Personalized Exercise for Cancer Care & Treatment
Featuring: Rob Newton, PhD, DSc
In short
Exercise medicine is now backed by a landmark randomized controlled trial — the CHALLENGE study, published in the New England Journal of Medicine — showing it directly improves survival and reduces recurrence risk in cancer patients, not just fitness. Professor Rob Newton explains how exercise prescriptions should be tailored to a person's specific cancer type, treatment, muscle mass, and physiological status, rather than following generic guidelines. People in active treatment, on androgen deprivation therapy, or with low muscle mass each need a different, carefully adjusted approach.
- •Ask your oncology team about a referral to a clinical exercise physiologist who specializes in cancer care — generic fitness advice is not the same as a prescription tailored to your cancer type and treatment.
- •If you have low muscle mass, prioritize high-volume resistance training focused on large muscle groups; your muscle tissue signals your immune system, and low muscle mass can significantly weaken your body's ability to fight cancer.
- •If you are receiving radiation therapy, performing moderate-intensity aerobic exercise immediately before your session may increase blood flow to the tumor and enhance radiation effectiveness — ask your care team whether this is appropriate for you.
- •Progress tracking should go beyond how you feel on a walk: tools like DEXA scans (muscle, fat, and bone density), blood tests for inflammation and immune markers, and wearable devices give a clearer picture of whether exercise is creating the internal changes that matter.
Watch on Cancer Patient Lab YouTube
Ask anything about this — free, no signup
Instant answers grounded in real guidelines, not the internet.
Personalizing Exercise for Your Cancer Care“ Brad Power October 8, 2025 “Patients who are more physically active have less risk of recurrence. They survive longer, overall, which is not surprising. Anyone who is physically active is likely to live longer. But more particularly, we see that their cancer-specific survival is greatly enhanced. We never knew before this fantastic study, called the CHALLENGE trial, whether it was a reverse causation.
In other words, that association was the fact that patients who were doing better, feeling better, were more likely to survive, and they also did more physical exercise. Now we have very solid evidence in a very large trial to show a direct causative drive, and this is in a randomized controlled trial. That study was presented at the American Society of Clinic Oncology in Chicago in the middle of this year.
It really made people sit up and listen, particularly the oncology community, about the power of exercise as medicine to treat cancer. Increasingly targeted exercise is being established as a first line treatment. It's not a ‘nice to have’. ’ It's much more nuanced than that. ” – Rob Newton, PhD, DSc “We need to stop talking about fitness.
We need to talk more about the internal mechanisms of the levers that we are adjusting and tuning to produce a more cancer-suppressive environment, or to enhance the effectiveness of a treatment, or to reduce the side effects. ” – Rob Newton, PhD, DSc “We now know that muscle tissue is a major endocrine organ, and it's signaling to all the other tissues in the body.
In particular, our muscle tissue is a major moderator of signaling to our immune system and modulating the effectiveness of our immune system.
Meeting Summary
Cancer treatment is episodic and focussed mainly on treatments such as surgery, chemotherapy, and radiation therapy. While these treatments can be lifesaving, truly integrative oncology encompasses other treatments and therapies as well. Exercise medicine, nutrition therapy, and psychological support are major pillars of cancer care, but access can be limited.
Fortunately, quality research is accumulating providing clear evidence that these “adjunct” treatments extend survival, enhance quality of life, facilitate the primary treatments while reducing their side effects, and reduce risk of recurrence.
As a result, access is opening up with more and more hospitals and cancer centers providing more extensive integrative oncology, including treatment in the home utilizing the greatly expanded capacity of the Internet and virtual health care due to Covid19. “Personalizing Exercise for Your Cancer Care“ Rob Newton, PhD, DSc, is uniquely qualified to lead a discussion on personalizing exercise medicine to complement traditional cancer care.
He is Professor of Exercise Medicine in the Exercise Medicine Research Institute that he established (2004) at Edith Cowan University, Perth, Western Australia.
His current major research directions include: exercise medicine as neoadjuvant, adjuvant, and rehabilitative cancer therapy to reduce side-effects and enhance effectiveness of surgery, chemotherapy, and radiation therapy; the influence of targeted exercise medicine on tumor biology, and exercise medicine for enhancing survival and reducing decline in quality of life, strength, body composition and functional ability in cancer patients.
What is personalized exercise for cancer care?
