Interview by Dr. Janette Watkins

When Steven Smith talks about cancer, he rarely begins with the diagnosis.

Instead, he talks about purpose.

For Smith, a cancer survivor, CrossFit coach, NASA educator, and doctoral researcher, the question was never simply how to survive. It was how to make the experience mean something. Looking back on the most difficult period of his life, he remembers making a decision that would ultimately shape both his recovery and his academic career.

“I feel like it’s up to us to make purpose in our lives.” Smith explains. “I don’t think there’s somebody up there saying, ‘I’m going to give Steven cancer, and here’s why.’ So for me, I had to decide what I was going to do with it. I went through cancer myself, and I just wanted to know how I could make it better for other people. I didn’t want it to just have happened.”

That desire to transform suffering into something useful eventually led Smith to pursue a doctorate focused on cancer survivorship. It also led him to discover something that many cancer survivors instinctively understand but that healthcare systems often fail to discuss: the profound role that exercise, strength, and community can play before, during, and after treatment.

Today, as he prepares to defend his dissertation, Smith’s personal story and research findings converge around a simple but powerful idea. Exercise is not merely something that helps prevent disease. For many cancer survivors, it becomes a tool for maintaining identity, preserving agency, and navigating one of the most physically and emotionally challenging experiences imaginable.

Long before cancer entered the picture, Smith had already discovered CrossFit. After a severe bout of COVID-19 left him hospitalized with double pneumonia and lingering lung damage, he knew he needed to make a change. He had spent much of his life engaging in resistance training, but the experience forced him to reevaluate what fitness meant and what his body was capable of.

“I needed something more functional,” he says. “I needed something that would really help me get fit.”

CrossFit quickly became more than a workout. Within months he earned his Level 1 certification, began coaching, and immersed himself in every aspect of the methodology. He completed specialty courses, pursued adaptive athlete training, and became deeply invested in helping others improve their health and performance.

“I drank the Kool-Aid immediately,” he jokes. “I was like, yes, this. Let’s do all of this.”

At the time, he had no idea how important that decision would become.

In October 2022, Smith noticed something unusual while shaving. There was a lump on the side of his neck. Initially, he dismissed it. It wasn’t painful. He didn’t feel sick. Like many people, he assumed it was something minor that would eventually resolve on its own. But when the lump became visibly noticeable, he decided to get it checked.

What followed was the familiar and agonizing process experienced by countless cancer patients. There were scans, biopsies, specialist appointments, and long periods of waiting.

“The worst part of the process is the waiting,” Smith recalls. “You do a scan and then wait for results. Then they do another test and you wait again. Then another test and more waiting. It feels like your whole life becomes waiting.”

Eventually, the diagnosis arrived. Smith had stage IV head and neck cancer.

The news was devastating. Tumors had spread beyond their original location, and additional abnormalities appeared in his lungs and liver. Doctors still needed to determine whether the cancer was HPV-positive, a subtype that responds significantly better to treatment than many other forms of head and neck cancer.

The result carried enormous implications for his prognosis, but it also created one of the more absurd moments of the entire experience.

"Over Christmas, my family was praying that I had an STD," Steven said, laughing. "Which is a weird thing for a family to be hoping for."

Fortunately, the test came back positive for the P16 marker associated with HPV-related disease. The diagnosis was still serious. The treatment would still be brutal. But suddenly the odds were much more favorable. The doctors believed they could cure him. First, however, they would have to put him through some of the most aggressive treatments in oncology.

His radiation oncologist sat down with Smith and his wife and delivered a message that has stayed with him ever since.

“He looked at my wife and said, ‘We’re going to hurt him badly, but then we’re going to make him better.’”

The treatment plan included daily radiation and intensive chemotherapy. Smith knew the physical toll would be significant. What he did not yet realize was just how much of himself he would lose during the process.

Before treatment began, however, he received an important warning. He was told he would likely lose a substantial amount of weight. Unlike many patients who receive that information and simply brace for what is coming, Smith decided to act.

He sought out the help of Dr. Thea Taylor, a CrossFit coach, chiropractor, educator, and respected figure within the CrossFit community. Together, they developed a plan with one objective: build as much muscle mass as possible before treatment started.

“I went to her and said, ‘This is what’s going on and I need to gain as much weight as possible before treatment starts,’” Smith recalls. “She basically said, ‘Say less. Let’s go.’”

The strategy was straightforward but demanding. Smith trained hard and ate relentlessly. He estimates he consumed roughly 4,500 calories per day while preparing for treatment.

“We would finish class and go eat,” he remembers. “Dr. Thea was basically ordering by the page from the menu. She’d take page two, page four, page six. We were serious about it.”

The effort paid off. Smith gained nearly twenty pounds before treatment began, much of it lean mass. At the time, he viewed it simply as preparation. Looking back, he sees it differently.

“I call it a savings account,” he says. “Had I not given myself that savings account to draw from, I wouldn’t be here.”

Within four weeks of beginning treatment, he lost fifty pounds.

“I went into treatment at 225 pounds and came out at 172,” he says. “The weight just disappeared.”

