Making sure you're safe when you're active

It’s important to keep physically active. But you may need to be careful with the activities you choose. This will depend on the cancer, your treatment, its side effects or any other medical condition. Your doctor or specialist nurse can give you advice.

Chemotherapy, radiotherapy or recent surgery can affect the type of activity that is safe for you. For example, chemotherapy increases your risk of infection. If your white cells are low, your doctor may advise you to avoid pools or gyms. If you have long term treatment effects, such as lymphoedema or nerve damage, you’ll also need advice on what’s safe.

Cancer or treatment, such as hormonal therapy, can affect your bones. If you have bone problems you’ll need to avoid activities that make you more likely to fall.

If you have another medical condition, such as heart or lung problems ask your doctor for advice.

Staying safe in the sun is also important while you are outdoors. Make sure you use suncream and wear protective clothing.

Being safe

Being physically active is safer than being inactive. But it’s important to know how to take care of yourself when you start to be more active.


If you're having treatment

Surgery

It is important to start moving around as soon as possible after surgery. This reduces the risk of complications such as blood clots. Depending on the operation, your surgeon, physiotherapist or nurse will tell you which activities you should avoid and for how long.

A physiotherapist or nurse may show you exercises to do when you get home. For example, women who have breast surgery need to do arm and shoulder exercises to improve their flexibility.

If you had surgery to your pelvis, you may be shown exercises to help strengthen your stomach (core) and pelvic floor muscles. Try to do these for as long as you were advised to. If you have pain, discomfort or swelling that stops you doing them, tell the physiotherapist or nurse.

Chemotherapy

Chemotherapy lowers the number of blood cells in your blood. If your number of white blood cells is low, you are more at risk of getting an infection. Your cancer doctor might advise you to avoid public places such as such as swimming pools or gyms until your white blood cells are back to a normal level.

We have a slideshow about avoiding infection at macmillan.org.uk/avoidinginfection

If you have a central line or PICC line, avoid swimming because of the risk of infection. You should also avoid vigorous upper body exercises, which could displace your line.

Platelets are cells that help the blood to clot. If your number of platelets is low, you are more at risk of bruising or bleeding. Your doctor may advise you to exercise gently until your platelets recover.

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, only do day-to-day activities until the anaemia improves.

Radiotherapy

If you have a skin reaction or redness due to radiotherapy, wear loose clothing when exercising to prevent rubbing against any areas of sensitive skin. Avoid swimming, as the chemicals in the water can irritate your skin. After treatment ends and any redness or skin reaction has gone, it’s fine to swim again. Ask your radiotherapy team for advice about swimming during and after treatment.


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, avoid high-impact activities. This is because there is more risk of you breaking (fracturing) a bone with these. High-impact activities are things that involve pounding or repetitive actions, for example jumping up and down on a hard surface or hitting a ball with a racket. They include running, jogging, football, tennis, squash, hockey and contact sports such as judo and karate. You should also avoid exercises where you repetitively bend forward at the waist, such as toe-touching and sit-ups.

It is safe for you to do low-impact activities. Good activities 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 dancing, body balance classes, tai chi and qi gong. Standing on one leg while holding on to a solid surface at home can help you improve your balance. You can make this more difficult by closing your eyes while balancing.

Peripheral neuropathy (nerve damage)

Some chemotherapy drugs can damage the nerves. This causes numbness or tingling in your hands or feet, muscle weakness or difficulty with balance and co-ordination.

If your feet or balance are affected, then running or brisk walking (especially on uneven surfaces) or walking up and down steps may not be the best activity for you. Cycling or swimming may be more suitable. Remember to check your feet regularly for cuts or blisters.

If you have numbness and tingling in your hands, it may be difficult or dangerous to use free weights or resistance bands.

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, the following may help:

Always wear a compression garment when you exercise.

  • Avoid doing lots of repetitive action with the affected limb.
  • Strength exercises are safe for people with lymphoedema, and they may help prevent symptoms.
  • Swimming can be helpful if you have lymphoedema, as it gently massages the lymphatic vessels. Ask your lymphoedema specialist for advice.
  • Build up the physical activity involving the affected arm or leg slowly.

