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Exercise after a cancer diagnosis

If you are being treated for cancer or recovering, you may have thought it was important to rest, but research shows that exercise benefits most people with cancer during and after treatment.

Being active can help manage some of the common side effects of treatment, speed up recovery, and improve your quality of life. For some cancers, exercise may even improve how you respond to treatment. Being physically active, along with eating a healthy diet, can help reduce the risk of the cancer coming back
(recurrence) for some cancer types. It also helps reduce the risk of developing other health problems, such as heart disease and diabetes.

According to the Clinical Oncology Society of Australia (COSA) position statement on exercise in cancer care, exercise should be prescribed to all cancer patients as a standard part of their cancer care to help manage the effects of cancer and its treatment. Exercise & Sport Science Australia (ESSA) also encourages people with cancer to exercise.

Exercise for people living with cancer should be tailored to suit the type and stage of cancer and any side effects. 

How exercise can ease common side effects

Cancer treatment causes various physical effects that are different for different people. Exercise has been shown to help ease some of these.

Side effectBenefit
fatigueFeeling tired, even when rested, is common in people with cancer. Sometimes it lasts for months after treatment ends. Staying active can help ease fatigue. Try adjusting how hard and how often you exercise – some people find shorter, frequent aerobic sessions are more manageable; others prefer strength-based training. Losing fitness and strength can make fatigue worse. Doing some low intensity exercise can help you maintain your fitness and strength (unless you have severe anaemia).
anaemiaLow red blood cell and/or haemoglobin count is another common side effect of cancer treatment. Symptoms of anaemia include unexplained tiredness and fatigue. Combined with good nutrition, exercise has been shown to improve anaemia. For mild or moderate anaemia, try a low-intensity exercise program, with gradual increases in intensity and/or duration. If anaemia is severe, ask your doctor about whether you should avoid exercise until it improves.
quality of lifeStudies show that physical activity can help improve quality-of-life issues, such as body image/self-esteem, wellbeing, sexuality, sleep disturbance, social functioning, anxiety, fatigue and pain.
mood changesFeeling anxious or depressed during and after treatment is common. Exercise encourages the brain to produce chemicals (endorphins) that can improve your mood.
loss of muscle strengthIf your muscles aren’t being used as much as usual during and after treatment, they can get weaker. Losing muscle strength is also a side effect of some types of hormone therapy and steroid treatment. Strength training will help make your muscles stronger.
heart problemsRadiation therapy to the chest and some types of chemotherapy and targeted therapy drugs may damage the heart muscle and increase the risk of heart problems (cardiovascular disease) after treatment. Aerobic activities can help reduce the risk of long-term heart problems.
loss of bone strengthCancer and its treatment, particularly radiation therapy, can have long-term effects on bone strength. Early menopause and some types of hormone therapy may also cause bones to weaken and break more easily (osteoporosis). Exercise that requires you to support your own body weight will help keep your bones strong.
lymphoedemaStarting an exercise program early in treatment may reduce the risk of developing lymphoedema, which causes swelling of part of the body, such as an arm or leg. If you have lymphoedema, a lymphoedema practitioner can help you develop an exercise plan.

Side effects that need extra care

Some side effects need extra care, and you may have to frequently adjust how hard and how long you exercise. Speak to your doctor, physiotherapist or exercise physiologist for help with this.

Cancer affecting the bones – If you have cancer in the bones (called bone metastases or bone mets), you might be more at risk of a break or fracture. Choose activities such as walking and swimming, rather than contact sports and activities such as running and jumping.

Low white cell count (neutropenia) – Some cancers and treatments can weaken your immune system and cause your white blood cell count to drop. This can increase your risk of developing an infection, so it is important to limit physical contact with other people and clean any shared exercise equipment before use. When your immune system is not working well (immunocompromised), avoid public spaces such as gyms, swimming pools and training venues until your white blood cell count returns to a safe level.

Low platelet count (thrombocytopenia) – Platelets stop bleeding in the body by forming clots. When the platelet count drops, you are at increased risk of bruising or bleeding. It is best to avoid contact sports and high-impact activities, as these could cause bruising or bleeding if you get knocked or fall over.

Skin irritation – Areas of skin affected by radiation therapy can be extremely sensitive and often uncomfortable. Choose activities and clothing to minimise fabric rubbing on affected areas. Chlorine can irritate the skin, so avoid pool-based exercise if you have a rash or your skin is reddened after radiation therapy.

Poor balance and coordination – Surgery or cancer treatment may affect your balance or coordination. Problems with balance may cause you to feel dizzy and lead to a fall. Choose exercises that improve balance and muscle strength, and avoid types of exercise that involve balance and coordination, such as cycling outdoors or using a treadmill. Avoid lifting free weights without a training partner if you have problems with your balance.

Peripheral neuropathy – Some chemotherapy drugs can damage the nerves causing feelings of pins and needles and numbness in the hands and feet. This is called peripheral neuropathy. If you cannot feel your feet, it may be difficult to maintain your balance and you may be more likely to fall. It’s safer to walk or run on even surfaces. If you have neuropathy in your hands, ask an exercise professional how you can lift free weights safely.

If you have osteoporosis, get advice on exercise from your doctor, nurse, physiotherapist or exercise physiologist.

Featured resource

Exercise for People Living with Cancer

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This information is reviewed by

This information was last reviewed March 2019 by the following expert content reviewers: A/Prof Prue Cormie, Chair, COSA Exercise and Cancer Group, and Principal Research Fellow – Exercise Oncology, Australian Catholic University, NSW; Rebecca Cesnik, Accredited Exercise Physiologist, ACT; Dr Nicolas Hart, Senior Research Fellow, Exercise Medicine Research Institute, Edith Cowan University, and Postdoctoral Research Fellow, Cancer Council WA; Stephanie Lamb, Life Now Project Officer, Cancer Council WA; John Odd, Consumer; Sharni Quinn, Clinical Lead Physiotherapist, Peter MacCallum Cancer Centre, VIC; Chris Sibthorpe, 13 11 20 Consultant, Cancer Council Queensland; Jane Turner, Accredited Exercise Physiologist, Concord Cancer Centre, Concord Repatriation General Hospital, NSW.

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