Exercising safely when you have cancer
It is usually safe to start doing some physical activity during or after treatment. It can be hard to think about exercise when you are dealing with the symptoms of cancer or side effects of treatment. But becoming more active may help deal with this.
If you decide to do some type of physical activity, it is important to make sure you do it safely. Even if you did regular physical activity before you were diagnosed with cancer, you may need to be more careful.
Most types of light physical activity are safe during and after cancer treatment. If you are thinking of starting a new sport or exercise plan, you might want to speak to your cancer doctor or specialist nurse. They can give you some advice, or they might refer you to a physiotherapist or cancer exercise specialist.
There are international guidelines for physical activity and cancer that were developed by the American College of Sports Medicine. They are supported by the National Cancer Institute and the British Association of Sport and Exercise Science. They advise that:
- physical activity is safe during and after cancer treatment
- you should try to avoid being inactive
- you should try to get back to your normal activities as soon as possible after treatment.
If possible, slowly build up to the recommended physical activity levels.
Research shows that even a little activity is better than no activity at all. As you start to feel more confident, you can slowly build up the amount of physical activity you do.
These are some general tips for keeping safe when doing any type of physical activity:
Start slowly and gradually build up.
Do not exercise if you feel unwell or if you have any symptoms that worry you.
If you have bone problems, you should avoid uneven surfaces and activities that increase the risk of falling. You should also avoid high-impact activities such as running.
Wear well-fitting trainers or walking shoes.
Drink plenty of water, so you do not get dehydrated.
Have a healthy snack after exercising, such as a banana.
You should stop exercising if you get any sudden symptoms, including:
a racing heart
unusual back or bone pain
unusual muscle pain
a headache that does not go away.
Speak to your doctor if you notice any of these, or any other symptoms.
Your doctor might encourage you to start some physical activity before surgery. This can help improve your general fitness level and help with your recovery.
It is important to start moving around as soon as possible after surgery. This reduces the risk of complications such as blood clots.
There may be some activities you should avoid, depending on the surgery. For example, if you have a stoma, you may be given advice on which activities to avoid at first. Your surgeon, physiotherapist or nurse will tell you which activities you should avoid and for how long.
If you had surgery to your pelvis, or near your hips, 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 can lower the number of blood cells made in the bone marrow. We need different types of blood cells to do different jobs. When the number of blood cells is reduced, you may be at an increased risk of some problems.
Risk of infection
White blood cells help you fight infection. If your number of white blood cells is low, you are at an increased risk of getting an infection. While your number of white blood cells is reduced, your cancer doctor might advise you to avoid busy public places where you are more likely to get an infection. This might include swimming pools or gyms.
Bleeding and bruising
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 and avoid high-impact activities. This is usually until the number of platelets is back to a safe level.
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, you may not feel like exercising or only be able to manage day-to-day activities. It is important to rest when you need to until the anaemia is reduced.
Central and PICC lines
If you have a skin reaction or redness due to radiotherapy, wear loose clothing when exercising. This is to prevent rubbing against any areas of sensitive skin.
You should avoid swimming, as the chemicals in the water can irritate your skin. After treatment ends and any redness or skin reaction has gone, it is fine to swim again. Ask your radiotherapy team for advice about swimming during and after treatment.
Some treatment side effects or other medical conditions can affect which physical activities are right for you.
If you have bone thinning or cancer in the bones, it is usually best to 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. This might include jumping up and down on a hard surface or hitting a ball with a racket. Examples of high-impact activities include:
- contact sports such as judo and karate.
It may be safe for some people who have a higher risk of fracture to do some of these activities. This will depend on your personal risk of fracture and whether you have symptoms such as pain in the bones. If you are at a high risk of fracture, speak to your cancer doctor, specialist nurse or physiotherapist before any type of high-impact physical activity.
Some people with bone problems may also be advised to avoid exercises where you repetitively bend forward at the waist. This includes toe-touching and sit-ups. This is because of the risk to the spine and back.
Many types of activity recommend bending and toe-touching as a warm-up. If you have secondary bone cancer in the spine or hip, check with your healthcare team whether this is safe for you to do.
If you have bone thinning or cancer in the bones it is usually safe for you to do low-impact, weight-bearing activities. Examples include:
- climbing stairs
- 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 low-impact dancing and tai chi.
Nerve damage (peripheral neuropathy)
Some chemotherapy drugs can damage the nerves. This causes:
- numbness or tingling in the hands or feet
- muscle weakness
- 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 the hands, it may be difficult to use free weights or resistance bands.
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, it is helpful to do the following:
- Always wear a compression garment when you exercise.
- Avoid doing heavy, repetitive action with the affected limb that you would not normally do.
- Avoid working the muscles from one position without movement (static contractions). For example, avoid the plank position. This is when you hold your body in a press-up position without moving up and down.
- 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.
- Build up the physical activity involving the affected arm or leg slowly.
Ask your lymphoedema specialist for advice. We have more information about lymphoedema.
Heart or lung problems
Most people with heart or lung problems can benefit from regular physical activity. It is important to 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 are 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 all activities to avoid damaging your skin.
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.
When any other wounds have properly healed, it is helpful to start with some exercise to strengthen the tummy (core) muscles. Your specialist nurse (sometimes called a stoma care nurse) can help you think about how to do some physical activity with the stoma. They can also advise you on any activities you need to avoid at first. They can also refer you to a physiotherapist.
We have more information about bowel cancer.
If you have advanced cancer
Physical activity is safe if you have advanced cancer. It has many of the same benefits as for people who do not have advanced cancer. It can help reduce symptoms such as tiredness, poor sleep and poor appetite. It can also improve bone health and general fitness.
If you have advanced cancer and want to get more active, the advice is the same as for people who do not have advanced cancer. You should start slowly and gradually build up the amount you do.
To start with, try to reduce the amount of time you spend sitting or lying down during the daytime. Moving around the house and doing easy, everyday things will help. You may be able to do short walks or gentle stretching exercises. These will help build fitness and flexibility. This can help with everyday tasks such as putting on shoes, dressing or washing.
Resistance exercises can also help strengthen your muscles and bones. This helps with getting in and out of chairs or baths, or going up and down stairs. Doing resistance exercises with exercises that improve balance can help reduce your risk of falls.
If you were very active before cancer or treatment, you may not be able to do the same amount as before you were diagnosed.
Ask your cancer doctor or palliative care team for advice before you start any type of exercise. You may need to avoid some types of physical activity. For example, if the cancer is in the bones or you have bone thinning, you should usually avoid high-impact activities such as running, football or tennis.
We have more information about advanced cancer.
Below is a sample of the sources used in our physical activity and cancer information. If you would like more information about the sources we use, please contact us at email@example.com
Schmitz K, Courneya K, Matthews C, et al. American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Medicine and science in sports and exercise. 2010. 42.
Thomas R et al. Physical activity after cancer: a review of international literature. British Journal of Medical Practitioners. 2014..
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical professionals and people living with cancer. It has been approved by Senior Medical Editor, Anna Campbell.
Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.
This content is currently being reviewed. New information will be coming soon.
How we can help
Chat online anonymously to others who understand what you are going through. Our community is available 24/7 and has dedicated forums where you can get advice and ask our experts.