Heart or lung problems

Most people with heart or lung problems can benefit from regular physical activity. Check with your doctor or specialist nurse before you start any exercise programme. We have more information about heart health.

Medicines to thin the blood

If you’re taking medicine to thin the blood, you will bruise more easily. Avoid high-impact activities, as you could get knocked or fall over. Take extra care during activities to avoid damaging your skin.

Stoma

If you have had surgery for bowel cancer, you may have a stoma. You will need to learn new skills to manage this. You may also need time to adjust to the changes in your body. This may affect what physical activity you choose to do. Your specialist nurse, sometimes called a stoma care nurse, will be able to help you think about how you can start doing some physical activity with the stoma in place.


General advice

  • Start slowly and gradually build up.
  • Don’t exercise if you feel unwell, have an infection or a high temperature, or have any symptoms that you are worried about.
  • Stop if you get any sudden symptoms, including feeling dizzy, chest pain, a racing heart, breathing problems, feeling sick, unusual back or bone pain, muscle weakness or a headache that doesn’t go away. Contact your doctor if you notice any of these, or any other symptoms.
  • Avoid uneven surfaces and activities that increase the risk of falling or hurting yourself, especially if you have bone problems.
  • Wear well-fitting trainers or walking shoes. Don’t risk getting an injury by wearing the wrong shoes.
Drink plenty of water so you don’t get dehydrated.
  • Protect yourself in the sun.
  • Have a healthy snack after exercising, such as a banana.

Which activities are best for you depends on the type of cancer you have, your treatments and any other conditions you have. If you are not sure, get advice from a cancer exercise specialist, your doctor or your physiotherapist.


Taking care in the sun

It’s important to protect your skin from the sun while being active. You’ll need to be careful, and you must make sure your skin does not burn as this can increase your risk of skin cancers.

There are a number of things you can do to protect your skin:

  • Stay out of the sun or strong sunlight during the hottest part of the day – usually between 11am and 3pm.
  • Wear clothing made of cotton or natural fibres. These have a close weave and give more protection against the sun.
  • Keep your legs and arms covered by wearing long sleeves and trousers. Wear a wide-brimmed hat to protect your face, neck and ears.
  • Always wear sunglasses in strong sunlight.
  • Use a high-factor sunscreen (SPF 30 or above) whenever you’re exposed to the sun. Follow the instructions on the bottle and re-apply it as recommended, especially after swimming. Choose a sunscreen that protects against both UVA and UVB radiation (known as broad spectrum).
  • Don’t use sunscreen instead of other methods of protecting your skin. Some people think that if they use sunscreen, they can stay out in the sun for longer. But the best protection is to cover up and to stay out of strong sunlight.
  • Don’t use a sunbed or sunlamp. If you like to look tanned, use fake tan lotions or sprays.
  • If you have a skin condition and use a sunbed as part of your treatment, your dermatologist will advise you to stop using the sunbed.

If you always keep your skin covered, talk to your doctor about whether you should take vitamin D supplements.


References and thanks

The information in this section has been produced in accordance with the following sources and guidelines:

  • American College of Sports Medicine. Roundtable on Exercise Guidelines for Cancer Survivors. Medicine & Science in Sports & Exercise. 2010. 42: 1409–1426.
  • Feuerstein, M. Handbook of Cancer Survivorship. 2007. Springer.
  • Irwin ML. Physical activity interventions for cancer survivors. British Journal of Sports Medicine. 2009. 43: 32–38
  • Thomas R, et al. Lifestyle and Exercise after Cancer. An Evidence Review for the Self-Management Work stream of the National Cancer Survivorship Initiative. 2010.

If you’d like further information on the sources we use, please feel free to contact us.

Thanks

Thank you to all of the people affected by cancer who reviewed what you're reading and have helped our information to develop.

You could help us too when you join our Cancer Voices Network.

Back to Keeping active

Who can help you get active

Talk to your physiotherapist or your doctor before you start doing physical activity. They’ll point you to appropriate exercise programmes.

Tips to get you started

You may find keeping active after a cancer diagnosis challenging. There are some tips that can get you started.

Activities near you

Several organisations and websites can help you find out what activities are available near you.