Having previously worked on a project looking into exercise for women with late-stage ovarian cancer, Dr David Mizrahi, The Kids' Cancer Project's Better Challenge Ambassador, discovered an entirely new passion when he began working at the Sydney Children’s Hospital in Randwick.

“I realised none of the kids were getting any exercise support or guidance, and kids should be running around,” says Dr Mizrahi, a Col Reynolds Research Fellow and Accredited Exercise Physiologist at the Daffodil Centre. Dr Mizrahi was recently named the 2023 Accredited Exercise Physiologist of the Year by Exercise and Sports Science Australia (ESSA).

Dr David Mizrahi and Hugo, diagnosed with cancer aged 11,
are both Better Challenge ambassadors this year.

“I realised I could help this group. That’s when I enrolled in a PhD to learn more about what these kids need for their exercise. Nobody in Australia had this knowledge.”

During his PhD, Mizrahi worked with a 10-year-old girl who had struggled with exercise, and with engagement in sport, for two years after her cancer treatment. She had been deeply involved in netball prior to her diagnosis.

Dr David Mizrahi and Hugo, diagnosed with leukaemia at 11, both believe in the power of exercise during cancer treatment.“We ran comprehensive exercise tests, including a VO2 max test on a treadmill. She was so proud of what she was able to achieve during those tests,” Dr Mizrahi recalls.

“We wrote a program around exactly what she needed, and she was really motivated to achieve her goals and get back to sport. That plan involved little bits of speed work, of fitness work, and of coordination work.”

A few months later, the young girl was on her way back to the netball court. Doctors had previously told her that exercise was good, but it had been a blanket statement. Medical experts didn’t understand exactly what to prescribe in terms of exercise. A customised fitness plan made all the difference.

“That was a simple success story, one that taught me a lot about the power of movement” says Dr Mizrahi, who also spent time at St Jude’s Hospital in Memphis on a Fulbright Scholarship before his work was further funded by The Kids’ Cancer Project.

Understanding the complexity of human wellbeing

Exercise oncology is a complex area that requires a lot more work, Dr Mizrahi says.

“It’s a difficult population,” he explains. “We’ve got different types of cancers. We’ve got babies and we’ve got teenagers. We’ve got families who are only just coping, trying to get through the experience. We’ve got kids who love exercise and kids who hate it.”

“Cancer treatment can be so debilitating, over the short and long terms. Almost 99% of childhood cancer survivors develop at least one chronic condition. After cancer treatment, kids are ten to 15 more times likely to get heart disease, and ten times more likely to suffer other conditions like diabetes, osteoporosis, accelerated ageing frailty and many other conditions. We know exercise can help reduce these risks.”

If medical practitioners and exercise physiologists can intervene and offer children an active lifestyle earlier, they can potentially prevent chronic diseases.

“We can help them avoid going into wheelchairs and help them back into school sport,” Dr Mizrahi says. “This helps them socially, psychologically and emotionally. It’s a huge win.”

How does donor funding help?

In a nutshell, Dr Mizrahi says, the more funding his team earns, the more children will receive individualised programs that bring them back to health and mobility more quickly.

So far, donor funding has given the team the capability to scale up its work across two hospitals – Sydney Children’s Hospital and The Children’s Hospital at Westmead.

“I’m trying to offer services to children who have just been diagnosed with all types of cancers, not just one,” Dr Mizrahi says.

“I’m also trying to work across most ages, from five to 18. We’re offering up to five sessions with an exercise physiologist, which mimics what is currently available via Medicare’s Enhanced Primary Care plan.”

Dr David Mizrahi with Owen Finegan (The Kids' Cancer Project CEO), and Hugo

Remote programs are also being offered to children who have completed treatment, to help aid their recovery. 

The current goal is the recruitment of 60 children in hospitals as part of the early diagnosis and treatment study, and another 60 children post-treatment, in the remote, virtual exercise trial.

“Without donor funding and support, we wouldn’t be able to run comprehensive physical fitness assessments to figure out where their specific deficits are,” Dr Mizrahi says. 

Dr Mizrahi also presents at medical conferences around the globe, sharing his knowledge and developing collaborative agreements, currently in place with researchers in the USA, Canada and Europe.

“I’m hoping the work we do, funded by The Kids’ Cancer Project, will not just help patients all around Australia but also around the world,” he says.

The Better Challenge: The magic of movement

Dr Mizrahi is an ambassador for the Better Challenge – which tasks participants to fundraise by taking on 90 kms anyway during September – Childhood Cancer Awareness Month - because it is particularly meaningful to his work and its purpose.

Any movement is beneficial for individuals, he says. For kids with cancer, that movement is even more important.

“When the child is really sick and having a hard time with treatment, just walking up and down the hospital corridor a few times to go to the toilet is great exercise,” Dr Mizrahi says. 

“Sitting in bed, throwing and catching a ball is good movement. Doing light-weight curls with resistance bands in bed counts as exercise. Any movement is good movement to prevent further decline.”

“The Better Challenge is a really nice conversation starter about the importance of exercise for everyone. Exercise makes us feel better physically, emotionally and mentally, and it reduces our risk of other problems.”

Perhaps best of all, he says, is the fact that the Better Challenge raises vital funds that fuel research aimed at improving the lives of kids with cancer.

“How can we improve the lives of kids with cancer?” he says. “It is purely about better treatments and better supportive care. We need to be able to do that work, and unfortunately the government only funds a small percentage of research. 

“So we’re super grateful that The Kids’ Cancer Project supports our work, and benefits the children.”