•Extensive individual assessments of body composition, metabolic factors, immune capacity, inflammatory status, gut microbiome, and psychological health
•Highly personalized exercise prescriptions that are dynamically adjusted based on your specific cancer type, treatment, and individual response
•Using advanced technologies like wearable sensors and AI to monitor and optimize the exercise intervention
•Focusing on changing internal physiological mechanisms to create a more cancer- suppressive environment
•Integrating exercise with nutrition and psychological support
•Continuously reassessing and adapting the exercise plan to enhance treatment effectiveness, reduce side effects, and improve patient outcomes Should you consider personalized exercise as part of the treatment for your cancer? A recent New England Journal of Medicine study demonstrated a causative link between exercise and improved cancer survival. Exercise personalized to your cancer type, treatment, and physical condition can:
•Enhance the effectiveness of traditional treatments like chemotherapy and radiation
•Reduce side effects of cancer treatments, such as fatigue related to radiation therapy
•Improve overall survival and cancer-specific survival
•Help create a more cancer-suppressive internal environment What are examples of personalizing exercise to your situation?
•If you have low muscle mass : prioritize high-volume resistance training, focus on large muscle groups and compound movements, use eccentric exercise techniques, maintain energy balance (not a deficit), and limit aerobic exercise to optimize muscle growth
•If you are getting radiation therapy : Perform moderate-intensity aerobic exercise immediately before radiation treatment, aim to increase blood flow to the tumor, use “Personalizing Exercise for Your Cancer Care“ precise cardiac output and optimal metabolism, to enhance tumor perfusion and radiation effectiveness
•If you are on androgen deprivation therapy : Use specialized resistance training techniques, emphasize muscle preservation, modify exercise to compensate for testosterone suppression What are the standard exercise targets and how should you vary from them?
•The standard exercise recommendation is 75 to 150 minutes of moderate to vigorous aerobic exercise, two or more resistance training sessions, and some balance training each week. This is effective for cancer survivors who are relatively well and not undergoing treatment..
•However, these generic guidelines are insufficient and in some cases contraindicated for cancer patients. The approach should be tailored to your individual situation, treatments, health issues, and changing conditions. How can you measure progress from exercise interventions? Measuring progress isn't just about fitness metrics, but understanding the underlying physiological changes that create a more cancer-suppressive environment and enhance treatment effectiveness.
•A “DEXA scan”: a quick, painless, low-dose X-ray scan, can assess your muscle mass, fat distribution, and bone density
•Your observations : including your psychological state, anxiety levels, depression indicators, and concerns
•Blood tests: which can analyze your “myokine” (proteins released by muscle cells that act as signaling molecules in the body) levels, inflammation markers, immune cell health, and overall blood cell count
•Wearable devices : to track your physical activity characteristics, sleep quality, changes in your physiological state, heart rate variability, oxygen saturation
•Functional performance assessments : strength measurements, your ability to perform daily living tasks, control movements, maintain posture, and generate force Should you consider blood flow restriction training?
•Blood flow restriction training could potentially help you build muscle with lower mechanical stress, especially if you have limitations or injuries.
•However, it has limitations: while it can help build some muscle mass, it lacks functional transfer and neural learning.
•It's most useful if you are struggling to do standard resistance training, but may not be widely accessible due to the specialized equipment and expertise required. How can you learn more about precision exercise in cancer? “Personalizing Exercise for Your Cancer Care“
•Follow research from Rob Newton's Exercise Medicine Research Institute at Edith Cowan University
•Contact Rob Newton at rob@fitmed.com
•Read recent publications in exercise and cancer care
•Attend conferences and webinars focused on exercise and cancer care
•Consult with clinical exercise physiologists specializing in cancer care
•Explore digital platforms and resources that provide personalized exercise guidance for cancer patients
•See previous discussions we have had on exercise and cancer care:
••
•Adding Exercise for Everyday Life and Developing a Medical Device to Personalize Cancer Treatment
•“Exercise as a Countermeasure to Hormone Deprivation Therapy Side Effects and for Bone and Mental Health”
•
•The information and opinions expressed on this website or platform, or during discussions and presentations (both verbal and written) are not intended as health care recommendations or medical advice by Cancer Patient Lab, its principals, presenters, participants, or representatives for any medical treatment, product, or course of action. You should always consult a doctor about your specific situation before pursuing any health care program, treatment, product or other course of action that might affect your health. For the video recording, please see here. “Personalizing Exercise for Your Cancer Care“ Meeting Notes KEYWORDS Cancer, exercise oncology, personalized exercise, exercise medicine, cancer therapy, survival impact, randomized control trial, targeted exercise, immunotherapy, muscle mass, fat mass, bone metastases, precision exercise, digital solutions, patient assessment, exercise prescription, cancer suppression. SPEAKERS Rob Newton (83%), Roger Royse (5%), Rick Davis (4%), Ken Martin (2%), Russ Hollyer (2%), Jeff Dwyer (2%), Gary Peters (2%), David Plunkett (<1%) CHAT CONTRIBUTORS Russ Hollyer, Rick Davis, Ken Martin, Gary Peters, DS, Helen, Vita Riera, Wee Kian, Jeff Marchi, Claire, Kajal Gokal, Brad Power SUMMARY Rob Newton, PhD, DSc, discussed the transformative impact of exercise on cancer care, emphasizing its role as a first-line treatment. He highlighted a randomized control trial recently published in the New England Journal of Medicine showing exercise significantly improves survival of patients with colon cancer Newton's research at Edith Cowan University in Perth, Western Australia, demonstrated exercise's effectiveness in enhancing chemotherapy and radiation therapy. He stressed the importance of tailoring exercise in cancer care to individual patient needs, and the potential of digital solutions to scale up personalized care. Challenges include funding and workforce capacity, but advancements in technology and standardization are expected to improve access and outcomes. OUTLINE Introduction to Personalized Exercise for Cancer Patients
•Rob Newton, PhD, DSc, discussed personalizing exercise to complement traditional cancer care.
