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Macmillan and Cancerbackup merged in 2008. Together we provide free, high quality information for people affected by cancer through our publications, website and phone service. Find out more|.
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This information has been written for you if you are living with or after cancer and would like to know more about the benefits of exercise and being physically active. We explain how increasing your physical activity can help you to feel better and also include practical advice.
Following a cancer experience many people want to make positive changes to their lives. Taking steps to live a healthier lifestyle is often a major part of these changes.
This information is designed to help you think about what changes you may want to make to your lifestyle and to help you to put these into practice.
If you have any further questions you can ask your doctor or nurse. You may also want to discuss this information with one of our cancer support specialists.
Regular exercise helps people lose weight and feel fitter.
It can also improve their self esteem and sense of wellbeing. Exercise is routinely used to help people recover from heart disease. There’s now evidence about the benefits of exercise for cancer survivors.
It’s often difficult enough for people without health problems to increase their physical activity. Following a cancer experience it’s likely to be a lot harder. You may feel you don’t have the energy or willpower to do exercise, that you don’t know where to start or that it’s too late. But it’s never too late to start.
Inactivity causes our muscles to lose strength and work less well. It can also increase feelings of extreme tiredness (fatigue|), stress and anxiety. Even a little regular exercise can build up your energy levels (stamina) and help you feel better. Exercise also helps people cope with treatment side effects and cancer symptoms.
You may have a cancer that’s curable or that can be controlled for many years. Looking after your general health is important. Regular exercise reduces the risk of heart disease, stroke, diabetes and bone thinning (osteoporosis).
Keeping to a healthy weight may reduce your risk of getting another new (primary) cancer. Some cancers are linked to being very overweight. In certain cancers exercise and maintaining a healthy weight may reduce the risk of the cancer coming back.
There’s still a lot we need to understand about how exercise, weight and cancer are linked. But there’s more evidence about this coming out all the time.
Being very overweight (obese) increases the risk of a number of different cancers. But the evidence is probably strongest for breast cancer (in women who’ve been through the menopause), womb cancer| and bowel cancer|.
The female hormone oestrogen is linked with breast and womb cancer. Before the menopause oestrogen is produced by the ovaries, but after the menopause oestrogen is made by body fat. Being overweight increases the amount of fat in the body and women who are overweight have higher than usual levels of oestrogen. In both breast and womb cancer the more fat there is, the higher the amount of oestrogen the body makes. It’s thought that around 4 out of 10 womb cancers (40%) may be caused by being obese.
Being overweight also increases the risk of bowel cancer. We don’t really know why this is but it might be connected to diet. A healthy diet contains more fibre, fruit and vegetables, which may help lower the risk of bowel cancer. But you’re also less likely to be overweight with this type of diet.
Studies are looking at why being overweight increases the risk of getting different cancers.
Being physically active helps us maintain a healthy weight, which lowers the risk of some cancers. But the benefits of exercise don’t seem to be just about keeping to a healthy weight. Exercise lowers different chemicals and hormones in our bodies and this may have a protective effect in some cancers.
Research has shown that exercise reduces the risk of some cancers, such as breast, bowel and womb cancer.
Some studies also suggest that regular exercise may reduce the risk of lung cancer and of developing a more advanced form of prostate cancer. But the most important way of reducing the risk of lung cancer is not to smoke or to give up if you do.
Some studies show that women who are more physically active, especially before the menopause, have a reduced risk of breast cancer. It may have something to do with exercise lowering oestrogen levels.
People who are physically active are also less likely to get bowel cancer. There are different possible reasons for this. Activity increases the rate that food moves through the bowel, which may mean it’s exposed to cancer causing substances for a shorter time. Another possible reason is that exercise lowers insulin (a hormone that regulates sugar levels). Having higher insulin levels is linked to bowel and breast cancer.
It’s also suggested that regular exercise has a protective effect because it lowers our stress hormone levels. However, there’s no real evidence that stress is linked with cancer and most of us have to cope with stressful events at some time in our lives.
An American research study showed that women with breast cancer who walked at an average pace for 3–5 hours a week, reduced the risk of their cancer coming back and therefore improved their survival. Studies have also shown that exercise may help reduce the risk of bowel cancer coming back.
We’re not sure why this is. It might be because exercise helps maintain a healthy weight and being overweight may increase the risk of some cancers coming back. Exercise (in combination with a healthy diet) helps to prevent weight gain. Or, these findings could be linked to the effects of exercise on hormone levels and other chemicals in the body.
We need more research into exercise and the risk of cancer coming back. But for some people with breast| or bowel (colon| and rectum) cancer, regular exercise and a healthy diet may help reduce the risk of cancer coming back.
You can benefit from taking regular exercise during and after your treatment. The amount you do will depend on the type of cancer you have, your treatment and generally how fit and healthy you are. Don’t give yourself a hard time if you haven’t previously been very active. Any exercise is better than no exercise and even a short walk each day can help. Just the smallest increase in your physical activity can improve your quality of life.
