Exercise and cancer: safe ways to be active during and after cancer treatment

Key takeaways

• If you are new to exercise, any movement you can do is better than nothing and can be built upon. If you have exercised before, talk to your primary care team or a cancer physiotherapist about adapting your regime.
• There are two types of exercise: aerobic and anaerobic. You should aim for a mixture of these cardio and strengthening types of exercise throughout treatment and beyond.
• Many exercise types, such as yoga utilise breath work and meditation. This can aid relaxation and be beneficial during and after treatment.

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Research says that physical activity can help us not just survive but thrive during and after cancer. Whether you are starting out or maintaining an existing exercise regime, it’s helpful to decide what you are trying to achieve from exercising and then determine a safe plan with your primary care team or a cancer physiotherapist.

Here Perci Professionals Kat Tunnicliffe, a cancer physiotherapist, and Lisa Jacques, a cancer nurse specialist and yoga instructor, talk you through safe forms of exercise, their benefits and strategies to keep you safe.

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Exercising during and beyond cancer: where do I start?

By Kat Tunnicliffe, Perci cancer physiotherapist

Exercise is a strongly evidenced treatment which aims to reduce pain, make us stronger for daily function, maximise our quality of life and it can potentially maximise cancer treatment options (Schmitz et al, 2019).

Still it can be hard to create and stick to an exercise programme if you’re tired and sore from treatment and hospital visits. However, any movement you can do is better than nothing. 

If you are new to exercise, start small and work your way up. A good place to start is with something you find fun and enjoyable. Alternatively, if exercise has been a part of your life talk to your core team and get referred for cancer physiotherapy, and get help adapt your exercise regime to suit you in your current situation.

Ask yourself, what are you trying to achieve with exercise?

Do you want to be stronger? Do you want to be more flexible? Do you want to improve your mood? Do you want to improve your overall body composition? Do you want to be able to go to the shops? Do you want to sit on the edge of the bed unaided?

Which exercises match your goals?

It’s important to understand that not all exercise is the same and given time and energy limitations with cancer treatment you may want to focus on your priority goals first to help you decide which activities suit you best. Discuss with a physio which exercise will help achieve your goals.

Do you have any barriers to exercise?

More often than not limitations can be fixed or helped by your primary care team. They can work with you to understand whether it is a side-effect of your treatment that is causing pain or balance issues. Perhaps you are on medications which affect your heart function, so low-impact exercise would be better suited to you. Your team or a cancer physiotherapist can advise you.

What is the best exercise for cancer patients during and after treatment?

There are two types of physical activity:

• Aerobic – this uses more oxygen and improves the way your heart (cardiovascular system) works, for example, running. The ideal would be to do this five to six days a week.
• Anaerobic – which increases your muscle strength and mass, for example, weight training. The ideal would be to do this three to four days a week.

A combination of aerobic exercise & anaerobic strengthening is recommended, totalling 150-300 minutes per week. 

150 minutes of exercise per week can seem daunting if you have never exercised before or in a while, however start small, spending a minute or two each morning and building from there.

Regardless of where the cancer is or has been, it is important to exercise your whole body. We advise people to pace themselves: don’t overdo it on a good day, and don’t underdo it on a bad day.

How can I exercise safely after cancer treatment?

Pain

• Know the difference between exercise soreness and other pain.
• To gain strength and endurance you need to make your muscles work. When muscles are worked effectively small tears are created which signals to the brain to build these muscles up. This pain, known as DOMS, lasts 2-3 days feeling like a dull/achy/stiff feel in the muscle. As you get stronger DOMS will ease but through more intense workouts with more vigor, you may experience it again.
• Shooting, searing, stabbing or catching are concerning, you should lessen the intensity or cease the activity and contact your primary care team.

Balance

• Often peripheral neuropathy can be a side-effect of chemotherapy. Exercise has not been shown to have much impact on pain/sensation changes but exercise won’t worsen neuropathy and has huge benefits on walking tolerance, strength, safety and function.
• If you are having issues with balance, exercise safely through both feet, on even terrain and build up from there. Remember, appropriate footwear is extremely important.

Blood counts

• If you have a low white blood cell count it is still fine to exercise but I recommend doing so in a place where you are less likely to catch an infection.
• If you have low platelet counts, which affects the ability for blood to clot,  do less heavier resistance or impact activities to reduce risk of muscular tearing or falling.

What type of exercise is recommended after breast cancer surgery?

Pain, weakness, stiffness and tightness in the upper quadrant (neck, thoracic spine, ribs, shoulder and arm) can last months or years after breast cancer treatment. It is important to maintain a range of motion for at least a year following the completion of your treatment.

Upper body specific conditioning like paddle sports can be great fun and help with endurance, strength, balance and lymphatic drainage. While yoga and pilates are also great for stretching and stability (in addition to your aerobic activity). A brisk stroll is also extremely beneficial after treatment. Find out about the benefits of walking after chemotherapy.

Can I practice yoga safely during and after cancer treatment?

By Lisa Jacques, Perci cancer nurse specialist and yoga instructor

• Yes, yoga is a great and safe way to stay, or become, active during cancer treatment.  
• Find a yoga teacher with specialist training or experience of working with people who are having cancer treatment, like those on Perci. They will be able to modify the yoga practice to suit you. 
• Listen to your body and work within your own capabilities. The styles of yoga vary widely. More gentle styles of yoga, such as Hatha, Yin and Restorative yoga, are especially likely to suit someone having cancer treatment. 
• Yoga is much more than physical exercise. It includes breath work, meditation and deep relaxation using Yoga Nidra. So even on the days you feel most tired during your treatment, it’s likely there will always be an element of yoga that suits you.

What are the benefits of yoga for people having cancer treatment?

Backed by a growing body of scientific evidence, oncology professionals and cancer charities advocate yoga as a safe, complementary practice. The benefits of yoga go far beyond that of simple stretching exercise and are long-lasting (Chandwani et al, 2014). Research shows yoga can:

• Help people cope with the physical side-effects of cancer treatment and the psychological effects of a cancer diagnosis and treatment.
• Reduce stress for cancer patients.
• Improve people’s physical and psychological condition, quality of life, energy levels, and immunity (Agarwal and Maroko-Afek, 2018).

Meet our full team of cancer experts at Perci Health including online exercise coaches, cancer dieticians and life coaches.

Here at Perci Health, we are here to support anyone that has been impacted by cancer. If you think you or your loved one could benefit from virtual access to high-quality cancer specialists, find out more about our support types or how we help those living with cancer.

While we have ensured that every article is medically reviewed and approved, information presented here is not intended to be a substitute for professional medical advice, diagnosis, or treatment. If you have any questions or concerns, please talk to one of our healthcare professionals or your primary healthcare team.