Cancer, exercise, and yes we know we should do it

A small problem with a recent cancer study's beneficial findings on exercise

Photo by Annie Spratt via Unsplash

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Well, I’ve got good news and bad news. As a bad news first based ‘stack, we’ll start with the tough stuff — and that is that if you’ve made it through cancer, new studies show that your best chance of avoiding relapse is to hire a personal trainer and sign up to get to work in the swole-zone. At least that should be your plan based on findings published in the New England Journal of Medicine. Oh, but as mentioned, the good news is that if you commit to exercising, you might not get cancer again.

As reported by The Guardian, a study published in the New England Journal of Medicine and presented at the American Society of Clinical Oncology, “a world-first trial involving patients from the US, UK, Australia, France, Canada and Israel has found that a structured exercise regime after treatment can dramatically reduce the risk of dying, the disease returning or a new cancer developing.” And to make sure we knew that they weren’t mincing words, they titled the session in which they were presenting their findings, “As Good as a Drug.”

Patients enrolled in the trial began an exercise routine that saw them linking up with a trainer and getting sweaty twice a month, later reducing to meeting once a month — for three years. These personal trainer sessions were apparently only the equivalent of three to four walks a week, lasting between 45 and 60 minutes. This exercise group was compared to a control group that was simply given a “healthy lifestyle book” — which I imagine was similar to so much hospital literature that I have admittedly baton-passed from my medical provider directly into the recycling bin.

The results were eye-opening, with the exercise group that stuck to physical activity having a 28% less chance of a recurrence five years out and a 37% chance of being less likely to die after eight years.

To which I would say — awesome! Now help us do it.

If exercise is as good as a drug then lets treat it like one and build it into those EOB’s. Let’s Rx the hell out of exercise with a year full of refills. Generic brand me 12 months of Gold’s Gym. Ship me a home IV pole and a Peloton. Let’s get all these TikTok trainers paired up with patients and reimbursed by Medicare. If it really is as good as a drug, let’s treat it like one. Let’s build the support systems and infrastructure so that cancer patients don’t look at that statistic as yet another burden of cost and time — both of which are at a premium for those who are sick.

These incredible results offer a tantalizing dangling carrot for patients looking for better odds, but the hallowed outcomes might feel like a walled garden if we don’t provide equitable pathways to achieve them. Everyone knows they should exercise, and not having cancer come back should be hella good motivation — but like so many of the nuances of post-treatment care, it’s much easier dictated than done.

With exercise usually labeled as a lifestyle choice, despite the obvious benefits (mental health, cardiovascular, diabetes), it puts the onus on the individual — much like making the decision not to smoke or frequently eating one’s body weight in pork belly. And while I’m wont to cut insurance companies much slack, I understand the boundaries that come with impositions on free will. But if it crosses from preventative to treatable, let’s try to offer better solutions than personal accountability — even if it may inevitably always come down to that.

Not everyone can become a Instagram-wielding power lifter or inspired marathon runner after their diagnosis — and I know the study isn’t asking that of patients. A few walks a week could feel like a simple ask. But conceptually, I couldn’t help but think that it side steps the fact that many cancer patients have physical and mental hurdles that compound in the same way that the benefits of exercise can — and I was never given a personal trainer to up my odds. Rather, I remembered the sick me from any number of years ago who could taste the spite in the back of my throat as a smiling practitioner gave me the good news of another thing to do — leaving me to figure out how to drag my non-consenting, aching body up and over yet another hill.

I write this not to dog on the findings — again, I think it’s great and am admittedly splitting hairs a bit. But let’s not let this boil down to the all too known finger wag of “you should exercise,” especially to a group of people whose bodies may have the toughest time complying. I mean, it’s right their in the findings. A pamphlet isn’t enough and talk is cheap. Personally, I can’t wait to meet my Prior Authorized California Blue Cross Anthem HSA PPO prescribed personal trainer.