In the past, many doctors advised that you should rest as much possible during treatment. But this advice is now changing. Too much rest may result in loss of stamina, muscle tone and bone strength.
It’s difficult to think about becoming more physically active when you’re coping with the side effects of cancer treatments. The more intensive your treatment the harder it’s likely to be to start exercising.
However, exercise has been shown to help people cope with both the short- and long-term side effects of treatment. For example, people who take moderate exercise (that requires as much effort as a brisk walk) during treatment seem to have fewer immediate and long-term complications than those who don’t. A review of studies in women with breast cancer showed that exercise improved fitness and physical well-being during chemotherapy| and radiotherapy|.
Regular exercise after treatment can be a positive step in helping you to recover. Doing something for yourself can give you back a sense of control. And because it builds up your strength and improves your general health you’ll feel better as a result.
Exercise may help improve the following side effects during and after treatment:
Fatigue (a feeling of having no energy at all) is often experienced by people affected by cancer. It happens as a result of the cancer and its different treatments. Fatigue can be experienced from the time you’re diagnosed but it’s often at its worst during treatment and it can last for months or longer afterwards.
Taking light to moderate exercise can improve your energy levels. Be careful not to overdo it as too much physical activity suddenly might make you more tired. Make sure you’re comfortable and safe when you exercise and you’ll gradually feel more energetic.
Anxiety, depression and sleep problems Exercise encourages the release of chemicals that help to improve mood (endorphins). Regular exercise can help to reduce depression and anxiety and lift your mood. It also helps you sleep better by lowering your stress hormones.
Weight gain Hormonal therapies for breast cancer and prostate cancer can cause weight gain. Chemotherapy| treatment often includes medicines called steroids|, which can cause weight gain. Regular exercise combined with a healthy diet can help to control or reduce weight gain.
Stress It’s common to feel stressed during and after treatment. Regular exercise can help lower your stress hormone levels and improve your mood. You’ll look better because the blood and oxygen supply to your skin is improved. And if you look better you often feel better.
Bone thinning (osteoporosis) Hormonal treatments for breast cancer and prostate cancer and being less active can increase the risk of bone thinning (osteoporosis). This means you’re at more risk of breaking a bone (a fracture). Weight-bearing exercise, such as walking or dancing, helps to keep your bones strong and reduces your risk of osteoporosis.
Exercise can also improve your co-ordination and balance. This improvement may reduce your chance of falling and the complications of a fall (such as a fracture). But if you have osteoporosis it’s important not to start exercising without taking advice from your doctor, nurse or physiotherapist.
Exercise can also help improve a number of cancer symptoms. Some of these symptoms, such as fatigue and stress, are already covered under treatment side effects. Other symptoms it can help improve are:
Before you start to exercise or increase the amount of exercise you take it’s important to get advice. There are different people and organisations that can help you.
Always talk to your cancer specialist or your GP (family doctor) before you start. They can advise you on the type and amount of exercise that’s safe for you to do. It’s also important to discuss any other conditions you have, such as high blood pressure, diabetes or lung problems, as these may be affected by exercise.
Some GPs have exercise referral schemes to help people become healthier and more active. There may be an exercise programme or some research going on at your cancer treatment centre. Ask your cancer specialist, GP or nurse for more information and advice.
You might find it helpful to get advice about exercise from a physiotherapist. Your GP or cancer specialist can arrange a referral for you.
There may be particular problems you need advice about. Try making a list of any physical problems you have.
A physiotherapist can help you to:
You can also ask questions about particular concerns, such as:
An occupational therapist can help you look at the way you manage day-to-day activities. Your GP or cancer specialist can arrange a referral for you.
Occupational therapists can teach you how to manage fatigue. They can suggest changes to your home to make you safer and more independent. Being more independent and doing simple things for yourself is a way of increasing your physical activity, and is a form of exercise too. Making things easier at home may help free up your time to do other things like going out for a walk.
More people manage to keep exercising if they do it with other people. The social side of being part of a group can be enjoyable. If you feel it’ll be hard to stay active then an exercise referral scheme may help you.
A recent study set up a 12-week supervised exercise programme for women with early breast cancer during treatment, and followed them up six months later. Women in the exercise programme showed physical and psychological benefits when they were compared to women who weren’t in the exercise group. These benefits were still there up to six months later.
Exercise referral schemes are not just aimed at people with cancer. They’re for anyone concerned about their health who wants to become more active. These schemes are available all over the UK. Your nurse or doctor will be able to tell you more about this.
Schemes are run by expert fitness trainers. They may be held at healthy living centres, community centres or leisure centres. Your doctor or nurse will advise if exercise is safe for you. They’ll pass on information about your health (this will be kept confidential) to the fitness trainers.
Before you start, your trainer will explain to you the benefits and risks of increasing your physical activity. After this you’ll be asked to give your consent. This means you agree to the exercise plan and understand the benefits and risks.
