Overview: The Promise of Exercise in Cancer Care
At Gathering Around Cancer 2025, Dr. Noel McCaffrey of Dublin City University highlighted a growing consensus: physical activity is a valuable ally in cancer care. Across treatment and survivorship, appropriately designed exercise programmes can support physical functioning, reduce fatigue, and improve quality of life for people living with cancer. Yet translating this promise into everyday clinical practice requires navigating a series of practical hurdles—from patient selection to program delivery, safety considerations, and long-term adherence.
What Makes an Exercise Programme Viable for Cancer Patients?
Dr. McCaffrey stressed that a viable programme must be tailored to the individual. Cancer care teams are tasked with balancing medical safety, treatment side effects, and personal preferences. Factors such as current treatment phase, comorbid conditions, baseline fitness, and fatigue levels all influence what type of exercise is appropriate. The goal is to craft a plan that is feasible, motivating, and sustainable within the patient’s daily life.
Key Components
- <strongAssessment: Baseline fitness testing and symptom profiling help identify suitable activities and safety precautions.
- Personalization: Programs may include aerobic work, resistance training, flexibility, and balance components, adjusted for cancer-related side effects like neuropathy or lymphedema.
- Progression: Clear progression milestones ensure continuous challenge without overburden.
- Monitoring: Ongoing monitoring for adverse effects, fatigue, and mood changes is essential to adapt the plan.
- Support Structure: Access to trained professionals, peer support, and convenient delivery modes enhances adherence.
Delivery Models: Where and How Exercise Is Delivered
Practical delivery models were a focal point in the discussion. Options include hospital-based or community-based programmes, home-based regimens with tele-coaching, and hybrid approaches that combine in-person assessments with remote check-ins. Each model has strengths and challenges: supervised sessions can ensure safety and motivation, while home-based plans offer flexibility and reduce travel barriers—an important consideration for patients dealing with treatment schedules and fatigue.
Safety and Risk Management
Safety is non-negotiable in cancer care. Dr. McCaffrey emphasized risk assessment protocols that screen for cardiopulmonary risk, treatment-related contraindications, and infection exposure. Collaboration between oncologists, physiotherapists, exercise physiologists, and nursing staff is vital to create an integrated safety net. Standardized guidelines help clinicians decide when to start, pause, or modify activities in response to symptoms like neutropenia, anemia, or severe fatigue.
Overcoming Barriers to Participation
Despite robust evidence, real-world uptake remains uneven. Barriers include transportation challenges, time constraints, fear of exacerbating symptoms, and a lack of confidence in exercising after a cancer diagnosis. Dr. McCaffrey noted that addressing these barriers requires more than clinical know‑how; it calls for patient-centered communication, clear expectations, and practical supports such as scheduling flexibility, transportation assistance, and cost considerations.
Motivation and Adherence
Maintaining motivation is often as important as the exercise prescription itself. Behavioural strategies—goal setting, self-monitoring, social support, and education about fatigue management—help patients stay engaged. Clinicians can empower patients by framing exercise as a component of treatment and recovery, not a luxury. When patients observe tangible improvements in strength, stamina, or daily function, adherence naturally improves.
The Path Forward: Integrating Exercise into Standard Cancer Care
Integration requires systemic changes: training clinicians in exercise oncology, establishing referral pathways, and ensuring sustainable funding for programmes. Data collected from routine practice can inform best practices, refine risk stratification, and demonstrate the long-term benefits for patients and healthcare systems alike. The consensus is clear: exercise should be an integral part of cancer care, offered as a standard option alongside medical treatment, nutrition, and psychosocial support.
Conclusion
Gathering Around Cancer 2025 underscored the practical realities of implementing exercise programmes for cancer patients. With thoughtful assessment, personalized plans, safe delivery models, and robust support, exercise can be a practical and impactful component of cancer care—helping patients move through treatment with greater strength, less fatigue, and improved well-being.
