Carly Bailey is the Director of Physical Activity and Integrative Oncology at UNC Cancer Center. She is a graduate of The University of South Carolina’s undergraduate curriculum in exercise science and UNC-Chapel Hill’s graduate curriculum in exercise physiology. Carly gained experience as a research coordinator for exercise oncology studies at UNC and then as the research and program coordinator at Cedars-Sinai with the Cancer Survivorship program.
Carly helps build and maintain the cancer center’s physical activity programs in her current position at UNC, like Get Real and Heel and The HealthScore Health Coaching Program. She also serves as a liaison between the cancer center and the community and is a certified exercise physiologist and board-certified health coach.
I recently had the pleasure of speaking with Carly and asked her some questions about the importance of exercise while managing a cancer diagnosis.
What inspired you to go into this line of work, and what was your career trajectory?
Initially, I thought I wanted to be a doctor, but after I spent some time volunteering in the hospital in college, I realized that I wanted to serve patients differently. So, I applied to grad school at Carolina for exercise physiology to work under Claudio Battaglini. I had always been interested in cancer and knew that I wanted to help people affected by cancer feel as good as possible and get stronger through exercise. Working with Dr. Battaglini launched my career into research and introduced me to Bill Wood. Working with Dr. Wood as his research coordinator right out of school allowed me to combine the three things, I am passionate about- exercise, cancer, and research. From there, I have progressed into program management and can help our exercise and wellness programs grow to benefit as many patients as we can.
Please tell us about Get Real and Heel and the recent renovations.
Get Real, and Heel (GRH) is a 16-week exercise program for people affected by cancer. Most of our participants have completed their primary therapy, but we are open to people with any cancer diagnosis, stage, or treatment course. GRH provides aerobic, strength, balance, and flexibility training daily, currently via zoom, to our participants for free. Participants work in small groups with expert trainers to help them start moving in a safe (and enjoyable!) way during and after their treatment. Our building just underwent a major remodel, and we are excited to return to our in-person programming later this spring! We plan to continue to offer remote programming so we can meet the exercise n
We opened up the upstairs, so it went from three smaller rooms to one large room. This will allow us to increase the number of people we can have work out at one time and enable us to safely facilitate group exercise classes, like yoga. Our locker rooms were in desperate need of beautification! So, we added tilework to the vanity, created a private changing area, and updated our fixtures. We also installed new floors new light fixtures and updated the paint in the whole building for a more modern look. Finally, we are getting lots of new cardio equipment and installing a large flower garden outside of our facility to make it even more welcoming and beautiful!
What are some of the benefits of exercising during cancer treatment?
There are so many! Exercising during treatment can help manage symptoms like fatigue, anxiety, depression, and pain, and it can also improve quality of life and physical function. Additionally, exercise is just plain good for you- it improves your strength, endurance, flexibility, cardiovascular health, decreases weight, improves well-being and quality of life, and can also decrease the risk of cancer recurrence in some cases.
Does exercise improve survival rates?
The data are looking that way in certain cancers like breast, prostate, and colon cancers. We also believe that exercise decreases the risk of recurrence in some cancers. We definitely know that for most people, exercise is safe and beneficial.
How does exercise for someone with a cancer diagnosis differ from regular exercise?
It usually doesn’t! The guidelines for those affected by cancer and the general population are the same. Everyone should be getting 150 min of moderate-intensity aerobic activity per week, be doing whole-body strength training at least twice a week, and stretching regularly. People with a cancer diagnosis need to consider the location of bone lesions if they have them. Their treatment could affect how their heart functions if they have lymphedema or other limitations. It’s important to start slow and ask your care team if you have questions.
Are the exercises the same, or are they customized to fit the patient?
Customized exercise is usually best for anyone. For someone affected by cancer, it’s important to consider surgeries, treatments, and the presence and location of bone lesions before starting an exercise routine. So, in that way, exercise is customized. However, most people affected by cancer can do most exercises. It’s best to start at a lower intensity and work your way up as you get fitter and stronger.
Some oncology patients experience depression and anxiety, can exercise help with that? Absolutely!
There is lots of evidence that exercise is really helpful in managing those symptoms! The great part about this is that it doesn’t take a high volume of exercise to see a big difference in these symptoms.
What are some issues that may prevent a cancer patient’s ability to exercise?
Most patients can exercise safely. If there are bone lesions, we would want to avoid load-bearing exercises in those areas. If a patient has low platelets, hemoglobin, or a fever, we would not want them to exercise until they are back to normal. If there is ever a question, they should ask their doctor or care team.
Can patients with lymphedema benefit from exercise?
Yes! The data show that exercise doesn’t cause lymphedema to worsen (we previously thought it could). It’s essential to wear your compression garments while you exercise, and if you notice volume changes, stop and consult your doctor or physical therapist.
What are some of the stereotypes about a cancer diagnosis and exercise?
I think people forget how strong they really are and start believing that they can’t do the things they want physically. But just because you have cancer doesn’t mean that you shouldn’t be exercising! Your body can still do amazing things and getting started with an exercise program is a great way to ease into a “new normal” during or after treatment.
Can regular exercise help prevent cancer?
Yes, we believe that exercise is protective for certain cancers- for both an initial diagnosis and recurrence.
What else should I have asked about this important topic that I have not?
I think it’s important to remember two things: 1. Be patient with yourself as you get into exercise. It might feel different or new to you, but the benefits are really worth it. If you’re struggling with motivation, finding a buddy can be helpful. 2. Doing something is ALWAYS better than doing nothing! If you’re too tired to go for a walk, maybe walk to your mailbox or do a loop around your house. Start small and celebrate your successes! Make it a goal to do a little something every day, and before you know it, you will be hitting the guideline goals of 150 min per week!
Are there resources you can share with patients who want more guidance on what kind of exercises would be suitable for them?
Physical therapy is great for people who need help with their function and can prevent injury before you start getting into a new exercise routine if you are really deconditioned (your care team can help you decide if you need PT before starting). Patients at UNC and its affiliates can join our free outpatient exercise program called Get Real and Heel- we offer remote exercise (and in-person soon!) for people who have been affected by cancer. The American College of Sports Medicine has a Pro Finder on their website that you can use to find cancer-certified exercise specialists in your area. The YMCA’s Livestrong program is also a great (and free!) way to get started and is in many YMCAs across the state.
Do you have a favorite exercise that you recommend for patients? Why is it your favorite?
Walking is usually the best place to start. You don’t need any fancy equipment, it’s a chance to get outdoors and get some fresh air, and the data indicate that walking is beneficial for cardiovascular, bone, and mental health.
Thank you, Carly, for all the great work you and your team are accomplishing with oncology patients and for participating in this interview!