•The New England Journal of Medicine paper published in June showed a causative impact of exercise on survival.
•The paper, led by Professor Kerry Courneya , was the first randomized controlled trial to demonstrate a direct causative effect of exercise on survival.
•The study showed patients who were more active had less risk of cancer recurrence and survived longer.
•The study established targeted exercise as a first-line treatment for cancer, not just a nice-to-have.
•Exercise can enhance the effectiveness of mainstream treatments like chemotherapy and radiation therapy.
•Rob’s Research Institute in Perth, Western Australia, is conducting research on enhancing the effectiveness of radiation therapy through targeted exercise. “Personalizing Exercise for Your Cancer Care“
•Targeted exercise can help in immunotherapy treatments, particularly for patients with multiple myeloma.
•There is a solid treatment plan for patients from initial chemotherapy to the course of immunotherapy. Personalized Exercise Research
•A study on targeted exercise for men with metastatic prostate cancer, led by Professor Newton and Professor Fred Saad , recruited 154 patients across 14 trial sites in 10 countries.
•The study aimed to demonstrate a causative relationship between targeted exercise and survival in men with metastatic prostate cancer.
•The study involved high-intensity resistance training, moderate-intensity continuous training, and high-intensity interval training.
•The study was supervised to ensure safety, and adverse events were monitored.
•The study showed that these patients with stage 4 cancer including bone metastases could undergo moderate to vigorous exercise safely.
•Myokines play a role in suppressing cancer growth and enhancing immune function.
•The study showed a 20% reduction in cancer cell growth in-vitro after six months of exercise.
•Further, each exercise bout produced a further burst of cancer-suppressing myokines. Precision Exercise Interventions
•The components of a precision exercise intervention include body composition, metabolic and cardiovascular factors, and immune capacity.
•An intervention includes extensive biological health and fitness assessments, integration of wearable sensors, and individualized exercise prescriptions.
•Ongoing monitoring and reassessment adapt the exercise prescription.
•Digital solutions can scale up precision exercise cancer care and make it accessible to more patients. Patient Education and Support
•Patient education to understand the underlying mechanisms of exercise is important.
•Exercise is a tool to create a more cancer-suppressive environment and enhance the effectiveness of treatments.
•Comprehensive assessments and tailored exercise prescriptions are needed to improve patient outcomes. Challenges and Future Directions
•Rick Davis raised concerns about the practical application of precision exercise oncology and the need for standardized data.
•Jeff Marchi asked about the appropriateness of his current exercise routine and the potential risks of overexercising.
•Ken Martin discussed the need for standardized measures and protocols in exercise oncology.
•There are ongoing efforts to standardize data and integrate it with electronic health records. “Personalizing Exercise for Your Cancer Care“
•Gary Peters asked about the challenges of accessing high-quality exercise programs and the risks of injury.
•The workforce needs upskilling.
•Leveraging digital technologies can provide remote support. “Personalizing Exercise for Your Cancer Care“
Full transcript
Roger Royse Welcome to the Cancer Patient Lab. Today we have Rob Newton, PhD, DSc. He is going to lead a discussion on personalizing exercise to complement traditional cancer care. Rob is the Professor of Exercise Medicine in the exercise Medicine Research Institute that he established in 2004 at the Edith Cowan University in Perth, Western Australia.
His research includes exercise medicine as neoadjuvant, adjuvant, and rehabilitative cancer therapy to reduce side effects and enhance effectiveness.
Want to learn more about your specific case?
Upload your medical records and ask Navis questions tailored to your diagnosis.