Rob Newton

I’m pleased to announce the release of my new book, MyExerciseMedicine for Cancer. This book is written first and foremost for people with cancer, survivors, and their families. I explain—in clear, accessible language—how exercise functions as a medical treatment and how it can be safely and effectively applied adjunct to surgery, chemotherapy, immunotherapy, hormone, targeted, theranostic, and radiation therapy, as well as throughout long-term recovery. The content draws on more than 40 years of research and clinical practice in exercise medicine, including over two decades devoted specifically to exercise oncology. While the book is designed to empower patients and families with practical, trustworthy guidance, it is also highly relevant for clinicians seeking to integrate evidence-based exercise prescription into standard oncology care. Key areas covered include: • How exercise influences tumor biology and immune function • Enhancing effectiveness of chemotherapy, immunotherapy, and radiation therapy • Reducing treatment toxicity and improving tolerance • Individualizing exercise prescription to different cancer types and stages and comorbidities • Practical guidance to begin, progress, and maintain exercise safely and systematically My aim is to provide a resource that supports informed decision-making, improves outcomes, and strengthens the role of exercise oncology as a core component of cancer treatment. Amazon links: Kindle eBook: amazon.com/MyExerciseMedi… Paperback: amazon.com/MyExerciseMedi… Hardcover: amazon.com/MyExerciseMedi… Thank you to the many patients, clinicians, and researchers who have contributed to this field. I hope my book proves useful for anyone seeking to apply exercise medicine to cancer treatment and survivorship. Special thanks to @EdithCowanUni for supporting my work over the past 22 years.

It is with pleasure that we share with you that our Graduate Certificate and Master of Exercise Science (Strength and Conditioning) programs will be Australian Government Commonwealth supported for students commencing in Semester 2, 2026. For more details please click on the links. Graduate Certificate - ecu.edu.au/degrees/course… Masters - ecu.edu.au/degrees/course… If you are interested in enrolling and have any questions, please email the Course Coordinator, Dr Chris Latella - c.latella@ecu.edu.au @Doc_Haff

Aerobic exercise in cancer care is not simply “try to walk more” It is a prescribed physiological stimulus. In the latest article in my Substack series, Exercise as Medicine in Oncology, I examine how aerobic exercise should be prescribed for people living with and beyond cancer. The key issue is dosage. Vague advice such as “go for a walk” or “stay active” can lead to both underdosing and overdosing. Too little stimulus may fail to improve aerobic capacity, fatigue, metabolic control, or treatment tolerance. Too much volume or intensity may exceed recovery capacity, worsen symptoms, or compromise muscle preservation in vulnerable patients. In this article, I discuss: • MICT • interval training • HIIT • aerobic circuit training • HIRT as a cardiorespiratory stimulus • heart-rate reserve and RPE • autoregulation during treatment • when aerobic exercise should be modified, reduced, or temporarily avoided • how to coordinate aerobic and resistance training Aerobic exercise is powerful medicine, but only when the mode, intensity, duration, frequency, progression, and timing are prescribed with clinical intent. This article draws from the framework in my book, MyExerciseMedicine for Cancer. amazon.com/dp/1764297512/ Read the article here: open.substack.com/pub/profrobnew… #Cancer #Oncology #ExerciseMedicine #ExerciseOncology #CancerRehabilitation #CardioOncology

Aerobic exercise is not background “cardio” in cancer care. It is a therapeutic intervention. In the latest article in my Substack series, Exercise as Medicine in Oncology, I examine why aerobic exercise is an essential modality in exercise oncology. Aerobic training improves the integrated function of the heart, lungs, blood vessels, blood, and skeletal muscle mitochondria. That matters because cancer and its treatments can impair oxygen delivery, vascular function, mitochondrial efficiency, metabolic control, immune regulation, and cardiovascular health. In this article, I discuss: • why cardiorespiratory fitness is a powerful clinical marker • how aerobic exercise reduces cardiovascular disease risk in cancer populations • how aerobic training influences tumour perfusion, oxygenation, and treatment delivery • why mitochondria matter for fatigue, oxidative stress, and possibly cognitive function • how aerobic exercise supports immune mobilisation and inflammatory regulation • why MICT, interval training, HIIT, aerobic circuits, and HIRT each have distinct roles The key point is simple: Aerobic exercise must be prescribed, not generalised. The question is not whether a patient should “do cardio.” The question is what aerobic stimulus is required, how it should be delivered, and how it should be adjusted to treatment, symptoms, and clinical goals. This article draws on the framework developed in my book, MyExerciseMedicine for Cancer. Read the article here: open.substack.com/pub/profrobnew… Book: amazon.com/dp/1764297512/ #Cancer #Oncology #ExerciseMedicine #ExerciseOncology #CancerRehabilitation #CardioOncology

