Exercise guidelines for cancer patients

Research has shown that exercise is safe, possible and helpful for many people with cancer.

What is physical activity?

Being physically active means any movement that uses your muscles and more energy than when you’re resting. Being physically active doesn’t have to mean joining a gym or an exercise class. It can also be walking to the shops, walking up the stairs, gardening or dancing.

There are two types of physical activity:

• aerobic – this uses more oxygen and improves the way your heart (cardiovascular system) works, for example, running
• anaerobic – which increases your muscle strength and mass, for example, weight training

Physical activity can also be of a:

• moderate intensity – this is when the activity makes you feel warmer, and breathe faster, but you can still talk; for example, brisk walking, cycling, swimming, gardening or housework
• vigorous intensity – this is an activity that raises your heart rate and makes you start to sweat and feel out of breath; for example, running, aerobics, netball, football and fast cycling

How active you are and what type of activity you can and want to do will depend on:

• the type of cancer you have
• your treatment and any side effects you hvae
• how physically active you are already
• what activities you enjoy

Why is being physically active important?

Research has shown that moderate and vigorous physical activity reduces the risk of cancers of the:

• bowel (colon only)
• breast – in women who have had their menopause (postmenopausal)
• womb (endometrium)

Being physically active can also help to prevent being very overweight (obese). Research links obesity to a higher risk of getting 13 types of cancers.

Research suggests that just being less sedentary can help as well. So, if you work at the computer get up and move around regularly and when you're watching TV you could get up during advert breaks or between programmes.

There is also evidence that being more physically active can help to reduce the risk of some cancers coming back. 

How being more physically active can help

There are very good reasons for being more physically active. It can improve your quality of life and help you feel better. Regular physical activity can reduce stress and give you more energy.

Research has shown that there is strong evidence that certain ways of being active can help people with cancer:

• reduce anxiety
• improve depression
• reduce fatigue
• improve quality of life during and after cancer treatment
• prevent or improve lymphoedema (a type of swelling caused by treatment to lymph nodes)
• improve general physical functioning

Guidelines

It is difficult to write exercise guidelines to cover everyone. Everyone is different in terms of how much exercise they can do. And there are many types of cancer and treatments. In general, if you have cancer, you should check with your doctor before starting any exercise.

International guidelines say that it is safe to be active during cancer treatment and after. Also, people with cancer should try to be active and get back to their normal activities as soon as possible.

The UK government and the World Cancer Research Fund (WCRF) have suggestions to help prevent cancer and other conditions. They say that all adults should try to do at least one of the following ways of exercising:

• 150 minutes of moderate intensity activity per week; for example, 30 minutes 5 times per week
• 75 minutes of vigorous activity per week

All adults should also try and build strength twice a week; for example, weight training or yoga.

Remember that everyone is different and exercise needs to be tailored to you. Take into account your fitness, diagnosis, and other factors that could affect safety.

When to avoid certain types of physical activity

People with certain types of cancer or having particular treatments might need to avoid some types of exercise. There are some situations where you need to take extra care.

Cancer affecting your bones

If you have cancer affecting your bones, you might be more at risk of a break or fracture. You must avoid putting too much strain on the affected bones. You could try swimming or exercising in water. The water supports your body weight, so the skeleton isn't stressed. Exercise such as yoga generally appears safe for everyone.

Low immunity

People with low immunity due to treatment should try to avoid exercising in public gyms. Ask your medical team when it is safe to start exercising in the gym with other people. This doesn’t mean you can’t be physically active in other ways.

Peripheral neuropathy

Some people have a loss of sensation, or feelings of pins and needles, in their hands and feet. This can be due to cancer treatments. It is called peripheral neuropathy. If you have this, it might be better to use a stationary bike than to do other types of weight bearing exercise.

After certain types of surgery

After certain types of surgery, you might have to wait before you can exercise like you used to. Talk to your doctor or specialist nurse for advice on what types of exercise you can do.

Getting started

It's fine to start being more active whether:

• you have just been diagnosed
• you're having treatment
• you have recently finished

How much you do depends on how fit you are generally. You can start by making a few small changes. For example you could start by walking around your house or walking around the block or even getting off the bus one stop early. 

If you aren't very physically active, you'll need to build up gradually. If you do too much one day, you might feel very tired and sore the next day. Don't feel that you always have to do more than yesterday. Some days you'll have more energy than others.

Start with short chunks (10 to 15 minutes) of gentle activity. Then gradually build up until you reach your target.

Try and stay active. You can break up periods of rest with activities around the house, for example, mowing the lawn or ironing.

Find activities that are enjoyable as you are more likely to stick to it. But try not to let past lack of activity put you off starting altogether. Gentle walking or swimming is fine for just about everyone. You can still build up day by day.