Exercising safely when you have cancer
Is it safe to exercise when you have cancer?
It is usually safe to start doing some physical activity before, during or after treatment. It can be hard to think about exercise when you are dealing with the symptoms of cancer or side effects of treatment. But becoming more active may help you cope with this.
If you decide to do some physical activity, it is important to make sure you do it safely. Even if you did regular physical activity before you were diagnosed with cancer, you may need more advice and support to ensure it is beneficial.
If you are fasting for Ramadan or other religious reasons, ask your healthcare professional for advice about exercise. It may be a good idea to concentrate on low intensity exercises for example flexibility.
How often can you exercise when you have cancer?
There are international guidelines for physical activity and cancer. They were developed by the American College of Sports Medicine. The guidelines state:
- physical activity is safe during and after cancer treatment
- you should try to avoid being inactive
- you should try to get back to your normal activities as soon as possible after treatment.
For some people, this can feel overwhelming. You can start slow and try to build up to the recommended physical activity levels. Doing something is better than doing nothing. It is important to listen to your body and do what you feel able to do.
Tips for exercising safely
Here are some general tips for keeping safe when doing any type of physical activity:
- Start slowly and gradually build up the activity you do.
- Do not exercise if you feel unwell or if you have any symptoms that worry you.
- If you have bone problems, you should avoid uneven surfaces and activities that increase the risk of falling. You should also avoid high-impact activities, such as running.
- Wear comfortable trainers or walking shoes.
- Drink plenty of water, so you do not get dehydrated.
- Protect yourself in the sun.
- Have a healthy snack after exercising, such as a banana.
Having some soreness or stiffness for 2 to 3 days after physical exercise and being tired during exercise is common. If you feel very sore or very tired, try to do a bit less the next time.
You should stop exercising if you get any sudden symptoms, including:
- feeling dizzy
- chest pain
- a racing heart
- breathing problems
- feeling sick
- unusual back or bone pain
- unusual muscle pain
- a headache that does not go away.
Speak to a doctor straight away if you notice any of these, or any other symptoms.
If you are having treatment
Surgery
Your cancer doctor might encourage you to start some physical activity before surgery. This can help improve your general fitness level and help with your recovery. This is known as prehabilitation or prehab. We have more information about being active before treatment.
It is important to start moving around as soon as possible after surgery. This reduces the risk of complications, such as blood clots. There may be some activities you should avoid. This will depend on the surgery you have had. For example, you may be advised to avoid lifting anything heavy for a while. Your surgeon, physiotherapist, clinical exercise physiologist or nurse will tell you which activities you should avoid and for how long.
Someone in your healthcare team may show you exercises to do when you get home. For example, people who have breast surgery are usually given arm and shoulder exercises to improve their flexibility. If you had surgery to your pelvis, or near your hips, you may be shown exercises to help strengthen your stomach and pelvic floor muscles.
Try to do any exercises for as long as you were advised to. If you have pain, discomfort or swelling that stops you doing them, tell the physiotherapist, clinical exercise physiologist or specialist nurse.
Radiotherapy
If you have a skin reaction due to radiotherapy, wear loose fitting clothing when exercising. This is to prevent rubbing against any areas of sensitive skin.
You should avoid swimming, as the chemicals in the water can irritate your skin. After treatment ends and any skin reaction has gone, it is fine to swim again. Ask your radiotherapy team for advice about swimming during and after treatment.
Risk of infection
White blood cells help you fight infection. Some cancer treatments and drugs can lower the number of white blood cells made in your body. If your number of white blood cells is low, you are at an increased risk of getting an infection. While your number of white blood cells is reduced, your cancer doctor might advise you to avoid busy public places. This is because you are more likely to get an infection when around lots of people. These places might include swimming pools or gyms. You could try to do some online classes. We Are Undefeatable have some exercise videos on their website.
We have more information about avoiding infection when you have reduced immunity. This includes a video about neutropenic sepsis.
Bleeding and bruising
Platelets are cells that help the blood to clot. Some cancer treatments and drugs can lower the number of platelets made in your body. If your number of platelets is low, you are more at risk of bruising or bleeding. Your doctor may advise you to exercise gently and avoid high-impact activities. This is usually until the number of platelets is back to a safe level.
Anaemia
Some cancer treatments and drugs can lower the number of red blood cells made in your body. If your number of red blood cells is very low, you will feel very tired and sometimes breathless. This is called anaemia. If this happens, you may not feel like exercising or only be able to manage everyday activities. It is important to listen to your body and rest when you need to until the anaemia has improved.
Central and PICC lines
If you have a central line or PICC line, you should avoid swimming. This is because of the risk of infection. You should avoid vigorous upper body exercises, which could displace your line.
If you have side effects or other medical conditions
Some treatment side effects or other medical conditions can affect which physical activities are right for you.
Bone problems
If you have bone thinning or cancer in the bones, you should speak to your healthcare team before doing or starting any exercise. It is usually best to avoid high-impact activities. This is because there is more risk of you breaking (fracturing) a bone with these types of activity.
High-impact activities are things that involve pounding or repetitive actions. This might include jumping up and down on a hard surface or hitting a ball with a racket. Examples of high-impact activities include:
- running
- football
- tennis
- squash
- hockey
- contact sports such as judo and karate.