I just signed the Axe the Tax on Health petition. Join me in calling for exercise physiology to be exempt from GST. It is a ridiculous situation in Australia where patients have to pay tax for exercise physiology services when this is not levied on physiotherapy, dietetics or psychology care. Sign and share today. #AxeTheTaxOnHealth gst.good.do/axethetax/axe-… @ESSA_NEWS

We were delighted to host the Balanced MP Event at NSW Parliament! MPs put their balance and strength to the test against Olympic Champion Duncan Armstrong. This event highlighted the vital role of Accredited Exercise Physiologists in preventive health and mental wellbeing.

Resistance training in cancer care is not just about doing weights. It is about prescription. In practice, this is where many exercise recommendations in oncology still fall short. Patients are often told to “do some strength training” or “use resistance bands.” But resistance training only functions as medicine when the dose is defined: * how hard * how many repetitions * how many sets * how often * how it progresses * how it is adjusted around surgery, chemotherapy, fatigue, anaemia, neuropathy, bone fragility, or lymphoedema That is what I address in the latest article in my Substack series, Exercise as Medicine in Oncology. Part 10: Prescribing Resistance Training in Cancer Care explains: * why 6–12 repetitions is usually the most practical therapeutic range * why proximity to fatigue matters more than light, easy effort * how sets, rest periods, and weekly volume determine the effect * how to use periodisation across weeks and treatment cycles * when advanced methods such as cluster sets or accentuated eccentric loading may be useful * why resistance training must be programmed, not generalized Resistance training is one of the most direct treatments we have for opposing treatment-related decline. It preserves muscle mass, improves muscle quality, increases strength and power, supports bone integrity, and helps maintain the physiological reserve required to tolerate therapy and remain independent. Read the latest article here: open.substack.com/pub/profrobnew… #Cancer #Oncology #ExerciseMedicine #ResistanceTraining #CancerRehabilitation #ExerciseOncology

Excited to share our latest publication in the Journal of Strength and Conditioning Research: Sex-Specific Immune Cell Mobilization and Recovery After High-Volume Glycolytic Squat Exercise William J. Kraemer, Mastro AM, Saenz C, Freidenreich DJ, Volk BM, Gomez AL, Fragala MS, Szivak TK, Post EM, Wolf MR, Comstock BA, Häkkinen K, Newton RU, Jeff Volek. This study examined how men and women differ in their acute immune response to a single bout of high-volume glycolytic resistance exercise. Among the key findings: Resistance exercise triggered a rapid and robust immune cell mobilization response. Men showed a greater transient increase in circulating lymphocytes, particularly natural killer cells, shortly after exercise. Women demonstrated a different recovery pattern, including increases in CD4+ cells at 60 minutes postexercise. Both sexes showed substantial time-dependent changes in immune cell populations during early recovery. These findings reinforce that resistance exercise is a potent immunological stimulus, while also highlighting that the magnitude and timing of the response are partly sex-specific. Understanding these acute responses may help inform more precise exercise prescription and recovery strategies, while contributing to our broader understanding of the interaction between exercise and immune function. DOI: 10.1519/JSC.0000000000005443 #ResistanceTraining #ExerciseImmunology #StrengthAndConditioning #SportsScience #ExerciseScience #ImmuneFunction #Research #JSCR #ExercisePhysiology journals.lww.com/nsca-jscr/abst…

