Bridging borders to advance global expertise in cancer exercise treatment

“What truly drew me to the field of exercise as a treatment for cancer was discovering how movement can profoundly improve people’s health.”

For Greek physiotherapy student Vasia Xanthopoulou, being introduced to therapeutic exercise by one of her university professors became the first piece in a puzzle that helped lay the foundation for her future career.

Inspired by a passion for bringing exercise to those who need it most, that moment sparked a journey that recently led Vasia to the industrial heartland and rolling hills of South Yorkshire, where she joined a global effort to improve cancer survival through the power of movement.

A fellowship programme built on collaboration

Along with exercise and physical fitness expert Konstantina Karnarou, Vasia recently completed a transformative visit to Sheffield Hallam University’s Advanced Wellbeing Research Centre (AWRC). 

This was part of a pioneering fellowship exchange programme funded by the Stavros Niarchos Foundation (SNF) through its Global Health Initiative (GHI).

Delivered in partnership with the AWRC and Greece-based nonprofit Regeneration & Progress (R&P), which is funded by SNF, the programme aims to advance global understanding of the benefits of exercise on cancer treatment.

The AWRC is a leading centre for physical activity research and innovation, and Vasia and Konstantina spent time there to learn about Active Together, a research-backed cancer exercise treatment service funded by Yorkshire Cancer Research that helps people prepare for and recover from cancer treatment. 

The service is underpinned by well-established scientific evidence that shows exercise can increase survival, improve recovery from treatment and reduce the risk of cancer coming back. 

Vasia and Konstantina are the latest researchers from Greece to take part in the fellowship programme, and their visit has helped open the door to a rich exchange of ideas.  

By sharing insights from Greece and gaining new perspectives from the Sheffield team, they have discovered learnings that will help shape cancer exercise programmes on both sides of the continent and across the globe.

Learning from leaders in cancer exercise

“I always knew I wanted to work in exercise and sports, even from a young age,” Vasia explained. “I enjoyed basketball and knew I should try to do something with my love of exercise. That’s why I went to university to study physical education and sports science, and that’s when I learned you could use exercise for people living with chronic diseases." 

Vasia completed a bachelor’s degree in physical education and sports science at the Aristotle University of Thessaloniki, before going on to achieve a master’s degree in exercise for prevention and rehabilitation. She is now working towards a second bachelor's degree in physiotherapy at the International Hellenic University in Thessaloniki. 

Personalising Exercise for People with Cancer

During her fellowship at the AWRC, Vasia supported a study that is comparing how healthy people and people with cancer respond to different intensities of exercise. The goal is to use this data to develop more precise exercise guidelines tailored to the personal needs of people with cancer.

For Vasia, her experience at the AWRC has become a “core memory”, helping to clarify her vision for the future and shape the direction of her career.

“The AWRC is more than just a building with beautiful facilities,” she shared. “What’s really great are the people, who are working on so many different things but towards the same goal. From exercise scientists to physiotherapists, they all support each other and collaborate to achieve amazing things. It’s an honour that I got to see a facility like this in person, as we don’t have many similar places in Greece.” 

Assessing Sleep and Balance in Cancer Exercise Treatment

Vasia shared her experience in Sheffield with Konstantina Karnarou, whose love of track and field during high school led her to complete a bachelor's degree in physical education and sports science.

Konstantina said: “Track and field was my passion, but rather than becoming a coach, I saw myself becoming an expert in therapeutic exercise for people with chronic conditions. During my degree this became my speciality, and I also did my master’s degree in this field.”

Konstantina is now based at R&P’s Sports Excellence Lab, which operates under the scientific supervision of the 1^st Orthopaedic Surgery Department of the National and Kapodistrian University of Athens at Attikon General University Hospital. She works closely with cancer patients and people with chronic diseases.

Her role involves delivering therapeutic exercise sessions, conducting performance assessments in elite athletes, and contributing to research. 

During Konstantina’s fellowship at the AWRC, she explored ways to enhance the Active Together programme by integrating sleep and balance assessments; two critical but often overlooked aspects of cancer treatment.

As part of her study, Konstantina spoke to Active Together members about her research, receiving a positive response to her aim to make the service even more holistic. 

“I found a gap in Active Together which we already assess in the Sports Excellence Lab,” Konstantina explained. “People with cancer often face sleep disturbances and a high risk of falls. Poor sleep can not only contribute to depression and fatigue but may also affect the body’s ability to tolerate treatment and cope with the side effects of treatment. 

“Some studies have also shown that poor sleep may impair the body's immune function and hormone regulation, which can make it more difficult for a person to overcome their cancer. By assessing these areas, we can tailor exercise programmes more effectively, improving people’s overall quality of life and hopefully making them even more likely to recover from cancer successfully. Sleep and balance assessments are something the team in Sheffield are now hoping to introduce.”

Inspired by the way different experts work together at the AWRC, Konstantina left Sheffield eager to bring new ideas back to Greece. 

“We have a similar way of working at the Sports Excellence Lab, but there’s room to grow,” she said. “The Sports Excellence Lab is like Active Together but there are not many other examples of this in Greece, and I think there’s no other place where exercise is delivered for people with chronic diseases, so more initiatives like that should be developed in my country and throughout the world.”

Investigating High-Intensity Interval Training for People with Cancer

Now Vasia and Konstantina have returned to Greece, they plan to work together and with researchers at the AWRC to review existing studies and find out how practical and effective high-intensity interval training is for people with cancer. Their project is called ‘Feasibility of High-Intensity Interval Training in Oncological Patients Before, During, and After Cancer Treatment: A Systematic Review’.

High-intensity interval training is physical activity performed at a high level of effort, typically pushing the body close to its maximum capacity. Examples include lifting heavy weights, circuit training, sprinting up hills and spinning classes. Sometimes called ‘vigorous’ exercise, it is known to have multiple benefits for healthy people and is included in the UK Chief Medical Officers’ Physical Activity Guidelines. 

“We want to understand the feasibility of high-intensity interval training for people with cancer before, during and after treatment,” Vasia explained. “Services like Active Together are proving the essential benefits of exercise for people with cancer, but there are many research gaps we still need to address. We need to focus now on understanding how the body of a person with cancer really works. This will help further define what we should consider when delivering an exercise programme.” 

A Shared Mission for Global Impact  

Both fellows were struck by the welcoming nature of Sheffield and the accessibility of green spaces and travel links. They explored cities across the UK, from London to Edinburgh, and found inspiration in the natural beauty and outdoor exercise opportunities of the Peak District.

But beyond the scenery, it was the potential impact that collaborative working could have for the future of exercise for people with cancer that left the deepest impression. 

Vasia and Konstantina’s experiences highlight the power of international collaboration in advancing cancer research and treatment. Through the fellowship, they have not only gained new skills and insights, but also become ambassadors for change, ready to bring innovation and compassion back to their communities in Greece.