The physical devastation was difficult to comprehend. Radiation damaged his thyroid and eventually contributed to the development of Hashimoto’s disease. Chemotherapy permanently affected his hearing. Eating became painful. Drinking water became nearly impossible. Eventually he required a feeding tube because consuming enough nutrition through normal eating was no longer feasible.

“I got to the point where I couldn’t drink water,” he recalls. “I remember having this craving to take a huge metal bowl full of cold water and just drink as much as I possibly could.”

For weeks, his world shrank to a chair in his home. His days revolved around treatment, fatigue, nausea, and survival.

Yet despite the physical suffering, it was the psychological experience that ultimately became the focus of his research.

“When you’re diagnosed with cancer, a lot of your agency gets taken away,” Smith explains. “Things begin happening to you. People are scanning you, testing you, biopsying you, treating you. You don’t really have much control over any of it.”

That observation became one of the central themes of his dissertation.

Through interviews with cancer survivors, Smith explored the role exercise played during treatment and recovery. Again and again, participants described the same phenomenon. Exercise gave them something they could control.

“What I found was that resistance training gave people back a sense of agency,” he says. “It was something active they could do. It wasn’t replacing treatment. It wasn’t replacing doctors. But it was something they could choose.”

Across interviews, survivors repeatedly described exercise as a way to reclaim ownership of their bodies and their lives. While treatments were being administered to them, exercise became something they were doing for themselves. The theme appeared so consistently that Smith could not ignore it.

“Every participant kept saying the same thing,” he says. “CrossFit and resistance training gave them back a sense of control.”

Equally powerful was the role of community.

One of the strongest findings from Smith’s dissertation centered on the importance of social support during treatment and recovery. Participants consistently described their gyms as places where they found understanding, encouragement, and belonging.

“One of the things CrossFit does best is community,” Smith says. “That community helps preserve who you are when everything else feels like it’s changing [...] community actually preserves a continuity of self during physiological disruption.”

He witnessed that support firsthand. His gym rallied around him. Friends checked in. Family members rearranged their lives to help him navigate treatment. His mother temporarily relocated from Georgia to Houston to care for him, and members of her community adjusted their schedules to support her while she was away.

Perhaps the most surprising finding from his research was what survivors were not hearing from healthcare providers.

Despite overwhelming evidence supporting physical activity and resistance training, very few participants reported receiving meaningful guidance about exercise from their medical teams.

“Out of all the people I interviewed, only one doctor really talked to them about exercise,” Smith says. 

As a result, many survivors turned elsewhere for answers. Social media platforms, podcasts, online influencers, and internet forums often became primary sources of information. Unfortunately, those sources are not always reliable.

“When people can’t get answers from healthcare, they go looking somewhere else,” Smith says. “And a lot of what they find is misinformation.”

That realization has inspired Smith’s next goal.

He envisions a future where CrossFit affiliates, healthcare providers, and organizations like the CrossFit Medical Society work together to create structured support systems for cancer patients.

His concept, called Building Oncology Wellness (BOW), would connect newly diagnosed patients with trained coaches and supportive fitness communities before treatment begins. The goal would be to help patients build strength prior to treatment, remain active throughout treatment whenever possible, and regain function afterward.

“I want people to have support before, during, and after cancer treatment,” Smith says. “I don’t want people sitting alone in a chair the way I did.”

The vision aligns naturally with the growing CrossFit Health Hub movement and the broader mission of the CrossFit Medical Society. It leverages the expertise already present within affiliates while creating stronger partnerships with healthcare systems.

For Smith, the goal is not to build a business empire or create a proprietary model. In fact, he openly encourages others to adopt the idea.

“I want people to steal it,” he says with a laugh. “I’m serious. Take it. Run with it. Help people.”

As he prepares to defend his dissertation and officially become Dr. Steven Smith, his focus remains unchanged. The cancer journey that once threatened to define him has instead become the foundation for a larger mission.

“The point of all of this was to help other people,” he says. “The only way I can do that is by getting the story out.”

His story is ultimately about far more than cancer. It is about preparation, resilience, community, and purpose. It is about the power of building a savings account of strength before adversity arrives—a reserve of muscle, fitness, confidence, and support that can be drawn upon when life becomes most difficult. In many ways, it reflects the CrossFit understanding of health itself. The Sickness-Wellness-Fitness Continuum teaches that health is not a fixed destination but a dynamic spectrum. Fitness expands our margin for error, our capacity to withstand stress, and our ability to recover when challenges arise. 

For Steven, CrossFit was not simply exercise during a cancer journey; it was a mechanism for moving farther along that continuum, building physiological and psychological reserves before they were desperately needed. His story serves as a powerful reminder that the goal of fitness is not merely to perform better in the gym. The goal is to be better prepared for life. And perhaps most importantly, it is a call to ensure that the next person who receives a cancer diagnosis has access not only to medical treatment, but also to the coaching, community, and evidence-based support that can help them move from sickness toward wellness, and ultimately back toward fitness.

*Publishing update: since this article was written Steven Smith has completed his doctoral dissertation and has earned his PhD.