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鈥淚f it weren鈥檛 for this place, I鈥檇 be dead,鈥� said a man wearing a baseball cap and a black T-shirt.   

He鈥檚 sitting in a chair at the front of the exercise room, his blood pressure being taken by a student. 鈥淚 would just sit at home, depressed.鈥�  

Another woman wearing gray leggings and a long sleeve T-shirt arrived, visibly upset. But within 20 minutes, she was working out on an exercise bike, laughing with two students.   

This is a normal Friday morning at the Ben Nighthorse Campbell Center, the one-story brick building home to the 猫咪tv Cancer Rehabilitation Institute (猫咪tvCRI). The sound of interns and practicum students encouraging their patients could easily be mistaken for the upbeat chatter of friends as they get to work on that day鈥檚 exercises. Their treatment is based on extensive medical training and best practices. Their goals are both lofty and weighty鈥�鈥�鈥�help cancer patients live better, longer lives.   

However, watching the smiles widen on the faces of patients, students and staff, it鈥檚 clear that the work done here is powerful in ways not fully explained by science, at least not yet.  

The Power of Exercise  

When Carole Schneider, Ph.D., a 猫咪tv professor of Sport and Exercise Science, was diagnosed with cancer in 1995, her treatments left her struggling with side effects like fatigue and muscular weakness. Then, there was little research on the effect of exercise on cancer survivors. But she and her doctor saw how the benefit of exercise directly counteracted the toxicities of her cancer treatment.   

Schneider quickly realized this area of study had the potential to greatly improve lives. So, she enlisted the help of her colleagues Cad Dennehy, Ph.D., and Dr. Sue Carter. With their help, they established 猫咪tvCRI in 1996 to study the role of exercise in cancer survivors鈥� rehabilitation.  

Today, the institute is recognized as a frontrunner in exercise-based cancer rehabilitation and is the only facility of its kind. 猫咪tvCRI has served over 1,000 adult cancer survivors with all types of cancer in various stages of treatment. More than 500 students participated in this experiential learning, conducting clinical and basic research in cancer rehabilitation.   

In fact, researchers at Memorial Sloan Kettering Cancer Center published a study in 2023 in the Journal of Clinical Oncology that found people diagnosed with cancer who regularly exercise reduced their risk of dying from all causes by 25% compared with people with cancer who did not exercise.  

Exercise Oncology: Extending Life  

Students at UNCCRI work directly with patients during their rehabilitation work. Buck Covington is the current graduate assistant at the institute and a doctoral candidate in the Exercise Physiology program. When Covington learned about the work 猫咪tv was doing in exercise oncology, the use of exercise in addition to cancer treatments to help patients, his entire career trajectory shifted.  

 鈥淸My advisor] was telling us about [猫咪tvCRI] and the field of exercise oncology in general, and immediately I was enamored with the idea,鈥� said Covington, who before that, planned to go into a physical therapy program.  

In August of 2020 when Covington first arrived at UNC, he was a doctoral student intern at UNCCRI working with individual patients on their rehabilitation plans. Both then and now, the institute opens bright and early at 7 a.m., with patients coming in every hour for hour-long appointments. Students chat informally with their patients to see how they鈥檙e feeling that day before starting their session.   

Students are right there with their patients every step of the way. Students take a completely hands-on approach in every session, from taking vitals to leading the patients in aerobic activity and resistance training.   

Patients participate in a four-phase program, with the first three phases lasting 12 weeks and the last phase lasting as long as they like. Each phase is fully customized to each patient by their student intern. At the beginning of each phase, patients undergo an extensive evaluation to establish their fitness baseline, which students and researchers use to gauge fitness maintenance and progress.  

Giving Hope, Gaining Wisdom  

While patients reap the many benefits of exercise and a student intern to keep them accountable, the students benefit from their patients as well.  

鈥淭here does seem to be some sort of effect between having a younger population of students who are learning and looking forward in life and more hopeful about the future, [work] with someone who鈥檚 maybe at the end of life, or at least not looking forward the same way we are,鈥� said Covington.  

鈥淚 think it causes a synergistic effect where we鈥檙e imparting hope on them, and they鈥檙e imparting wisdom and guidance on us.鈥�  

Covington has personally gone above and beyond for his patients. At one point, a patient鈥檚 health deteriorated to the point that they were no longer able to come into 猫咪tvCRI for their treatment. Rather than allowing that to be the end of the patient鈥檚 relationship with 猫咪tvCRI, Covington and another student went to the patient鈥檚 house multiple times a day, five days a week for nearly a year.   

鈥淭hey were there up until the day he died. That鈥檚 the kind of commitment that a lot of these kids have. It means that much to them,鈥� said Reid Hayward, Ph.D., director of 猫咪tvCRI.  

For Clay Drake, 鈥�90, 猫咪tvCRI has been a game changer in his cancer treatment.  

When Drake was diagnosed with multiple myeloma, a type of cancer affecting the white blood cells that produce disease- and infection-fighting antibodies, in 2016, he was given five years to live based on the aggressiveness of the cancer. Despite that, Drake didn鈥檛 focus on the timeframe. Instead, he decided to do everything he could to improve his health.  

