Returning to work after cancer treatment is never a straight line. While someone might be “medically cleared,” the reality of day-to-day function often tells a different story, one marked by lingering fatigue, reduced stamina, and uncertainty about physical limits.
That was the case for Jackson, a Contract Manager whose return-to-work journey required more than just time off. It needed structure, support, and a strategic approach to pacing and rebuilding.
*Name changed for privacy
The Physiology
Jackson was diagnosed with sinonasal adenocarcinoma and a functional pituitary tumour with acromegaly. Basically said, he was dealing with a rare form of cancer in his nasal passages, along with a hormone-producing tumour in his brain; complex conditions that came with a wide range of symptoms and challenges. After undergoing multiple rounds of treatment and surgery, he was left with persistent fatigue that affected not only his physical capacity, but also his cognitive stamina.
Despite sleeping well, Jackson experienced daily fatigue that disrupted his ability to socialise, exercise and enjoy activities like hiking and biking with his wife. While he had managed working 2 hours per day, 3 days a week, he found himself running on empty, unable to manage the physical and cognitive demands of both work and life.
Exercise Physiology in Action
When Jackson first met with our Exercise Physiologist, Carmyn, the priority for her was clear: build his tolerance for both physical and cognitive fatigue so he could return to full-time work and life, in a way that was sustainable.
Carmyn designed his program with three key pillars:
- Biofeedback & Load Management: She wanted Jackson to monitor his Heart Rate Variability (HRV) daily, allowing her to track recovery and adjust the plan in real time. HRV became a powerful pacing tool, helping Jackson understand when to push and when to rest.
- Functional Strength & Conditioning: With a mix of gym-based strength work and cardiovascular training, Jackson would gradually build the physical capacity he needed to tolerate daily tasks, manage stress and improve his mood and sleep.
- Cognitive Load & Multi Tasking: Carmyn wanted to include cognitive drills, dual-task exercises, memory work and reaction tasks, to help build back Jackson’s ability to focus and perform mentally demanding work tasks without crashing.
Plus Carmyn’s ongoing collaboration with Jackson’s Occupational Therapist, was a key factor that would ensure his return-to-work plan was paced appropriately.
From Surviving to Thriving
Over the course of just ten weeks, Jackson’s physical and mental capacity transformed. His ability to tolerate work, manage stress and enjoy life returned, piece by piece, week by week.
At first, he was only managing a few hours of work spread over three days. But by the end of the program, Jackson had returned to full-time hours and duties. He no longer worried about whether he could keep up or how long he’d last at work. As he put it, he felt like “part of the furniture” again. Settled, capable and back in control.
His fitness metrics told a similar story. Grip strength increased, cardiovascular fitness returned and his muscular endurance nearly doubled in key functional movements like lifting and pressing. Postural tolerances that had previously limited him, like standing or stair climbing, were no longer a barrier.
Perhaps most striking, though, was the shift in his confidence and perception. His self-rated ability across multiple tasks (such as cognitive work tasks and hobbies) increased from 13 out of 40 to a perfect 40 out of 40. His quality of life score more than doubled and fatigue levels dropped sharply.
Jackson even went on a 20-kilometre bike ride with his wife, a milestone that would have seemed impossible just months prior.
Final Thought
For clients recovering from cancer, fatigue is often one of the most limiting and misunderstood symptoms. Exercise Physiology provides the missing link between medical clearance and meaningful recovery, supporting people to rebuild strength, confidence and capacity in everyday life.
If one of your customers came to mind while you were reading this, touch base! We would love to chat about how we may be able to help them write a similar story.
Author: Tessa Nielsen
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