During and after cancer treatment

How does activity help during and after cancer treatment?

Being active can ease fatigue, anxiety and low mood, and can improve physical functioning and quality of life, both during and after cancer treatment¹. Exercise is generally safe for cancer survivors¹.

During treatment. Regular activity improves fitness, strength and tiredness, among other things people report about how they feel³. The ASCO guideline recommends regular aerobic and resistance exercise during treatment with curative intent³.

After treatment. For adults who have finished treatment, exercise tends to improve quality of life and to reduce anxiety, fatigue and pain. These benefits were still seen 12 weeks later and, for quality of life and fatigue, up to 6 months later⁴.

How much. The most consistently helpful pattern is moderate aerobic activity, such as brisk walking, at least 3 times a week for at least 30 minutes, kept up for at least 8–12 weeks¹. For tiredness, moderate aerobic activity three times a week for at least 12 weeks can help, during and after treatment¹. For anxiety and low mood, moderate aerobic activity three times a week, or aerobic plus strength work twice a week for 6–12 weeks, can help. Strength work on its own does not appear to ease anxiety¹.

Starting small. If you're inactive, begin with a little gentle activity: as little as 5 to 10 minutes of walking, several times a day. Even small amounts help². A longer-term target is 30 minutes on five days a week, and it can be built from blocks of 5 or 10 minutes². Gentle activity on its own is unlikely to ease tiredness, so build towards moderate activity as you can¹.

As an adult living with a long-term condition, aim for the same amounts as other adults where you can. If you can't, any activity you're able to do brings benefits.

When to check with a health professional

If you're starting exercise after a long break, it's always a good idea to see your doctor first. This matters especially during or soon after cancer treatment, so check with your cancer team or doctor about what suits you.

Exercise doesn't replace prescribed medicines or treatment. Keep taking them as prescribed, and talk to your doctor before changing or stopping them.

For an injury or a health condition, see a health professional, such as your doctor or a physio.

Some situations need specific advice from your cancer team first:

• Cancer in the bones (bone metastases): avoid rapid or loaded movements at the end of a joint's range near the affected area, and take steps to reduce the risk of falls. Start with active movement and no load, and progress slowly only if pain or symptoms don't worsen. Physical therapists or clinical exercise physiologists with extra cancer-exercise training are best placed to prescribe exercise⁵.
• Lymphoedema, or a risk of it after breast cancer: aerobic exercise seems generally safe. Resistance training is considered safe when a fitness professional supervises it, starting low and progressing slowly¹.
• Weight loss from treatment: talk to your care team so that exercise doesn't add to the weight loss and tiredness¹.

Call your local emergency number for chest pain or pressure (or pain spreading to the arm, neck, jaw or back, especially with sweating or feeling sick), severe breathlessness, fainting or collapse, signs of a stroke, a serious injury, or someone who isn't safe. Don't wait to see if chest pain passes.

If you feel sick, sweaty or unwell, have unexplained discomfort, or have breathlessness or dizziness that doesn't settle during or after activity, don't just ease off. Use the emergency advice above, or see a doctor soon if it has settled.

A sore muscle or joint, or soreness a day or two later, is a reason to ease off. Exercise doesn't have to hurt to work, and pain during activity is a signal to stop or ease off. See a doctor or other health professional if it persists or gets worse.

Unusual tiredness isn't something to push through or simply rest off. Get it checked by your doctor or cancer team.