Even at points when Drake鈥檚 treatment wasn鈥檛 working, or he had to spend multiple months in the hospital, he never stopped trying to get ahead of his diagnosis. He underwent experimental procedures, including two different stem cell transplants using both his and a donor鈥檚 stem cells.  

It wasn鈥檛 until about a year after undergoing the stem cell transplant that Drake found out about UNCCRI, and it ended up making all the difference.  

鈥淲hen I first started going [to 猫咪tvCRI], I couldn鈥檛 use my left leg, but it changed everything. We were at a point where we didn鈥檛 know what we were going to do. And here I am, nine years later, talking about this place,鈥� said Drake.  

Drake has been a patient at UNCCRI for about eight years now and has full use of his left leg.  

He credits the structure of 猫咪tvCRI鈥檚 program with holding him accountable to exercise. Drake and other patients know that when they don鈥檛 go into 猫咪tvCRI it doesn鈥檛 just affect them, it affects their student interns too. Throughout their course of rehabilitation, they develop a mutually beneficial relationship where patients gain strength and improve their health, and the students gain hands-on experience working with patients.   

Each relationship is different, with some developing a deeper bond than others. The relationships Drake has fostered with his student interns have each been distinct. One student, with whom he trained for two and a half years, had a particularly significant impact on him.   

鈥淗e just got a job with UCHealth in Denver. He鈥檚 going to be doing some rehab-related stuff 鈥� and he鈥檚 going to find his way. That鈥檚 the kind of stuff that鈥檚 more powerful to me than just the exercise piece. Certainly, the exercise is why we do it, but it鈥檚 also about the relationships,鈥� said Drake.  

To this day, Drake and that former student keep in touch, golfing together at least once every summer. Drake even tried helping their partner find a job when he learned they were trying to move closer.  

鈥淚鈥檒l do whatever I can if that鈥檚 the direction they want to go and I can help them,鈥� said Drake, 鈥淚 will absolutely do it.鈥�  

The Science Behind the Exercise  

The strength and depth of the relationships built at UNCCRI are a testament to the culture that鈥檚 been developed from the very beginning.  

Hayward has poured his heart and soul into the institute since 1998. Schnieder was Hayward鈥檚 advisor while pursuing his master鈥檚 degree at the University of Kansas. He was almost immediately recruited to work at UNCCRI after its inception.   

Hayward鈥檚 background in cardiovascular pathophysiology, the study of disorders affecting the heart and blood vessels, was a natural match for the institute. Many of the chemotherapy drugs and radiation drugs cause damage to heart tissue, called cardiotoxicities. Hayward鈥檚 expertise in that area, coupled with his understanding of the healing properties of exercise, made him the perfect addition to the small but mighty team.  

From the beginning, 猫咪tvCRI studied the effects of exercise on the cardiotoxicities of chemotherapeutic drugs. Some of their findings show that exercise does protect the heart from the negative effects of chemotherapy.   

Exercising allows the heart to create proteins that pump the toxic drugs out of the heart, reducing the damage they can cause. Hayward and his team found that those toxicity-fighting proteins are not created inside tumors, but instead they add protection to the heart without affecting the drugs鈥� ability to fight the cancer.   

The research conducted at UNCCRI today is examining new ways to understand the correlation between exercise and cancer recovery.   

For example, one study looks at lactate, a naturally occurring chemical compound produced by the body when cells break down carbohydrates for energy. Lactate is produced at higher rates when oxygen levels are low, such as during exercise.  

猫咪tvCRI students are evaluating whether there is a difference in how quickly patients break down lactate before and after their 12-week session at the institute. Finding a difference would allow researchers and practitioners to better understand how the program affects metabolism and how it can improve different health markers related to cancer.   

Another study is evaluating whether exercising at certain times of day impacts the body鈥檚 ability to maximize the benefits of exercise therapy.   

Since its founding, 猫咪tvCRI has produced more than 150 national presentations, journal articles and manuscripts culminating in a published textbook. International and national educational programs in addition to public and private consulting firms that teach others how to implement and manage cancer rehabilitation centers have recognized 猫咪tvCRI as a leader in the field.  

Every patient who comes through 猫咪tvCRI鈥檚 program has their data, such as their cancer treatment history and vitals, saved in the institute鈥檚 database. Saving current patient data for future use allows students to look back and evaluate whether a certain variable might have an impact on patient outcomes before they actually design a study around it.  

A Culture Built on Personal Care  

While 猫咪tvCRI is doing incredible work on the quantifiable aspects of cancer rehabilitation, the interpersonal aspect that so many patients emphasize has its own profound effects.   

鈥淭here鈥檚 something that happens between the students and the patients. It鈥檚 something that I can鈥檛 describe because it鈥檚 more than the sum of its parts. There鈥檚 synergy there that happens with them,鈥� said Hayward.  

The hands-on work that students do with patients results in innumerable positive health outcomes. But it鈥檚 the relationships they build that keep patients coming back.   

The community fostered at UNCCRI has a profound impact on the lives of both students and patients, giving students invaluable career experience and patients the ability to take aspects of their health into their own hands, literally. The powerful connection and care patients experience from students and staff at UNCCRI plays a vital role in forging a transformative rehabilitation experience. 猫咪tv