is crucial in fostering a comprehensive care model that places exercise at the forefront.
For decades, exercise was considered an optional part of cancer care—something beneficial for general health but not essential. The evidence is now overwhelming: exercise is not just supportive—it’s a therapeutic intervention that recalibrates tumor biology, enhances treatment tolerance, and improves survival outcomes. With over 600 peer-reviewed studies, Dr. Kerry Courneya's work has fundamentally reshaped our understanding of how structured exercise—whether aerobic, resistance training, or high-intensity intervals—can mitigate treatment side effects, enhance immune function, and directly influence cancer progression.
Timestamps:
(00:00) Introduction
(04:31) Why exercise should be effortful
(05:17) How to meaningfully reduce risk of cancer
(09:06) What type of exercise is best?
(10:43) How exercise reduces risk—even for smokers and the obese
(13:32) Weekend-only exercise
(16:33) 150 vs. 300 minutes per week (more is better—up to a point)
(18:47) Why pre-diagnosis exercise matters
(21:53) Why resilience to cancer treatment starts with exercise