In a conversation with CancerNetwork®, Nathan Goodyear, MD, spoke about the role that exercise and lifestyle intervention can play in the treatment of patients with cancer. He described how prescribed exercise may serve as a biologically interventional therapy that can help prolong longevity, reduce the risk of recurrence; and supplement the efficacy of standard therapeutic approaches like chemotherapy, immunotherapy, and surgery.

Goodyear, an integrative medicine physician at the Williams Cancer Institute, pointed to literature indicating the potential benefits of structured exercise programs across different cancer populations. For example, data from the phase 3 CHALLENGE trial (NCT00819208) highlighted a lower risk of death and reduced recurrence following a 3-year structured program among patients with stage II and III colorectal cancer. Furthermore, the OPTIMUS trial (NCT02950324) demonstrated that a short-term exercise program that takes place before surgery or alongside chemotherapy can increase CD8-positive T-cell infiltration while decreasing immunosuppressive cells, effectively turning “cold” tumors “hot.”

Additionally, Goodyear addressed some preconceptions surrounding the potential role of exercise in oncologic care, defending it as a prescribable therapy that necessitates a deliberate, properly applied approach to achieve success among patients. He discussed the importance of structuring individualized exercise-based regimens by considering performance status and other physical patient characteristics. He also noted how exercise intervention may mitigate immunosenescence and accelerated aging may be associated with one’s disease and anti-cancer therapy. 

“Surgery, chemotherapy, and radiation…have efficacy; there’s no question about that. They also promote senescence and accelerated aging. What if we’re able to bring in these therapies that can work to break those cycles, like exercise?” Goodyear stated. “If it improves the outcome, helps the patient heal better, empowers their immune system in intended [and] direct ways that are reproducible in the research, and if it helps to block that accelerated aging, we reengage the immune system, countering the immunosenescence that is accelerating that process called inflammation.”

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