Dr Rebecca Robinson — Exercise, Medicine and Cancer — Injury Rehab Network

The first Injury Rehab Network with BASRaT of 2026 featured a presentation from Dr Rebecca Robinson, Consultant Sport and Exercise Medicine (SEM) Physician at the OrthTeam Centre. The online event took place on the afternoon of Tuesday, 13 January, with 275 sports rehabilitation practitioners in attendance.

Dr Robinson shared insights into exercise medicine and cancer. The recording is available to watch here.

Dr Rebecca Robinson – Sport and Exercise Medicine Consultant

Dr Rebecca Robinson is a Consultant in Sport and Exercise Medicine (SEM) who specialises in the health of athletes at all levels, from junior to international, as well as the physical health needs of individuals with musculoskeletal injuries and long-term health conditions. This also includes looking after people before surgery and during treatment for medical conditions such as cancer.

Her interests include developing care to support female athletes at all life stages and addressing the medical issues associated with relative energy deficiency syndrome (REDS), including bone stress injury assessment and recovery.

She has specialised in sport and exercise medicine since 2016 and works with sports teams (including GB Boxing, LTA, athletics), as well as the NHS.

The treatments she provides include managing physical injuries, from physical assessment to scan referral and rehabilitation medical assessment of physical health, cardiorespiratory fitness and rehabilitation, including in cases of muscle loss and osteoporosis, as well as underlying conditions that limit health and performance (e.g. fatigue, energy deficiency, breathing disorders in sport, exercise with and after cancer).

Exercise, Medicine and Cancer

Her presentation, “Exercise and Cancer,” explored the profound impact physical activity can have on the disease trajectory. Exercise was highlighted as more than a supportive measure, and as a form of medicine that can influence tumour biology and improve survival rates.

The presentation covered:

• Prevention and Protection: How an active lifestyle can reduce the risk of certain cancers, such as endometrial cancer, by improving body composition and reducing visceral fat.
• During Treatment: The role of exercise in optimising the dose of chemotherapy received, improving blood flow to tumours, and managing side effects like fatigue.
• Late Effects: Reducing the impact of long-term side effects, including neuropathy, cardiotoxicity from specific drugs (like anthracyclines), and respiratory function.

The Science: Cellular Mechanisms

She explained the physiological changes that occur with exercise. Cancer cells often rely on “aerobic glycolysis” (a shortcut in energy production), and aerobic exercise appears to disrupt this process, creating an environment that is less favourable for tumour growth.

She noted that “No drug can replicate the benefits of exercise.” Movement and physical activity are therefore vital for maintaining health and preventing disease.

Key physiological benefits include:

• Tumour Metabolism: Direct negative influence on the tumour’s microenvironment.
• Anti-inflammatory Effects: Reduction in pro-inflammatory cytokines (e.g., IL-6, TNF-alpha) and an increase in anti-inflammatory mediators (e.g., IL-10).
• Immune Function: Enhanced immune surveillance and natural immunity.
• Oxidative Stress: Improved regulation of oxidative stress and free radicals.

Prehabilitation

Prehabilitation was discussed as the process of optimising a patient’s physical health before surgical or medical treatment. She referenced the challenge trial (Courneya, 2025) and work from projects like Prehab for Cancer in Manchester, Active Against Cancer in Harrogate, and Active Together in Yorkshire. The challenge trial provides the first level 1 evidence that structured exercise improves disease-free and overall survival.

The evidence suggests that prehabilitation can:

• Enhance functional capacity (VO2 max) before surgery.
• Significantly reduce the length of hospital stay.
• Reduce hospital readmissions.
• Improve overall survival and quality of life.

Case Studies

To bring the science to life, two case studies were shared:

• Ovarian Cancer: A sedentary patient with a low VO2 max (12 ml/kg/min) who was initially deemed unfit for complex surgery (HIPEC). Through a tailored prehab programme, her VO2 max improved to over 14 ml/kg/min, allowing her to undergo successful surgery and tolerate full-dose chemotherapy. She highlighted the dose-response associated with physical activity for inactive individuals, where rapid initial gains are made simply by moving more.
• Multiple Myeloma: A patient with bone lesions and a fear of falling. A multidisciplinary approach (including osteopathy and pain management) ruled out metastatic pain in the sacroiliac joint, allowing for a graded strength programme that restored independence and bone loading confidence.

Safety and Late Effects

A common question addressed was: “Is exercise safe?” Citing Macmillan guidelines, she confirmed that exercise is safe during and after most cancer treatments, provided it is tailored to the individual.

Specific considerations discussed included:

• Bone Metastases: Not a total contraindication. Stability must be assessed, but loading can often be maintained to preserve bone stock.
• Lymphedema: Previous advice to avoid using the limb has been overturned. Graded exercise, combined with well-fitting compression garments, is now best practice to improve muscle pump function and lymphatic drainage.
• Cardiotoxicity: Monitoring for cardiac strain in patients receiving specific chemotherapy agents.

Further information and follow Dr Rebecca Robinson

• Dr Rebecca Robinson at OrthTeam Centre
• 5K Your Way
• Active Against Cancer – Harrogate
• Active Together – Yorkshire Cancer Research
• CanRehab
• Challenge Trial (Courneya, 2025)
• Cancer Research UK article
• Moving Medicine
• Prehab for Cancer – Manchester

Q&A

Dr. Rebecca Robinson kindly answered several questions from the audience following her presentation.

Q1 – Are there differences in exercise effects based on age or gender?

Answer – While biological factors (like menopause or adolescence) play a role, exercise is beneficial for everyone. The key is individualisation, aligning the exercise plan with the patient’s lifestyle and motivation.

Q2 – How do you manage underweight patients struggling to eat?

Answer – Exercise typically won’t exacerbate weight loss if dosed correctly and can actually stimulate appetite. She emphasised the importance of working with dietitians, especially in upper GI cancers, to use supplements and calorie-dense foods (cake) to support the metabolic demand.

Q3 – Is exercise recommended for bed-bound patients (e.g., with sciatica)?

Answer – Yes. Even bed-based or chair-based movement is vital to prevent rapid deconditioning. Small movements can improve blood flow, mood, and mobility. Resources like 5K Your Way offer chair-based options.

Q4 – Are short bursts of exercise effective?

Answer – Yes. Recent papers (Jan 2026) suggest even 10-minute bouts of activity can trigger beneficial gene expression changes in cancer cells.

Q5 – What is the guidance for lymphedema?

Answer – Graded exercise is key. Ensure the patient has a well-fitting garment and seek advice from a specialist physio (e.g., CanRehab trained). Resistance training helps rebuild muscle, which aids lymphatic clearance.

Presentation Recording

The recording of Dr Robinson’s presentation is available to watch here.

2026 Injury Rehab Network events

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