Resistance training is still underused in cancer care. That needs to change. In the latest article in my Substack series on Exercise as Medicine in Oncology, I examine why resistance training is not an optional adjunct to cancer care, but a primary treatment modality. Resistance training is the most effective exercise intervention we have for preserving or rebuilding muscle mass, improving strength and power, supporting bone integrity, and maintaining the physical reserve required to tolerate cancer treatment and preserve independence. It also matters biologically. Skeletal muscle is not simply tissue for movement. It is a major endocrine, metabolic, immune, and neuroprotective organ. When it is lost, patients lose far more than strength. In this article, I discuss: why resistance training is foundational in exercise oncology the endocrine and immune role of skeletal muscle the relevance of myokines to cancer biology why general activity is not a substitute for resistance training why muscle preservation matters for treatment tolerance, physical function, and long-term outcomes This article is based on the framework developed in my book, MyExerciseMedicine for Cancer, which brings together the scientific and clinical foundations of exercise oncology across the cancer continuum. You can read the latest article here: 👉 profrobnewton.substack.com/p/resistance-t… And the book is available here: 👉 amazon.com/dp/1764297512/ #Cancer #Oncology #ExerciseMedicine #ResistanceTraining #CancerRehabilitation #ExerciseOncology

@sciqst This field is advancing rapidly. In my latest book I explain precision exercise oncology in great detail amazon.com/dp/1764297512/

That's an excellent point, Rob. Tailoring exercise to the specific needs of cancer patients is crucial for effective management. This raises the question of how one might develop personalized exercise protocols that align with different stages of cancer and treatment modalities. Are there any tools or guidelines you find particularly useful? #Medicine #CancerCare For a deeper dive into the biomedical foundation of such approaches, Sci-Quest can be an invaluable resource. It’s a one-stop platform designed to answer every biomedical question and generate comprehensive reviews. Check it out here: sciqst.com

Exercise is only medicine when it is prescribed with precision. In cancer care, telling patients to “stay active” is often not enough. The type, dose, and progression of exercise must match the clinical problem. Walking may help reduce inactivity, but it will not adequately treat muscle loss, weakness, or low bone density. Different exercise modes have different therapeutic mechanisms. That is why exercise prescription should be approached with the same clinical discipline as any other therapy: the right treatment, for the right patient, at the right time. My latest SubStack article explores the principles of exercise prescription in oncology and why skeletal muscle should often be a primary therapeutic target. open.substack.com/pub/profrobnew…

@protocol_nash I agree 100%. Recovery is almost as important as the exercise medicine. Sleep is the most significant recovery strategy and we work hard to help our patients with this.

@ProfRobNewton Curious whether the Substack addresses recovery state. Even with perfect prescription — right mode, right dose — a sleep-deprived or dehydrated patient won't respond the same way. The exercise stimulus lands, but the adaptive response is different.

Excited to share our latest paper, just published in the Journal of Ageing and Longevity: “The Effect of Boosting Dietary Lactobacillus and Phytochemical Rich Foods on Biomarkers of Longevity—A Phase II Randomised Placebo Controlled Trial.” mdpi.com/2673-9259/6/2/… In this double-blind randomised controlled trial involving 208 older men with untreated early prostate cancer on active surveillance, we found that boosting phytochemical-rich foods was associated with improved grip strength over 4 months, and that the addition of a Lactobacillus probiotic was linked to even greater improvements in grip strength, lower neutrophil-to-lymphocyte ratio, and higher testosterone at trial completion. Grip strength is a practical and meaningful marker of health span and ageing, so these findings add to the growing interest in how diet, gut health, and targeted nutritional strategies may influence functional ageing. Importantly, the interventions were also well tolerated. This work highlights the potential synergy between phytochemical-rich foods and probiotics, and points to the need for larger and longer studies using more definitive clinical outcomes. Congratulations to my co-authors and collaborators on bringing this study to publication. #Research #HealthyAgeing #Longevity #Nutrition #GutHealth #Probiotics #Phytochemicals #GripStrength #ProstateCancer #ExerciseMedicine

FitMed is supporting me to deliver workshops on precision exercise oncology in London and Lisbon this June - I am hugely thankful for the support. FitMed has put two modules together, the first entirely online which students complete at their own pace. The second is a face to face practical workshop which I am very excited to be teaching. Full details are available at FitMed Academy: fitmed.com/fma-exercise-o…

Is it safe for people with cancer to exercise? Or are we asking the wrong question? The issue is not whether patients can exercise. The issue is whether we are screening and prescribing it properly. Cancer is a chronic disease. The same structured risk assessment we apply in other chronic conditions should apply here — with additional consideration for treatment effects, bone health, and symptom burden. In practice, exercise safety is not determined by avoiding activity. It is determined by: • appropriate screening and risk stratification • correct setting and level of supervision • adjustment of mode, intensity, and dose • ongoing monitoring and autoregulation When this is done properly, nearly all patients can participate safely — including those with advanced disease. In Part 7 of my Substack series on Exercise as Medicine in Oncology, I outline: • how the ESSA screening framework applies in cancer • how risk determines supervision and exercise setting • how to use perceived exertion to guide intensity • when exercise should be modified vs paused Exercise safety in oncology is not about restriction. It is about precision. Read the article here: profrobnewton.substack.com/p/exercise-ris… #Cancer #Oncology #ExerciseMedicine #ExerciseOncology #ClinicalPractice

