Getting started

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 and any other medical conditions you might have. 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 is safe.

It’s important to get advice before you start becoming more active. Your cancer doctor, GP or specialist nurse can tell you what type of exercise is most appropriate for you. You can also get support from a physiotherapist or an occupational therapist.

We have lots of tips for getting started, including joining a walking group, playing a sport or encouraging your friends and family to join you. Setting yourself realistic targets and keeping a record of your progress will help you to stay active.

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.

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.


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.


Who can help?

If you haven’t been active before or for a long time, or if you feel nervous about starting physical activity, it can help to get advice. The following professionals and organisations can help you:

Your doctor

It’s best to talk to your cancer doctor, specialist nurse or GP before you start exercising. They can give you advice on whether it is safe for you to exercise and any precautions you need to take. Some GPs, cancer treatment centres and support groups have exercise referral schemes. These referral programmes support people to change their behaviours and get healthier and more active after illnesses such as cancer. There may be an exercise programme that is part of some research at your cancer treatment centre. Ask your cancer doctor or nurse for more information.

A physiotherapist or cancer exercise specialist

Your GP or cancer specialist can refer you to a physiotherapist or a qualified cancer exercise specialist if you need one. You may also be able to refer yourself to a physiotherapist. They can help you:

  • decide on an individual exercise programme that is safe and effective
  • become an independent exerciser
  • increase your physical fitness
  • improve your energy, strength, flexibility, co-ordination and balance
  • manage the side effects or after-effects of treatment
  • enjoy and increase your physical activity
  • avoid injuries.

You can ask them questions such as:

  • ‘I’ve never exercised before – how should I start?’
  • ‘How can I improve my shortness of breath and feel less tired?’
  • ‘How can I improve my balance?’
  • ‘Can I improve the strength of my hands, arms or legs?’
  • ‘Which exercises can help me get up the stairs?’

If you have more specific needs, they may be able to arrange a rehabilitation programme for you.

Exercise referral schemes

Many people find that exercising in a group keeps them more motivated. If you think this might help, or you feel you need close supervision from an expert, you may want to join an exercise referral scheme. They are mostly held at local community centres, healthy living centres, leisure centres and libraries. Ask your GP or cancer doctor about any in your area. Not all areas have an exercise referral scheme, or the schemes may be restricted to certain medical conditions.

Specially trained exercise professionals manage many of these schemes. But it’s a good idea to check whether they have been trained to work with people who have or have had cancer.

When they make your referral, your doctor will share some information about your health with the exercise professional. They will keep this confidential.

Your trainer will explain the benefits and risks of increasing your physical activity. You will be asked to give your consent. This means you agree to the exercise plan and understand the benefits and risks. They will advise you on whether it’s best to exercise in a group or on your own. Your trainer will match the activities to your individual needs and ability.

Some areas also have schemes in care homes, hospices and day centres. They often include activities such as chair-based exercises, walking, dancing, pilates, gentle exercise to music, circuits, tai chi and yoga.

An occupational therapist

Your GP or cancer doctor may refer you to an occupational therapist. They can advise you on how to pace yourself and manage tiredness.

They can also suggest changes to your home that will make it safer and help you be more independent. Doing simple things for yourself in the home is a way of increasing your physical activity. If things are easier at home, you will also have more time and energy to do activities such as walking or gardening.


Tips for getting started

Our guide Move more: your guide to becoming more active can help you get started. It includes goal-setting pages, tips and advice. It also includes a DVD, which shows you aerobic, strength and flexibility exercises, at a variety of intensity levels.

When you start getting more active, begin by doing something you enjoy and that fits in with your life. This could be a brisk walk with friends, playing with your children or grandchildren in the park, gardening or walking to the shops.

Here are some more ideas:

  • See if your family or friends want to join you to do some activity.
  • Join a walking group and make friends while you walk.
  • Walk or cycle to the shops, to see friends or to work.
  • Try swimming, cycling, dancing or gardening.
  • Play a sport, such as badminton, golf, table tennis or bowls.
  • Try a new walking sport, such as walking football or walking netball.
  • Try stretching exercises, such as yoga, tai chi or pilates.
  • Visit your local leisure centre (or its website) to see what activities are available.
  • Ask your GP to refer you to a structured exercise referral scheme or a physiotherapist.

It’s not always easy to get active for the first time, or to return to activity during or after cancer. Having clear goals, staying motivated and having support can all be very helpful. If your family and friends can take part with you, that can help you meet your goals. Our Move more guide can also help you achieve this.

Here are some things that other people have found helpful:

  • Remind yourself of the benefits and reasons why you’re doing this.
  • Set yourself short-term (one-week) and long-term (six-month) goals that you can feel you can achieve at your own pace. This might be getting up from the sofa regularly, going for a walk or doing an exercise class. It might help motivate you if you have a long-term goal to aim for, such a sponsored local event.
  • Slowly increase the amount you do. If you have a setback due to bad weather, illness or a holiday break, return to an easier stage of your activity plan.
  • Keep a record of how active you’ve been and how you feel, so you can see your progress. There’s space to do this in our Move more guide.
  • Share your plans with other people who are supportive. They might join you, help with commitments like childminding, or even drive you to the venue.
  • Try being active with other people such as family or friends, or join a group or club.
  • Make sure the activities are fun and enjoyable. Some people find it’s helpful to do a variety of activities.
  • Don’t be put off if you don’t achieve a goal. Think about why you weren’t able to achieve it and plan a new one. Sometimes it can take longer to develop fitness after treatment, so you may need to change the dates you expect to achieve your goals.

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.

Activities near you

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