A medical research study examining the effects of mild individualized cardiovascular activity in renewing the energy of cancer survivors

A joint venture between

  • The Climb Back from Cancer™ Foundation
  • The Tom Baker Cancer Centre (Calgary, Alberta, Canada)
  • The University of Calgary

*The Climb Back from Cancer™ Protocol is in the experimental stages and hence this document is for discussion purposes only. Until full clinical trials of the protocol are completed and the results are peer-reviewed, approved and published, use of The Climb Back from Cancer™ Protocol must not be undertaken without proper supervision by qualified medical professionals and exercise physiologists in a controlled and properly equipped environment. If you wish to assume any and all risks in trying the protocol, you must first consult a physician. If your physician approves your participation, you must then professionally engage a fully qualified exercise physiologist(s) before becoming involved in any activity related to the protocol. Thereafter, all activity sessions must be supervised by this professional(s) in a proper setting. Failure to comply with any of these directives could result in loss or change of health, accident, injury, or death to the participant and/or those around them. Therefore, all risks are those of the participant(s). Neither the author(s), Climb Back Inc., The Climb Back from Cancer™ Foundation, the Tom Baker Cancer Centre, the University of Calgary, any member of the Survivor Fatigue Study team nor any other associated individual(s), institution(s), entity(s) or body(s) whatsoever, whether named or unnamed, assume any liability whatsoever. Any and all risks are entirely those of the participant(s).

Please feel free to share this information with others. If you do, please attribute it as follows:
© 2004 Alan Hobson (Updated December 2013)
2-Time Cancer Survivor,
Founder, The Climb Back from Cancer Survivorship Program
Protocol Co-Creator

Together, we can make a difference.

The Survivor Fatigue Study

The Challenge of Fatigue

  • The American Cancer Society estimates that 70% to 100% of cancer patients experience fatigue during their illness
  • More than half report that they feel extremely fatigued almost daily
  • On top of that, up to 30% of cancer survivors report a loss of energy after treatment
  • The physical, psychological, emotional, interpersonal and economic results of fatigue may …
  • be more debilitating than pain and nausea
  • be more devastating than loss of mobility, income, or self-esteem
  • continue long after treatment, even indefinitely
  • Physically, patients may experience reduced mobility, vitality and energy and as a result be unable or uninterested in engaging in any physical activity, even playing with their children or grandchildren
  • Psychologically, they may become depressed, anxious and irritable
  • They may also experience frequent mood swings and be unable to focus mentally
  • Emotionally and interpersonally, they may disengage from friendships and other relationships and feel very alone
  • Economically, they may be unable to earn a living, make payments or pay bills
  • In short, they may be breathing, but they may not actually be living
  • Everyone from children through seniors is affected
  • The human cost is catastrophic
  • The economic cost in lost income and productivity, absenteeism and the financial burden placed on government(s) is equally massive
  • So is the burden on private industry
  • Every year, North American insurance companies pay hundreds of millions of dollars in short- and long-term disability insurance claims to support fatigued survivors
  • As we continue to search for the all-important cure for cancer, millions of survivors struggle daily to climb back
  • Every 7 seconds in North America someone turns 50
  • As the 79 million Baby Boomers approach retirement, and the incidence of cancer increases with age, the number of patients is also increasing and with it the number who are facing fatigue
  • Because 2 of every 3 cancer patients now survive, the challenge of chronic fatigue after treatment grows daily as well

The Discovery – Renewable Energy

A team of leading oncologists, psychologists, and exercise physiologists at the University of Calgary and the Tom Baker Cancer Centre in Calgary, Alberta (north of Montana) are researching the effectiveness of physical activity protocols that could help millions of cancer survivors renew their energy and recapture their lives. Based on my experiences with mild individualized physical activity after a blood cell transplant for cancer of the blood (acute leukemia), The Climb Back from Cancer™ Protocol could be one potentially effective method of helping patients and survivors climb back to better lives.The Survivor Fatigue Study in progress. Exercise physiologist, Dr. David Smith (second from right), of the University of Calgary’s Department of Kinesiology, oversees a survivor’s climb back.