I’m delighted to be speaking with the Us TOO New York Prostate Cancer Support Group at an upcoming online session this week. Patient-led support groups play an incredibly important role in helping people navigate a prostate cancer diagnosis. They create a space where patients, partners, caregivers, clinicians, and researchers can learn from one another and share practical insights. In this session I’ll be discussing the science and clinical evidence behind exercise as a therapeutic strategy in prostate cancer — including how structured exercise can: • Improve treatment tolerance and effectiveness • Reduce side effects of therapy • Preserve muscle and physical function • Support long-term survivorship and quality of life It’s always a privilege to engage directly with the patient community and translate the research from the lab and clinic into practical strategies people can use in their daily lives. If you or someone you know is affected by prostate cancer, the Us TOO New York group runs excellent educational sessions. More information: ustoonewyork.org hashtag#ProstateCancer hashtag#ExerciseOncology hashtag#CancerSurvivorship hashtag#ExerciseMedicine hashtag#PatientSupport

Is exercise safe for people with cancer? This question still limits the use of exercise in oncology. Clinicians worry about complications. Patients worry about doing harm. The result is that exercise is often diluted into vague advice to “take it easy” or avoided altogether. The evidence tells a very different story. Across hundreds of clinical trials, structured exercise has demonstrated a very strong safety profile in cancer populations — including patients with advanced disease and bone metastases. In the recent global INTERVAL-GAP4 trial in men with metastatic prostate cancer, participants completed a demanding program of moderate- to high-intensity resistance and aerobic exercise with high adherence and very few exercise-related adverse events, despite extensive metastatic disease and ongoing systemic treatment. The greater risk for many patients is not exercising at all. In Part 6 of my Substack series on Exercise as Medicine in Oncology, I examine: • how safety should be assessed • absolute vs relative contraindications • exercise modification for bone metastases, neuropathy and treatment toxicity • why exercise does not compromise cancer treatment intent Exercise in oncology is not a lifestyle option. It is a clinical intervention. Read the article here: profrobnewton.substack.com/p/safety-contr…

Cancer-Related Fatigue and the Role of Exercise (Part 5) Fatigue during cancer treatment is not simply “low energy.” It reflects complex physiological changes including inflammation, skeletal muscle loss, mitochondrial dysfunction, endocrine disruption, and reduced cardiovascular capacity. In this SubStack article, I examine: • Why prolonged low-intensity aerobic exercise may be insufficient • Why resistance training is central to fatigue management • How interval-based exercise can deliver effective stimulus efficiently • The role of autoregulation and precision prescription Exercise for cancer-related fatigue is not about “doing more.” It is about applying the correct dose to target the underlying mechanisms. Read the full article via the link below. This post is part of my ongoing series on exercise as medicine in oncology, drawn from the framework developed in my book "MyExerciseMedicine for Cancer". open.substack.com/pub/profrobnew… #Cancer #ExerciseMedicine #Oncology #CancerRelatedFatigue #Rehabilitation #ClinicalExercise

I’ve just published Part 4 of my Substack series on exercise as medicine in cancer care. This article focuses on a question that is often poorly addressed in oncology settings: how exercise dose, intensity, and progression actually determine biological and clinical effect. The piece examines: 1) why exercise effects are dose-dependent, not activity-dependent 2) why intensity must be interpreted relative to physiological capacity 3) how under-dosing fails to activate key mechanisms 4) how exercise is appropriately progressed, maintained, or regressed during treatment 5) why resistance exercise cannot be optional in cancer care A central theme is that exercise should be prescribed and adjusted using the same principles applied to other cancer treatments: mechanism, dose, timing, and tolerance. You can read Part 4 here: open.substack.com/pub/profrobnew… This series is based on the framework developed in my book MyExerciseMedicine for Cancer and is written for clinicians, researchers, and patients interested in mechanism-driven exercise oncology. #Cancer #Oncology #ExerciseMedicine #Rehabilitation #CancerCare #ClinicalPractice