Many people with a cancer diagnosis are understandably cautious about undertaking increased levels of physical activity. Can exercise make my cancer spread? Will it make my treatment side effects worse? How will exercise work with my medications? These are just some of the common questions asked. 

Steven Harulow looks at why you should exercise after a cancer diagnosis and offers some tips on how to start.

What are the benefits of exercising with or after cancer? 

The past decade has seen a growing raft of international research evidence showing that exercise is not only safe during and after cancer treatment, but also that it can have physical and mental health benefits, and can improve many aspects of an individual’s quality of life. 

In May 2018, the Clinical Oncology Society of Australia (COSA) launched its position statement on the role of exercise alongside surgery, chemotherapy and radiation in cancer care. According to COSA, “All people with cancer should avoid inactivity and return to normal daily activities as soon as possible following diagnosis (ie, be as physically active as current abilities and conditions allow).”

Writing in the online publication, The Conversation, COSA lead author Professor Prue Cormie said, “Research shows exercise can help cancer patients tolerate aggressive treatments, minimise the physical declines caused by cancer, counteract cancer-related fatigue, relieve mental distress and improve quality of life.”

Professor Cormie also made international headlines when she added, “If the effects of exercise could be encapsulated in a pill, it would be prescribed to every cancer patient worldwide and viewed as a major breakthrough in cancer treatment.”

If you needed yet more and more positive words and encouragement, in 2019 experts from the American College of Sports Medicine concluded that physical activity is an important step that individuals can take to prevent the development of seven common types of cancer – colon, breast, kidney, endometrial, bladder, stomach and oesophageal – and can even reduce the risk of recurrence

How can I get started with exercise after a cancer diagnosis?

So it’s agreed, physical activity is a good thing to do if you have cancer or are undergoing cancer treatment. The question is how to start when you’re feeling exhausted and are unsure about what to do for the best?

The key to safety and success is to introduce exercise gradually and to take a cautious approach – starting with low- intensity activity and progressing steadily as your exercise tolerance increases.

Remember, you don’t need to don the lycra or join a gym to get more active. Standing up, stretching and going for walk make for an excellent start to your fitness journey. Talk to a professional.

Always talk to your specialist cancer doctor or nurse for advice before you start any new programme of exercise and find out if there are any specific activities you should avoid.

You can also talk to an exercise professional qualified in cancer rehabilitation or with a background in treating individuals with cancer or cancer-related symptoms. There may be someone working at your hospital or your GP may be able to refer you to specialist rehab services at a local leisure centre or gym. 

In many areas you can access individual or group exercise programmes for people with cancer. Charities such as Trekstock offer great advice on how to get moving during and after cancer treatment.

If you are still receiving treatment, such as chemo or radiotherapy, you may need a medical referral before you can start an exercise programme. If you’ve finished treatment you can quite often refer yourself.

How much exercise is right for me?

There is no universal exercise prescription for someone with cancer. After all, we have different levels of experience and abilities, and our own personal preferences. 

However, the message is the same whether you are a seasoned 10km runner or a complete exercise novice – start slowly and gradually, build up the number of times you exercise each week(frequency), how hard you work (intensity), how long you exercise for during each session (time) and the types of activities you do.

Can I exercise if I have fatigue?

There will be times, particularly during treatment, when you simply can’t get out of bed because the fatigue is too much. The important thing is to recognise this, accept that some days will be tougher than others and not get too despondent. Instead, picture your longer-term goals. For example, this could be the 5km charity walk, 10km run or 20km bike ride you will do later in the year. 

Focus on the periods when you feel better and when you do, make it your aim to get up and get moving. You can start small as you build up your stamina. Even a short stroll or gentle stretching will make you feel a little better at this stage.

Tips on starting exercise after a cancer diagnosis

▪ Stay safe – share your physical activity ideas with your doctor or nurse. Only go ahead if your doctor agrees it is safe for you to do so. Ask about any precautions you should take.
▪ Make a plan – set realistic goals for yourself and build up your activity gradually.
▪ Think heart, think strength  aim to do cardio exercise (where your pulse rate rises and you get out of breath) and strength-building activities (where you work against resistance or gravity).
▪ Start slow, small and sensible – make a warm up an essential part of your exercise routine. Don’t go too hard or too fast initially – you will only exhaust yourself and run an increased risk of injury.
▪ Take a flexible approach  regular stretching can help improve posture-related problems.
▪ Listen to your body – some days will be better than others, so adapt your activities accordingly. On down days remember that doing something like stretch, no matter how small, is better than doing nothing.
▪ Make it social – exercising with friends and family can make it feel more like fun and provide the support you may need. Why not try working out together online over Zoom or Google Hangouts? Or set up a accountability group on WhatsApp or Facebook to share your achievements?
▪ Own your space – don’t feel embarrassed if you exercise in public and don’t worry at all about what others think about you or your workout. 

Finally, always keep in mind why you are exercising. Remember, increased physical activity will improve your stamina, lessen your fatigue and help you carry out day-to-day activities. It will help you maintain a healthy weight, prevent later health problems, such as osteoporosis and diabetes, and reduce the risk of cancer recurrence. 

Increasing your physical activity will also help yotake back control of your body so that you can return to your previous levels of activity or perhaps even better.

A version of this article and more is available on Steven’s website. If you're inspired to start exercising, you can try our online exercise videos or our seven day yoga series on Trekstock's YouTube channel. You can also sign up for our RENEW exercise programme, a free eight week small group exercise programme with Level 4 Cancer Rehabilitation Instructors, which will now be held digitally. 

We will be holding an online panel discussion on exercise on the 15th April: sign up for our Lifting the Lid on Cancer and Exercise event today.