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Tara Loader Wilkinson

Veteran mountaineer Petra Thaller does not easily accept defeat – especially from cancer.
In 2014, the German mother-of-two, then aged 53, was hiking the Carstensz Pyramid – also known as Puncak Jaya – which at 4,884 metres (16,024 feet) is Indonesia’s highest peak.
She found it odd that she felt so tired on the climb. At one point, while crossing a river, she hurt her breast, which immediately swelled up and felt tender and sore.
On her return to Germany, her doctor found five malignant tumours in her breast. Treatment was aggressive: lymph node removal, chemotherapy, a mastectomy and then radiotherapy.
Less than two years later, while still in treatment, two small nodules – diagnosed as “precancerous” – were found in her other breast.
Although no treatment was required at that stage, she felt as if she was back at square one, she says over Zoom from her home in Munich, Germany.

Her doctor supported her decision to have that breast removed and reconstructed as well.
Thaller kept her life as normal as possible.
“I think being ‘a patient’ often makes people sicker, psychologically. When people say, ‘I’m ill, I’m suffering,’ it doesn’t make you feel better,” she says.
“A lot of the time I barely thought about it. I said to my kids, ‘Don’t treat me as if I am ill.’ I went shopping, cooked, was a single mum, carried on working. It’s my way of doing things.”
To stay alive and thrive, stay active
An incredibly fit person, Thaller continued to live an active life: running, mountaineering and swimming with her children, and not slowing down in her job as the publisher and editor-in-chief of an outdoor sports magazine.
During her cancer journey, Thaller was surprised at others’ lack of awareness that outdoor physical activity was a good complement to prescribed treatment for cancer survivors.

In 2015, wanting to help others, she set up Outdoor Against Cancer (OAC), which went on to become an international NGO. She began holding free weekly training sessions in a park, along with mountain hikes and night hikes in public spaces, all designed for cancer survivors.
Later, she trained trainers to hold their own sessions.
Through OAC, Thaller began to get the word out about the importance of structured exercise and physical activity for cancer survivors to a broader audience in Europe, speaking at summits, conferences and other events.
She leans on science to support her message.
She joined forces with exercise physiologist Rudolfs Ceseiko in 2023, who shares her commitment to preventing cancer or its recurrence through physical activity and exercise. He is now OAC’s exercise expert and adviser.
On his Facebook page, he notes that “there are more than 30,000 studies on the valuable importance of physical activity in oncology [cancer], including our own research”.


4x4 training boosts physical and mental health
Ceseiko’s master’s degree studies in Norway focused on so-called 4x4 training. He had started leading these types of outdoor sessions for cancer patients in rehab camps in 2017.
The 4x4 training method is high-intensity interval training consisting of a six-minute warm-up, followed by four intervals of four minutes of higher intensity training, interspersed with three minutes of active recovery.
The method significantly improves maximum oxygen uptake, or VO2 max, the maximum amount of oxygen your body can use during intense exercise, Thaller says.
The higher this is, the better your health. It is a good predictor of your risk of getting diseases like heart disease, type 2 diabetes or certain cancers.
The risk of cardiovascular disease and early death is lower in people with high VO2 max compared with those with low VO2 max. People who can raise their VO2 max over time will lower their risk of disease.
This is why 4x4 training “can be a highly effective method for improving cardiovascular and metabolic health”, says Thaller.

Ceseiko is one of OAC’s regular hosts for the free training sessions.
“It must be emphasised that these activities not only promote physical health, but also improve mental well-being if they are done regularly and structured,” he says in a Facebook post.
“If you are plagued by fear, ignorance, depression, powerlessness, anxiety or you want to know how you can help yourself with physical activity medicine, feel free to join 4x4 outdoor classes.”
Thaller is a keen believer in the healing power of nature, which is why all of OAC’s classes are held outdoors, usually in public parks.
“One of the most important aspects for cancer survivors is maintaining quality of life and mental stability, and reducing fatigue. Being outside helps with that. A better state of mind also helps people better tolerate chemotherapy and radiotherapy.”
In 2018, Thaller wrote a book in German with sports scientist Dr Thorsten Schulz about her journey, called Outdoor Against Cancer: How Exercise and Sport in Nature Help Fight Cancer – Faster Recovery, Better Quality of Life, Better Prognoses.

