Latest Research: Moderate- to High-Intensity Exercise During Chemo Yields Significant Benefits

Research published April 27th in the prestigious Journal of Clinical Oncology provides persuasive evidence that cancer centers cannot claim they are delivering the highest standard of care unless they are providing patients with a challenging, supervised exercise program. Anything less means that cancer patients are suffering needlessly.

The Journal reports on a clinical trial with 230 participants who were randomized into one of three groups while they were undergoing adjuvant chemotherapy. The study started with each patient’s first chemotherapy cycle and continued until 3 weeks after the last cycle. Each of the three groups started with 77 or 76 patients:

  • Low-intensity, home-based physical activity program
  • Moderate- to high-intensity, supervised physical activity program (at the cancer center)
  • Usual care, which meant no routine physical activity

The research yielded a clear result:

“Conclusion: A supervised, moderate- to high-intensity, combined resistance and aerobic exercise program is most effective for patients with breast cancer undergoing adjuvant chemotherapy. A home-based, low-intensity physical activity program represents a viable alternative for women who are unable or unwilling to follow the higher intensity program.”

What does “most effective” mean? What are the benefits patients gained during chemo?

“The results of this trial support our hypothesis that moderate- to high-intensity exercise during chemotherapy has a beneficial effect on cardiorespiratory fitness, muscle strength, fatigue, and chemotherapy completion rates. Salutary effects were also found for symptom burden (eg, nausea and vomiting, pain, constipation) and return to work. The effects of low-intensity physical activity were less pronounced (except for nausea) and were limited to measures of endurance, symptom burden, and return to work.

“Patients who participated in a physical exercise or activity program were more likely to have returned to work at 6-month follow-up than those in [usual care]. This not only has financial implications, but also carries meaning in terms of quality of life and a sense of return to normalcy.”

This is research that empowers oncologists who want to provide the best possible care and survivors who want to receive it. You can give this research to your oncologist to explain why you would like a referral for supervised, structured exercise as part of your oncology treatment. Encourage your oncologist to help you make the argument that insurance providers should reimburse cancer patients for exercise programs just as they currently reimburse cardiac patients for exercise programs.

Your cancer treatment team is providing you with the highest quality care ONLY if they are  providing you with access to a supervised program of moderate- to high-intensity exercise.

If you know someone who would benefit from reading this study, the link to the study abstract is:

For more information, or if you’d like to read the entire study, email us at

Nancy L Howe

I was a daily exerciser and I ate my fruits and vegetables, but in 1997, I was diagnosed with cancer anyway. I experienced first-hand the benefits of physical activity during treatment and beyond. That was my "Aha!" moment. I left my corporate career, earned my masters at Arizona State University studying exercise science, and joined the staff of University of Arizona cancer researchers in 2005. In 2013, I earned my Cancer Exercise Specialist certification from the University of Northern Colorado, Rocky Mountain Cancer Rehabilitation Institute, and founded Strong Cancer Recovery. In 2017, I joined the Arizona State University Cancer Prevention and Integrative Medicine research team, and entered the PhD program at ASU's College of Nursing and Health Innovation. My research focus is breast-cancer-related lymphedema, including the preventive and ameliorative benefits of physical activity.

2 thoughts on “Latest Research: Moderate- to High-Intensity Exercise During Chemo Yields Significant Benefits

  1. Thank you, Nancy, for this article which supports the importance of supervised, structured exercise as part of an oncology patient’s treatment….and the value of patients and oncologists advocating for insurance coverage on these programs.

    1. Yes, advocacy is key to getting coverage for exercise therapy. This latest research supports what we have seen in our own work — that we don’t have to be tentative about exercise intensity. When survivors are comfortable doing more, we get even better results.

      Until now, oncologists haven’t had the documentation they needed to be more encouraging about exercise therapy. Now we need to get the word out, loudly and clearly.

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