Your fitness trainer will advise you on whether it’s best for you to exercise in a group or on your own. They’ll match the types of exercise to your individual needs. You may be given a plan of exercise to carry out at home.
Some areas have services that encourage schemes like this in care homes. Hospices and cancer support services may also offer exercise classes and activities such as T’ai Chi or Yoga. Ask at the hospital, your GP surgery, local community or leisure centres to find out what is available in your area.
It’s always important to get advice from your doctor about your exercise plan before you start.
There are some general things you’ll need to be careful about:
It’s important to begin gradually. If you haven’t exercised much before your cancer diagnosis you’ll have to start slowly. Try to set goals that can be achieved at your own pace. A simple activity like walking can be done for a little longer and further each day. Just doing an activity for a few minutes a day can help. Listen to your body and be careful not to overdo it. Your muscles will tell you when you need to stop and rest.
Keep a diary to record how active you’ve been on a daily or weekly basis. This helps you to see your progress.
Ask your family and friends for their support. Think of ways they can help, such as taking you to a class. Better still, ask them to join in with you. Simple things like walking, cycling or going swimming with your family or friends helps build up your physical activity and it’s also fun.
This depends on your cancer, its treatment and how fit you are and what you want to achieve. If exercise is an important part of your recovery from cancer you might want to achieve as much as you can. Remember to get advice from your doctor before you start.
Regular exercise is usually defined as 30 minutes of moderate activity at least 3–5 times a week. During this your heart should be beating slightly faster but you should still be able to talk (what you’d experience during a brisk walk). This is a lot to start off with and you don’t have to do the 30 minutes in one session. You can divide your 30 minutes into 10 minutes three times a day. You don’t have to stick with the same exercise either. Remember the smallest amount of exercise is better than no exercise.
Begin exercising gently, listen to your body and gradually build it up. Stop if it’s painful or if you find that you’re struggling or feeling unwell.
There is no exercise that’s best for everyone. Choose an activity that you enjoy and carry on with it.
This uses large muscle groups repetitively for a period of time. It involves raising the heart rate so that the lungs and heart work harder to pump blood through the body. Common aerobic exercises are:
Walking This is a good choice to start with. All you need is a pair of comfortable walking shoes and you can do it indoors, outdoors or on a treadmill. Walking is a weight-bearing exercise (your feet and legs support your body’s weight). It’s good for strengthening bones and reducing further bone loss if you already have bone thinning (osteoporosis). Hiking, dancing and climbing stairs are also weight-bearing exercises.
Running and jogging These are good weight-bearing exercises, but they’re high impact and may put stress on your spine and joints. If you already have bone loss it’s better to choose a gentler weight-bearing exercise. Remember, if you don’t have much stamina you’ll need to build up your fitness level.
Cycling You can use a regular bike or a stationary exercise bike. Cycling doesn’t put strain on the back, hips, knees or ankles so it can be helpful for people who are very overweight. It‘s not a weight-bearing exercise but it’s good for your heart and lungs and strengthens your muscles.
Swimming This is a good exercise for anyone and causes very little strain on your joints as it’s not a weight-bearing exercise. It’s good for your heart and lungs and it can be effective and comfortable if you have bone or joint pain. Any movement in the water makes your muscles work harder so it’s good for strengthening your muscles. Swimming can be a helpful exercise if you have lymphoedema.
The following exercises are not aerobic but are also helpful:
Resistance exercise Resistance means you’re working against the weight of another object. It’s good for people at risk of or with bone-thinning problems. This exercise strengthens muscle and helps to build bone. Resistance exercise includes using free weights (dumb bells etc) or weight machines at home or in the gym. It can help you to cope with things like opening heavy doors or jars.
Flexibility exercise Flexibility is important and having flexible joints helps prevent injury. Simple stretching exercises can be a good way to start exercising especially if you’ve been very unwell.
Some people use yoga or pilates as part of their fitness routine. Yoga is a calming exercise, which strengthens and tones the body without raising the heart rate (though some types of yoga can be more strenuous). Body movement or stretching exercises that increase your flexibility are often helpful especially if you have problems with pain. T’ai chi is another type of exercise that increases your flexibility.
You may need to be guided by an instructor for these exercises. Let your instructor know about your condition so that they can guide you through the routine safely.
If gyms and exercise programmes don’t appeal to you there are other ways you can build up your physical activity in day-to-day life. You can:
Exercise as part of a healthy lifestyle has benefits for people who have experienced cancer. We hope this information helps you understand more about this and encourages you to become more active.
Always talk to your cancer specialist or GP if you’re thinking of starting your own exercise programme. These professionals can advise you about any training schemes in your area.
You might also find our useful organisations| information helpful.
This section has been compiled using information from a number of reliable sources, including:
For answers, support or just a chat, call the Macmillan Support Line free (Monday to Friday, 9am-8pm)
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.