Schulz researches the links between cancer and sports at the Technical University of Munich in Germany, and oversees the OAC coach training programme that is part of the university’s sport and health for life programme.
OAC now has a presence in 18 countries – including Morocco, Spain, Portugal, Austria and Latvia – and has 800 certified trainers.
Exercise links to improved cancer recovery well documented
From her own experience, and that of hundreds who have been helped by the OAC method, Thaller was already convinced that exercise helps cancer sufferers. Scores of studies support this.
A 2021 report in the British Medical Bulletin, titled “Why exercise has a crucial role in cancer prevention, risk reduction and improved outcomes”, reviewed 180 studies on the effects of exercise and physical activity on cancer.
It noted that “a physically active lifestyle and, particularly, supervised exercise rehabilitation programmes after cancer are linked to an improvement in many common adverse effects across multiple types of cancer”.

It concluded: “The importance of physical activity before, during and after cancer treatments is being appreciated as emerging evidence indicates that exercise improves several common side effects associated with cancer therapies and correlates with an improved overall survival and a lower probability of relapse.”
‘Exercise can prevent cancer recurrence, death, better than drugs’
A landmark study published in June in The New England Journal of Medicine adds persuasive evidence to the growing pile.
Researchers recruited 889 mostly late-stage colon cancer patients who had started chemotherapy after having had surgery.
Half were assigned to a group that took part in a three-year structured exercise programme, working with coaches twice a month to help them reach a goal of three to four 45- to 60-minute walks each week. The others were given health education, including on the value of exercise and nutrition.
It found that the exercise programme was linked to significantly longer disease-free survival and longer overall survival.

The results were presented at the annual meeting of the American Society of Clinical Oncology (ASCO) in Chicago, in the US state of Illinois, in late May.
Dr Julie Gralow, ASCO’s chief medical officer, said in a release: “For the first time in the history of medicine, there is clear evidence that exercise can prevent cancer recurrence and death better than many of the drugs currently prescribed to patients.”
Dr Pamela Kunz from the Yale School of Medicine and an ASCO expert in gastrointestinal cancers added: “Post-treatment exercise is both achievable and effective in improving disease-free survival. Exercise as an intervention is a no-brainer and should be implemented broadly.”
Thaller’s mission is to expand OAC’s work to help do just that. She stresses the importance of patient empowerment in taking charge of their own well-being.
“It’s not just the fight against cancer, it’s about enhancing health to contribute to society. We are all responsible for our own health. It’s not just the doctors’ task. You have to save your own life.”
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Wellness

How exercise helps cancer survivors stay alive and thrive, and 1 way to boost VO2 max

Petra Thaller leads a group on a mountain hike. The veteran mountaineer set up Outdoor Against Cancer after her own cancer diagnosis in 2015, to help convince others of the power of outdoor exercise in helping cancer survivors heal. Photo: OAC

Petra Thaller celebrates atop Carstensz Pyramid in 2014. Photo: Petra Thaller

Thaller on a trek while undergoing chemotherapy treatment in 2015. Photo: Petra Thaller

After she set up Outdoor Against Cancer, Thaller began to get the word out about the importance of structured exercise in cancer patients’ recovery. Photo: Instagram/petra_thaller

Rudolfs Ceseiko leads a free morning 4x4 session. Photo: Facebook/ceseiko

Thaller, wearing a bandana, does strength training exercises outdoors in 2015. Photo: Petra Thaller

Ceseiko leads an outdoor 4x4 training session. Photo: Facebook/ceseiko

How a breast cancer and PTSD survivor reinvented herself as a strength and mobility coach