The Method

Out of a group of 259 survivors of blood cell and bone marrow transplants (25-30 percent of whom were severely fatigued), 13 survivors volunteered to participate in a pilot study. Although the number of participants in the pilot was small, it was significant because the individuals selected were experiencing high to extreme levels of fatigue. One participant had been unable to return to work full-time for eight years after a bone marrow transplant because of fatigue. Others were experiencing varying degrees of weariness. All wanted help.Participants followed an individually tailored and regularly adjusted mild aerobic activity protocol based on their heart rates and blood lactate levels (essentially a by-product of physical activity). They engaged in mild to challenging cycling on stationary bicycles three times a week for 15-30 minutes per session. Researchers unearthed some intriguing findings.

Results of the Pilot Study

After only 12 weeks of activity, participants were able to:

  • Regain the energy levels of the normal adult population
  • Reduce anxiety, anger, and depression by 65 percent

These findings are unprecedented in the history of cancer recovery research for survivors of blood cell and bone marrow transplants, traditionally those who experience some of the worst levels of chronic fatigue.

Bone Marrow Transplantation (2006), 1-10. © 2006 Nature Publishing Group

Read Published Pilot Study Results: BMTexercisefinal


The numbers running vertically from the bottom to the top along the left side in the chart indicate energy levels. An energy level of 35 to 40 is roughly equal to that of the normal adult population. The numbers running horizontally from left to right along the bottom of the chart are the identification numbers for each participant, with two bars above each participant. The bar on the left (in blue) is each participant’s level of fatigue before entering the study. The bar beside it on the right (in green) is their level of energy after 12 weeks on The Climb Back from Cancer™ Protocol. A quick glance reveals that…

1. All 13 of the participants experienced an improvement in their energy levels.
2. Nine of the 13 participants, almost 70 percent of the sample, achieved a return to energy levels of the normal adult population.
3. Six of the 13 participants, almost 50 percent of the sample, doubled or almost doubled their energy levels in just 12 weeks.

After a test to individualize his activity, a study participant takes a breather (literally) in the Human Performance Laboratory at the University of Calgary.

The Climb Back from Cancer™ Protocol at a glance

Session A: 30 minutes of easy* cardiovascular activitySession B: (2 days later) 15 minutes of hard(er)* cardiovascular activitySession C: (2 days later) 20 minutes of moderate* cardiovascular activity*The intensity of each activity session is tailored to each participant based on the results of fitness tests conducted by qualified and trained exercise physiologists under the supervision of an oncologist or other qualified physician.


The Next Step

With the two-year pilot study completed, Phase I followed. It involved survivors of three of the most common types of cancer — breast, prostate and colorectal. For respiratory reasons, participants with lung cancer were not able to participate. This study and the pilot cost a total of $300,000. The money was raised from private donors, the Community Opportunity Foundation of Alberta, two Hike for Hope events in 2006 and 2007 and other channels.Over a period of three years, the candidates used the same Climb Back from Cancer™ Protocol used in the pilot study and compared it to results of participants who followed the physical activity guidelines of the American College of Sports Medicine (ACSM, currently regarded as the standard). Unfortunately, due to challenges in recruiting and maintaining a sufficient number of study participants, it was not possible to have a group that followed neither The Climb Back from Cancer™ Protocol nor the ACSM guidelines. In research circles, this is called a “control group.”

Results of the Phase 1 Study

The results of Phase 1 were inconclusive, due largely to an inability to keep candidates consistently involved because they were going in and out of treatment. Only 11 of each group (Climb Back from Cancer & ACMG Guidelines) were able to be recruited and as noted above, there was no control group. This now begs the question…what do we do next?

The Future

I am currently seeking a forward-thinking healthcare organization to demonstrate that we can use The Climb Back from Cancer™ Protocol and other physical activity programs to reduce the demands on the healthcare system, decrease disability insurance claims and improve the quality of life of survivors and caregivers. If you know of any such progressive organizations and/or have professional contacts within them, please contact Alan Hobson at [email protected].