It may be safe for some people to do some of these activities. This will depend on your personal risk of fracture and whether you have symptoms, such as bone pain.
Some people with bone problems may also be advised to avoid exercises where you repetitively bend forward at the waist. This includes toe-touching and sit-ups. This is because of the risk to the spine and back.
Many types of activity recommend bending and toe-touching as a warm-up. If you have secondary bone cancer in the spine or hip, check with your healthcare team whether this is safe for you to do.
Some low-impact, weight-bearing activities that are usually safe for anyone with bone problems include:
- walking
- dancing
- climbing stairs
- swimming
- cycling
- light-resistance exercises.
It is also a good idea to do some exercises that improve your co-ordination and balance. This is to reduce your risk of falling. These exercises include low-impact dancing and tai chi.
We have more information about primary bone cancer and secondary bone cancer.
Nerve damage (peripheral neuropathy)
Some cancer treatments can damage the nerves. This causes:
- numbness or tingling in the hands or feet
- muscle weakness
- difficulty with balance and co-ordination.
If you are unsteady and at risk of falling, get advice about this. from your healthcare team. You may need help from a physiotherapist.
If your feet or balance are affected, then some activities may not be recommended. These include:
- running or brisk walking, especially on uneven surfaces
- walking up and down steps.
Using an exercise bike or swimming may be more suitable. Remember to check your feet regularly for cuts or blisters.
If you have numbness and tingling in the hands, it may be difficult to use free weights or resistance bands. There are gloves you can buy that are used for weightlifting. These may help you grip the weight. They can also help if the weight is very cold or has a texture that your hands are sensitive to.
Lymphoedema
Physical activity can help you reduce the risk of developing lymphoedema. Or if you have lymphoedema, physical activity can help you manage it.
If you have lymphoedema, it is helpful to do the following:
- If you have a compression garment, you usually need to wear it when you exercise. Speak to your lymphoedema specialist if you find this uncomfortable. Avoid exercises where you use your muscles without moving your body. These are called static contractions. For example, avoid the plank position. This is when you hold your body in a press-up position without moving up and down.
- Swimming can be helpful if you have lymphoedema, as it gently massages the lymphatic vessels.
- Build up the physical activity involving the affected arm or leg slowly.
Ask your lymphoedema specialist for advice. We have more information about lymphoedema.
Heart or lung problems
Most people with heart or lung problems can benefit from regular physical activity. It is important to check with your doctor or specialist nurse before you start any exercise programme. This ensures there are no unstable heart or respiratory issues. We have more information about heart health.
Medicines to thin the blood
If you are taking medicine to thin the blood, you will bruise more easily. Avoid high-impact activities or contact sports, as you could get knocked or fall over. This may lead to additional complications. Take extra care during all activities to avoid damaging your skin.
Stoma
If you have had surgery to the bowel or bladder, you may have a stoma. You may need time to adjust to the changes in your body. This may affect what physical activity you choose to do.
When any other wounds have properly healed, your specialist nurse (sometimes called a stoma care nurse) can help you think about how to do some physical activity with the stoma. They can also advise you on any activities you may need to avoid. They can also refer you to a physiotherapist or clinical exercise physiologist.
We have more information about bowel cancer.
If you have advanced cancer
Doing physical activity is safe if you have advanced cancer. It has many of the same benefits as for people who do not have advanced cancer. It can improve bone health, mood and general fitness. It is important to remember that cancer or side effects of treatment may affect what you can do. Listen to your body and take things slowly.
If you have advanced cancer and want to be more active, the advice is the same as for people who do not have advanced cancer. You should start slowly and gradually build up the amount you do.
If you have advanced cancer, most types of light physical activity are safe, such as going for a short walk.
You can ask your cancer doctor or palliative care team to refer you to a clinical exercise physiologist or physiotherapist for advice before you start any type of exercise. You may need to avoid some types of physical activity. For example, if the cancer is in the bones or you have bone thinning, you should usually avoid high-impact activities such as running, football or tennis.
To start with, try to reduce the amount of time you spend sitting or lying down during the daytime. Moving around the house and doing everyday things, such as cleaning, will help. You may be able to do short walks or gentle stretching exercises. These will help build fitness and flexibility. This can help with daily tasks such as putting on shoes, dressing or washing.
Resistance exercises can also help strengthen your muscles and bones. These help with:
- getting in and out of a chair
- getting in or out of the bath
- going up and down stairs.
Doing resistance exercises and exercises that improve balance can help reduce your risk of falls.
If you were very active before cancer or treatment, you may not be able to do the same amount as before you were diagnosed.
We have more information about advanced cancer.
About our information
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer.
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References
Below is a sample of the sources used in our physical activity information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk
Campbell K, Winters-Stone K, Wiskemann J, et al. Exercise guidelines for cancer survivors: consensus statement from international multidisciplinary roundtable. Med Sci Sports Exerc. 2019 November; 51911): 2375-2390 [accessed February 2023].
www.gov.uk Physical activity for adults and older adults: 19 and over [accessed February 2023].
Date reviewed
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