We Know It Helps. Why Aren't More People Hearing About It?

I work in this field, but if I hadn't happened to read these articles recently, I wouldn't know about it, either.

Back in April, I wrote about why exercise is one of the most powerful tools we have to fight cancer.

I described how movement activates immune cells, reduces chronic inflammation, improves insulin sensitivity, and changes the cellular environment required for tumors to thrive.

I also shared my personal "Exhibit A": my daughter, who’s six and a half years post-stage 4 diagnosis (and three and a half years beyond the prognosis she was given), Katie prioritizes exercise every single day—early morning walks, Yoga With Adriene, and strength training.

Correlation isn’t causation, but I can’t help but believe her exercise habits have had a positive effect on not just her survival, but just as important, her quality of life.

When I was waxing enthusiastic about the powerful effect of exercise on cancer, Katie reminded me that people going through cancer treatment are often far too exhausted and ill to even think about working out. Telling someone who’s wiped out from chemotherapy to "hit the gym" is tone deaf and downright discouraging.

We used to think of exercise oncology as a hopeful vision for the future. But a recent New York Times article found that the future is arriving, and the numbers are exciting!

A $3,000 program, a $480,000 drug

A major randomized controlled trial in colon cancer patients found that patients who participated in a structured, trainer-guided exercise program over three years weren’t just feeling better, they were living longer.

Ninety percent of the patients in the exercise program were alive after eight years, compared to 83% in the control group.

Consider the cost. A new pancreatic cancer drug, daraxonrasib, costs about $480,000 a year. It comes with unpleasant side effects and can extend life by a few months, but doesn’t increase long-term survival. The three-year exercise program cost $3,000 per person. (This isn’t colon cancer, so it isn't a head-to-head comparison, but the contrast is dramatic.)

The oncologist who led the trial said, "If we had a drug with this magnitude of benefit, it would immediately become standard of care and funded by insurance companies."

Bridging the gap: from “biology” to “behavior”

This brings us back to Katie’s point about fatigue. How do you get a weary patient from knowing exercise is good for them to actually doing it?

Dr. Kathryn Schmitz, an exercise oncology researcher whose book, Moving Through Cancer, I recommended back in April, nailed the problem: “Exercise is not just biology. It is also behavior.”

Simply telling patients to exercise isn’t enough. People need support, guidance, and accountability. In Dr. Schmitz’s Moving Through Cancer program, a trainer works with patients one-on-one, sometimes virtually right in their living rooms, tailoring the movement to whatever the patient can manage that day.

For some, it’s work to manage neuropathy or joint pain. For others, it’s working toward getting back out on the bike trail or playing pickleball.

Change is coming…..

Until now, structured exercise programs have mostly been limited to major cancer centers, and in many cases, pay out of pocket for exercise during cancer treatment. That leaves out many people, especially those who are less well off or live far from those centers. Some of the greatest challenges have been dealing with insurance companies.

Things are moving in a hopeful direction:

• Insurance coverage is coming: The University of Pittsburgh Medical Center (UPMC) announced it will become the first health system in the country to cover exercise oncology through its employee health plan for breast cancer patients starting next year, with plans to expand to all cancer types by 2028. The data showed that guided exercise saves health systems money by reducing ER visits, unplanned doctor visits, and hospitalizations.

• Hospital accreditation: Dr. Schmitz and her team have succeeded in incorporating exercise support into the standards that cancer hospitals must meet for accreditation.

Exercise oncology is moving out of the “nice-to-have” category into standard, reimbursable medical care!

If you or someone you love is dealing with cancer, ask your care team about exercise before you start anything. Then look for support:

• The American College of Sports Medicine’s Moving Through Cancer directory lists about 2,300 programs nationwide.

• Many YMCAs offer free or low-cost programs for people with cancer.

• Moving For Life offers free virtual programming.

One more benefit of exercising is that it can give you a sense of control over your life.

It can feel like that’s something you’ve lost when you’re dealing with cancer, and something no drug can deliver.