Exercise During Cancer Treatment

Aprobado por la Junta Editorial de Cancer.Net, 06/2022

Exercise is an important part of a cancer treatment plan. A growing amount of research shows that regular exercise can greatly improve physical and mental health during every phase of treatment. Even if you were not active before your cancer diagnosis, an exercise program that meets your unique needs can help you get moving safely and successfully.

What are the benefits of exercise for people with cancer?

There are many benefits to exercise during cancer treatment. Some of these include:

Improve how treatment works and reduce treatment side effects. In general, exercise can improve the body's response to treatment, no matter the stage or type of cancer. Regular exercise has been shown to:

  • Reduce treatment-related fatigue

  • Maintain heart and lung fitness, physical ability, and strength

  • May reduce feelings of anxiety and depression, and improve quality of life

  • After surgery for lung cancer, decrease the amount of recovery time needed in the hospital

In some studies, exercise has also been associated with better survival rates for certain cancers, including breast cancer and colorectal cancer.

Improve overall health status. In general, exercise can improve a patient's overall health. Some of the health benefits of exercise include:

Reduce risks of co-existing conditions and other cancers. Co-existing conditions are other health concerns that you have in addition to cancer. Regular exercise may:

  • Reduce the risk of developing co-existing conditions, like heart disease and diabetes

  • Help manage co-existing conditions you already have

  • Reduce the risk of developing other cancers

Improve mental health. Exercise has been shown to reduce the risk of depression and anxiety.

Before you exercise during cancer treatment

Always talk to your doctor before you start an exercise program during or after cancer treatment. If you were physically active before treatment, you may or may not be able to follow the same exercise routine as before while you are receiving treatment.

After treatment, it will take time to return to your pre-cancer fitness level. Talk with your health care team about what exercise program is right for you. They might give you the go-ahead to start to exercise on your own, or they might suggest a cancer rehabilitation program or a qualified cancer exercise specialist who can design the best exercise program for your unique situation. You may be able to follow the plan independently or you may need to work with the cancer rehabilitation clinician or exercise specialist for some time. Your unique exercise plan will depend on:

  • The type of cancer you have

  • The treatments being used

  • The side effects you are experiencing

  • Your level of fitness

  • Any other health problems you might have

There are also group fitness programs, such as LIVESTRONG at the YMCA, designed to help people living with or beyond cancer stay physically active. Learn more about how cancer survivors can get exercise support.

Building your exercise program

Based on the available scientific research, ASCO recommends that people with cancer take part in aerobic and strength-training exercise during cancer treatment. However, there is not enough research on exercise during cancer treatment for ASCO to recommend a specific amount and type of exercise to reduce the side effects of cancer treatment. 

The information below provides an overview of exercise recommendations that have been shown to be helpful in supporting general health and could be considered during and after cancer treatment.

Stretching. Stretching regularly can improve flexibility and posture. It helps increase the flow of blood and oxygen to the muscles, and it can help your body repair itself. Stretching is often helpful if you have been inactive while recovering from cancer treatments. For example, radiation therapy can limit your range of motion and cause your muscles to stiffen, and regular stretching during and after can improve mobility and flexibility. After surgery, stretching can help break down stiff scar tissue and restore range of motion in order to get you back to regular activities of daily life.

Balance exercises. Loss of balance can be a side effect of cancer and its treatment. Balance exercises can help you regain the function and mobility you need to return to your daily activities safely. Maintaining good balance also helps prevent injuries, such as falls. Learn more about balance exercises after cancer treatment.

Aerobic exercise. This kind of exercise is also known as cardio, a type of exercise that raises your heart rate. It strengthens the body's heart and lungs and can help you feel less tired during and after treatment. Walking is an easy way to get aerobic exercise. For example, your health care team may suggest walking 40 to 50 minutes, 3 to 4 times per week, at a moderate pace.

Strength training. Muscle loss often happens when a person is less active during cancer treatment and recovery. Some treatments also cause muscle weakness. Strength training, or resistance training, helps you maintain and build strong muscles. Increasing muscle mass can help improve your balance, reduce fatigue, and make it easier to do daily activities. It can also help fight osteoporosis, a weakening of the bones that some cancer treatments can cause.

The U.S. Centers for Disease Control and Prevention (CDC) recommend 2 days of full body strength training each week. A strength training program can include hand weights, exercise machines, resistance bands, and your own body weight. Learn more about safely strength training and stretching.

How to exercise safely during cancer treatment

If you are having side effects from cancer or its treatment, it is important to take safety precautions while exercising. You may have to change your exercise plan depending on your specific side effects. For example, if treatment is affecting the nerves in your hands, weight machines may be safer to use than hand weights. Or if treatment has caused bone loss, ask about avoiding exercises that put strain on the neck and raise the risk of falling.

Here are other ways to make sure that you get the most out of your workout plan in a safe way:

  • Start slowly. Even if you were physically active before cancer treatment, build up your level of activity slowly. This can help avoid injury and keep you from getting discouraged.

  • Exercise in a safe environment. If treatment has weakened your immune system, avoid large gyms where germs spread easily. Work out at home or outside if the weather is nice.

  • Listen to your body. If your energy level is low, adjust how long or how hard you exercise until you feel better.

  • Stay hydrated and eat a nutritious diet. Drink plenty of water during your workouts and throughout the day to avoid dehydration. Eating nutritious foods, especially foods high in protein, help your body recover after exercise. An oncology dietitian can help you develop a nutrition plan.

  • See your doctor regularly. Your health can change throughout and after treatment. Talk with your doctor about your important health indicators, such as your blood count, during your regular checkups so you know if it is safe to exercise.

Learn more about steps you can take to make sure your exercise program is safe and successful after treatment.

How is exercise included in a cancer rehabilitation program?

Sometime exercise is done as part of a cancer rehabilitation program. It is important to understand the difference between exercise and cancer rehabilitation. Cancer rehabilitation is a comprehensive treatment program that helps a person regain or maintain their ability to function during and after cancer treatment. Sometimes a person may need cancer rehabilitation to build strength and balance before being able to safely exercise on their own. The exercises included in an overall cancer rehabilitation plan are therapies used to address specific health and movement issues.

Ask your health care team if you would benefit from talking with a cancer rehabilitation specialist. Learn more about cancer rehabilitation.

This information is based on the ASCO recommendations for Exercise, Diet, and Weight Management During Cancer Treatment. Please note that this link takes you to another ASCO website.

Questions to ask the health care team

Consider asking your health care team the following questions:

  • What kind of exercise program do you recommend for me?

  • Could this exercise program change over time?

  • Are there specific kinds of exercise that I should avoid during cancer treatment? What about after my treatment is complete?

  • Do you recommend cancer rehabilitation for me?

  • Do I need to avoid the gym during cancer treatment? If so, what exercises can I do at home?

Related Resources

The Importance of Exercise

An Exercise Program for You: 5 Tips for People With Cancer

Exercise During Treatment: An Expert Q&A

Physical Activity Tips for Survivors

More Information

ASCO: Exercise, Diet, and Weight Management During Cancer Treatment

National Cancer Institute: Physical Activity and Cancer

National Heart, Lung, and Blood Institute: Guide to Physical Activity

National Cancer Institute: Obesity and Cancer Risk