Being physically active has fewer risks than being inactive. But, it’s important to be aware of issues to take account of when you begin to be more active.

Which activities are best for you can be affected by the type of cancer, your treatments and any other conditions you have. If you are in any doubt, get advice from your doctor.

Treatments can affect the type of activity that’s safe for you and how much you can comfortably do.

Chemotherapy

Chemotherapy lowers the number of cells in your blood. If your white cells are low you’re at more risk of getting infections.

Your cancer doctor might advise you to avoid public gyms and swimming pools until your white blood cells are back to a normal level. Common sense will guide you.

If you have a central or PICC line, avoid swimming because of the risk of infection. Don’t do any type of vigorous upper body exercises, that could possibly displace your line.

If your platelets (they help the blood to clot) are low, you are more at risk bruising or bleeding. Your doctor may advise you take gentle exercise until your platelets recover.

If your red cells are very low (anaemia), you will feel very tired and sometimes breathless. Your doctor might ask you to only do day-to-day activities until the anaemia improves.

Radiotherapy

If you have a skin reaction or redness due to the radiotherapy, avoid swimming as the chemicals in the water can irritate your skin. After treatment when any redness or skin reaction has gone it's no longer a problem.

Surgery

It's important to get moving as soon as possible after surgery. This helps to reduce your risk of complications, such as a blood clot, and it will help with your recovery. Depending on the operation, your surgeon will tell you which activities you should avoid and for how long.

A physiotherapist or nurse may show you exercises to carry on with when you go 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 pelvic floor muscles. Try to do these for as long as they advise. If you have pain or discomfort which stop you doing them get in touch with the physiotherapist or nurse.

The cancer, other treatment side effects, or some medical conditions can affect the physical activity that’s right for you.

Bone problems

If you have bone thinning or cancer in the bones, avoid high-impact activities. This includes running, jogging, football, tennis, squash, hockey etc where there’s more risk of falling and causing a bone to break (fracture). Do not do exercises that involve bending forward at the waist, such as toe touching and sit ups.

Good activities are walking, dancing, climbing stairs, swimming and resistance exercises. It’s also a good idea to also do exercises that improve your coordination and balance to reduce your risk of falling. This can include dancing, exercising to music and Tai Chi.

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 coordination. If your feet or balance are affected, running or brisk walking especially on uneven surfaces, may not be the best activities for you. Cycling or swimming may be more suitable. Remember to check your feet regularly for cuts or blisters.

Lymphoedema

Always wear a compression garment when you exercise. Avoid doing lots of repetitive action with the affected limb. Swimming can be helpful if you have lymphoedema as it gently massages the lymphatic vessels. Ask your lymphoedema specialist for advice and build up the physical activity involving your 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 before you start any exercise programme.

Medicines to thin the blood

If you’re taking medicine to thin the blood, avoid high-impact activities, for example running, jogging, football, tennis, squash or hockey, that could result in bruising from a fall or blow.

Stop if you experience any sudden symptoms, including feeling dizzy, chest pain, a racing heart, breathing problems, feeling sick, unusual back or bone pain, muscle weakness or a persistent headache. Contact your doctor if you notice any of these, or any other symptoms.

• Don’t exercise if you feel unwell, have an infection or high temperature, or have any symptoms that worry you.
• Wear well-fitting trainers – don’t risk an injury by wearing the wrong shoes.
• Drink plenty of water so you don’t get dehydrated.
• Have a healthy snack such as a banana after exercising.
• Avoid uneven surfaces and activities that increase the risk of falling or hurting yourself, especially if you have bone problems.

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.

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.

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