Doctor’s Orders: Exercise as Part of Cancer Treatment

You may already know the benefits of exercising. From boosting energy to reducing stress and improving mental function, being physically active is important for your health. Research has also shown that physical activity is linked to a lower risk of several types of cancer. But can you work out if you already have cancer?

Key takeaways:
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    Exercising is generally safe during cancer treatment. Based on new guidance, oncologists are encouraged to recommend exercising as part of cancer therapy.
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    Some benefits of exercising during cancer treatment include maintaining health, reducing the side effects of treatment, and improved coping.
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    To help make your bones and muscles get stronger, aim for a 30-minute strength-training session at least twice a week.
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    Among other benefits, aerobic exercises help strengthen your heart function. Try 30 minutes of aerobic exercises like walking or cycling five days a week.
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    Remember to discuss your plan to exercise with your oncologist first. Start slow, do what you can, and plan to increase gradually.

Should I exercise if I have cancer?

Yes, but it’s a good idea to check with your oncologist first to see what exercise program is right for you. Exercise is essential to healthy living, and you don’t stop reaping its benefits because you have cancer.

Being physically active during cancer treatment can help:

  • Reduce the side effects of treatment.
  • Improve physical ability.
  • Increase muscle strength.
  • Strengthen your bones.
  • Prevent muscle loss.
  • Improve sleep.
  • Reduce the risk of developing other cancers.
  • Sharpen your focus.
  • Strengthen your immune system.

If you worked out regularly before cancer, you might not be able to continue the same exercise program during treatment. But your cancer care team can help you find an exercise program that’s right for you.

If you weren’t physically active before cancer treatment, your cancer care team could help you create an exercise plan. They will likely recommend that you start slow and work your way up to a more active exercise routine as you can tolerate.

Your personalized fitness plan may depend on many factors, including:

  • Your medical history.
  • Prior exercise and fitness level.
  • The type of cancer you have.
  • The types of treatments you’re receiving.
  • Other medical conditions you may have.

What does the research say about exercising with cancer?

In May 2022, the American Society of Clinical Oncology (ASCO) released new recommendations supporting exercise during active cancer treatment. The researchers examined scientific reviews and randomized clinical trials for the previous four years.

They concluded that cancer care providers should recommend that people undergoing cancer treatment – either chemotherapy or radiation therapy – take part in regular aerobic and strength-training exercises. These types of exercises were also found to be beneficial for people before and after lung surgery.

Some of the benefits of exercise highlighted in this study include:

  • Decreased side effects of treatment such as fatigue.
  • Maintained heart and lung functioning.
  • Improved quality of life.
  • Reduced anxiety and depression.

Let’s say you have early-stage breast cancer and are receiving chemotherapy, this new guideline would apply to you as long as your oncologist gives you the approval.

This is the first guideline that specifically addresses the effects of exercise during cancer treatment. The scientists of this study also looked at diet and weight management strategies during cancer treatment but did not find enough evidence to make specific recommendations.

What kind of exercises should I do when I have cancer?

A mix of physical activity will give you a well-rounded fitness routine. The recommendation is for at least 150 minutes of moderate-intensity aerobic activity (or 75 minutes of vigorous-intensity aerobic activity) per week. You should also aim for two days of muscle-strengthening activity per week.

Moderate-intensity aerobic activity

Any activity that raises your heart rate counts as moderate-intensity aerobic exercise. So, you can try aerobic exercises like:

  • Walking at a moderate or brisk pace.
  • Bicycling.
  • Swimming.
  • Doing yard work.

For example, you can walk 30 minutes a day for five days a week or walk for 50 minutes 3 times a week. Do what you can as long as you’re getting some movement.

Muscle-strengthening activity

When it comes to muscle-strengthening exercises – also called resistance training or strength training – are activities that make you use your muscles to build endurance and make you stronger. When you’re less active, your muscles may become weak, and you lose muscle mass.

Some examples of strength-training exercises are:

  • Lifting weights.
  • Pilates.
  • Squats.
  • Lunges.
  • Push-ups.

Consider strength training 2 times a week. Each day, pick a strength-training exercise and aim for 2 sets of 8 to 12 reps.

For example, on day 1, you can do 8 to 12 squats, take a break, then do another set of 8 to 12 squats. On day 2, you may do 2 sets of 8 to 12 lunges. Start small and work your way up.

Should I avoid certain types of exercise if I have cancer?

While the research showed strong evidence to support exercise during cancer treatment, you may need to take extra precautions.

If you’re receiving chemotherapy and your immune system is low, you should avoid using public gyms. But you can be physically active in other ways, such as walking, going up and down the stairs, doing yoga, and stretching exercises at home. Don’t have dumbbells at home to lift weights? Try using canned goods or milk jugs.

Some types of cancer can affect your bones, causing them to be weak and at risk of breaking. In this case, talk to your cancer care team about the safest exercises for you. It’s best to avoid high-impact activities like running and jumping up and down. Swimming may be a good option to give your heart and lungs a good workout without putting too much stress on your bones.

If your platelet count is low, you may bleed easily. In this case, your healthcare provider may recommend limiting all activity or doing modified exercises like those that don’t involve resistance. A leisure walk may be a good alternative.

Certain cancer treatments can damage the nerves in your hands and feet, causing a loss of sensation, tingling, weakness, and numbness. This is called peripheral neuropathy. Because peripheral neuropathy can also cause problems with balance, you should avoid certain types of exercises like strength training.

You may have exercise restrictions after certain types of surgery. Get your healthcare provider’s approval before resuming physical activity after surgery.

Quick tips for exercising during cancer treatment

  • Talk to your oncologist before starting any exercise program during cancer treatment.
  • Discuss with an exercise therapist who is familiar with exercises for cancer patients.
  • Set an exercise goal for each week.
  • Consider the days you don’t particularly feel good and work around them.
  • Plan to exercise on the days you have the most energy.
  • Start with a warmup routine to prepare your body.
  • Start slow and gradually build up intensity and duration.
  • Listen to your body and remember to rest too.
  • Pick exercises that you enjoy and you’re likely to stick to.
  • Drink plenty of water to stay hydrated.
  • Protect yourself from the sun.
  • Find an exercise buddy.
  • Remember to cool down after you exercise.
  • Don’t feel bad if you miss a day of exercise, and be patient with yourself.

If you’re receiving cancer treatment, discuss your exercise plan with your cancer team first. Being physically active during cancer treatment may help reduce some side effects, increase energy, improve muscle strength, and help you cope. Aim to do some movements on most days, but listen to your body.


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