Korean-American strength and mobility coach Han-mi Walsh-Riddle exercises at the gym at Soho House in Sheung Wan, Hong Kong. Photo: Jelly Tse

Walsh-Riddle competes in the the 2024 IKO Hong Kong Kettlebell Championship in November 2024. Photo: courtesy of Han-mi Walsh-Riddle

Walsh-Riddle at the Soho House gym in Sheung Wan. She says the PTSD that followed her cancer treatment was the beginning of her mental health struggles. Photo: Jelly Tse

Walsh-Riddle’s next plan is to earn a certification in nutrition. Photo: courtesy of Han-mi Walsh-Riddle

How to lower cancer risk by up to 30 per cent? Exercise, eat more whole plant-based foods, and avoid drinking alcohol, scientists say

Can adopting practices such as exercising and quitting drinking help lower your risk of getting cancer? And if so, by how much? New research has some answers. Photo: Shutterstock

Dr Eugene Kwan, in Hong Kong, says studies have demonstrated the substantial impact of regular exercise in preventing several types of cancer. Photo: Dr Eugene Kwan

Maintain a weight as low as possible within the healthy range throughout your life to lower cancer risk. Photo: Shutterstock

Dr Anna Herby is a dietitian and nutrition education specialist at the Physicians Committee for Responsible Medicine in the United States

You may want to give the snack food aisle a miss, to limit consumption of fast foods and processed foods high in fat, starches, or sugars. Photo: Shutterstock

To lower cancer risk, choose water over alcoholic or sugar-sweetened beverages. Photo: Shutterstock

Whole grains, vegetables, fruit, and beans dominate a whole-food, plant-based diet, which can be powerful for cancer-risk reduction. Photo: Shutterstock

No time for daily exercise? Being a weekend warrior can have the same health benefits

Santina Philips (right), a personal trainer whose gym in Hong Kong runs high-intensity workouts three times a week,  known as “Bear Camp”, for people too busy to exercise daily, with a client, Kimberly Kwok, a mother of two who runs multiple businesses. Photo: Dickson Lee

Santina Philips (right), a personal trainer and founder of Ursus Fitness, whose gym runs high-intensity weekend workouts known as Bear Camp, with client Kimberly Kwok, a participant in them. Photo: Dickson Lee

Kimberly Kwok, busy during the week raising her children and running multiple businesses, has been doing high-intensity Bear Camp weekend workouts at Ursus Fitness for 10 years. Photos: Dickson Lee

The Weekend Warrior Workout at Hong Kong University combines different exercises for a complete fitness challenge, says Venus Chan, a trainer at the Centre for Sports and Exercise. Photo: Venus Chan

Weekend workouts can be a starting point from which participants gradually add more exercise sessions as they start to feel the benefits, says Santina Philips, personal trainer at Ursus Fitness in Sai Ying Pun, Hong Kong. Photo: Dickson Lee

Kimberly Kwok is aware of the need to avoid overexertion at weekend workouts and mindful about preventing muscle strain and fatigue, making sure to stretch, warm up and cool down. Photo: Dickson Lee

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Lifestyle

Health & Wellness

Health

Mountaineer Petra Thaller, who survived breast cancer, leaned on exercise to thrive in recovery and set up an NGO to help others do the same


Mountaineer Petra Thaller, who survived breast cancer, leaned on exercise to thrive in recovery and set up an NGO to help others do the same.


How exercise helps cancer survivors stay alive and thrive, and 1 way to boost VO2 max

.css-1c6uqr6{color:inherit;font-weight:inherit;font-size:inherit;font-family:inherit;line-height:inherit;overflow-wrap:break-word;}Mountaineer Petra Thaller, who survived breast cancer, leaned on exercise to thrive in recovery and set up an NGO to help others do the same

Mountaineer Petra Thaller, who survived breast cancer, leaned on exercise to thrive in recovery and set up an NGO to help others do the same