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Physical activity during and after cancer treatment

Physical Activity During and After Cancer Treatment

Many people affected by cancer want to make positive changes to their lives. Taking steps to live a healthier lifestyle can be a big part of this.

When you are living with or after cancer, becoming more active can be a positive change to make in your life. We can all benefit from being physically active. It helps reduce the risk of health problems such as heart disease, stroke and diabetes and there’s also evidence that physical activity can benefit people affected by cancer.

Being active during treatment

During treatment, doctors and nurses usually advise you to try to limit the time you spend sitting or lying down. They may encourage you to do some gentle activity such as short walks. If you are not active, you may feel more tired and lose muscle strength and cardiorespiratory fitness. Cardiorespiratory fitness is how well your heart and lungs deliver oxygen to muscles over longer periods of time.

Being physically active during treatment is generally safe. But, there may be activities you’ll need to avoid or be careful with. If you’re still concerned, you can speak to one of our doctors or physical activity session leaders for advice.

“I’m quite a sporty person. I like to run regularly. Once I was diagnosed with cancer I thought I couldn’t do that anymore. The Living Well course helped me to realise that I can actually live my life and do the things that I enjoy doing.” – Joe

What you can manage will depend on your level of fitness and the treatment you are having. You can be the judge of this. It might just be reducing the amount of time you spend sitting down. You could try doing some light housework, making yourself a snack or going for a walk
with family or friends. Remember to pace yourself.

Try not to do too much on a good day. If you already exercise, you’ll need to do so at a lower intensity during treatment. You can gradually increase it again after treatment.

“I found that by starting off with a small amount of exercise, I could build on it over time, to the point where I could jog on a treadmill and I’ve never done this in my life.” – Angela

Reducing cancer side effects

You may have side effects during your treatment and for some months after it finishes. Being more physically active may help reduce some of these.

Reduce tiredness (fatigue)

Feeling as if you have no energy (fatigue) is a very common treatment side effect. It can sometimes last for months after treatment. Being more active can help you to manage fatigue. Even a small increase in activity can help to improve your energy levels.

“After diagnosis, I was scared of exercising for fear that it might throw me back into a fatigue cycle. Penny Brohn taught me that exercise was good. It is about building it in around my fatigue.” - Angela

For most people, taking short walks, preferably every day, is a good way to be active. Walk at a comfortable pace for you. Don’t push yourself too hard. Doing too much, too soon, may make you more tired. Simple strength exercises such as ‘sit to stand’, yoga, Tai Chi and Qi Gong can also be helpful when your energy levels are low.

Reduce stress and anxiety, and improve your mood

Stress, anxiety and low mood are common problems during and after treatment. Physical activity encourages the brain to produce chemicals (endorphins) that improve mood and reduce stress.

Being active with other people – by joining a group or going with friends or family – can really help. So can being active outdoors, in a green environment such as a park. You could try gardening or joining our Nordic Walking group. Yoga is another activity that can relax you and reduce stress.

“Nordic walking showed me that you can get active, even though chemo can feel debilitating with lots of side effects. Walking is an antidepressant, I am hooked and go every week. It offers relaxation too.” – Michelle

Sleep well

Being more active during the day helps you to relax and sleep better at night. For more information see our difficulty sleeping resource.

Reduce constipation

A short walk each day can help with constipation. You should also drink plenty of fluids and have more fibre in your diet (unless your doctor advises against it). Check our recipes blog for ideas on what to cook and eat.

Build muscle strength

You may lose muscle bulk and strength during and after treatment. This happens when your muscles aren’t being used as much as usual. It’s also a side effect of hormone therapy for prostate cancer and steroids.

Strength training such as climbing stairs, moving from sitting to standing and resistance training using light weights will help increase your muscle strength. You can gradually build this up after treatment.

Relieve joint pain and improve range of movement

If you have painful joints, regular physical activity can help ease pain by building muscle strength and improving flexibility. Joints that have a full range of movement are less likely to be sore. If you have sore joints, swimming and cycling are good because they put little strain on the joints.

“I learnt that my daily swim is a really important part of how I keep mentally on top of living with cancer. It has a calming effect and it keeps me fit too.” – Rod

Being active after treatment

Being physically active after treatment is a positive step in your recovery. It may help to reduce the risk of:

  • Late effects of treatment
  • Other health problems
  • Developing a new cancer
  • Certain cancers coming back

Late effects

These are side effects that may develop months or years after treatment.

Heart health

Some treatments may slightly increase the risk of heart problems in the future. These include radiotherapy that’s given close to the heart and certain chemotherapy or targeted therapy drugs.

Aerobic activities, such as Nordic walking, running, swimming or cycling may help to protect your heart and reduce the risk of late effects developing.

Bone health

Hormonal therapies for breast and prostate cancer, and early menopause due to cancer treatments, can increase the risk of bone thinning (osteoporosis). Weight-bearing exercises (activities where you are supporting your body weight) will help keep bones strong.

They include walking, dancing or resistance training. If you have osteoporosis, get advice on exercise from your doctor, nurse, physiotherapist or exercise specialist. For more information on being safe if you have bone problems.

Keeping to a healthy weight

It’s not uncommon to gain weight during treatment. This may be because you’re less active than usual. Hormonal therapy drugs and steroids, which are sometimes given with chemotherapy, can also cause weight gain. Being active and eating healthily are major factors in controlling your weight.

Keeping to a healthy weight can help reduce the risk of:

  • Joint problems
  • Other health problems
  • Certain cancers coming back
  • Developing a new (primary) cancer – the strongest evidence for this relates to breast, womb and bowel cancer

Reducing the risk of cancer coming back

There is some emerging evidence that being active at the levels recommended and keeping to a healthy weight can reduce the risk of certain cancers coming back or progressing. A review showed that women with breast cancer who walked at an average pace for 3–5 hours a week after treatment had a reduced risk of the cancer coming back. Studies have also shown that walking at an average pace for 3–6 hours a week reduced the risk of bowel cancer coming back. Another study showed that walking briskly for at least 3 hours a week may reduce the risk of early prostate cancer progressing.

Research in this area is still new and limited to certain cancers. We need more evidence before we can say exactly how much exercise is needed to get the benefits, and exactly how it may protect against a recurrence of cancer. But so far, the signs are that with certain cancers, being active can make a difference.

Being safe

Being physically active has fewer risks than being inactive. But, it’s important to know how to take care of yourself when you begin to be more active. Which activities are best for you can depend on the type of cancer you have, your treatments and any other conditions you have.

If you are in any doubt, get advice from one of our doctors.

Treatments

Chemotherapy

Chemotherapy lowers the number of blood cells in your blood. If your white blood cells are low, you are more at risk of getting an infection. Your cancer doctor might advise you to avoid public places such as swimming pools or gyms until your white blood cells are back to a normal level.

If you have a central 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 platelets are low, you are more at risk of bruising or bleeding. Your doctor may advise that you take gentle exercise until your platelets recover. If your red blood 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 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 fine to swim again.

Surgery

It’s important to start moving around as soon as possible after surgery. This reduces the risk of complications such as blood clots and helps with 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 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 pelvic floor muscles. Try to do these for as long as you were advised to. If you have pain or discomfort that stops you doing them, tell the physiotherapist or nurse.

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