What should I do for exercise?

Exercise can help support your health and well-being during treatment — and can make you feel good!

What are the benefits?

Your body relies on physical movement and exercise, and the benefits of exercise for cancer patients continue to grow. According to guidelines by the American Society of Clinical Oncology (ASCO), the benefits of exercising are so significant that they ask oncologists to recommend aerobic and resistance exercises to help with side effects for patients undergoing treatment with curative intent.

In addition, the ASCO guidelines say that exercising during treatment can benefit you in other ways:

Decreases fatigue and increases energy levels
Helps maintain strength and muscle mass
Preserves cardiorespiratory fitness
Lowers levels of depression and anxiety
Improves quality of life in general
Helps maintain physical functioning and performance

And the good news is that exercising during active treatment has a low risk of adverse events, meaning it’s unlikely you’ll do yourself harm by working up a sweat.

Other benefits include

Helping maintain a healthy weight
Improving sleep quality
Regulating bowel function
Strengthening immune systems
Reducing risk of reoccurrence and improving survival rates, according to this study

How much should I exercise?

Exercise guidelines for cancer patients are the same as guidelines for the general public. A comprehensive exercise program should include the following activities. However, it’s important to remember to listen to your doctor and your body. You also want to build in plenty of time to rest. Do what you can do, because any time spent exercising is beneficial for your physical and mental health!

Moderate exercise for 150 to 300 minutes per week, or vigorous exercise for 75 to 100 minutes per week

This averages out to 30 to 60 minutes of moderate exercise or 15 to 20 minutes of vigorous exercise every weekday. You can also combine the two to mix it up a bit!

Moderate exercise is any type of movement where you get your heart rate up but don’t feel out of breath. If you are doing moderate exercise, you should be able to carry on a conversation with someone. Some examples are walking, swimming, or cycling along a flat path. This is a good place to begin if you are just getting started or trying to gradually build up strength.

Vigorous exercise means that you are exercising at a level where at times you feel out of breath. You would probably struggle to maintain a long conversation, but you should be able to manage a sentence or two at a time. Some examples include aerobics, high-intensity interval training (HIIT), running, or vigorous cycling.

Strength training twice per week

Strength training exercises are recommended at least twice a week. This could be a short 15 to 20 minute session, as you don’t want to overdo it!

Strength training is any type of exercise that involves using resistance (weights, bands, machines, or body weight) to help maintain your muscles. This is really important for people going through treatment, as many people experience weight and muscle loss. Some cancer treatments can also directly affect muscle mass, so making an effort to keep your muscles strong is important.

Stretching and balance exercises twice a week

A short session of 15 to 20 minutes is enough! Yoga is a great example of this exercise. If in-person classes are not your thing, there are also lots of free videos available on YouTube to help you get started.

Stretching helps keep your muscles healthy and your joints mobile. Cancer treatments can affect balance, and some patients with neuropathy have issues with balance. Like everything, practice helps improve your balance!

For more information on neuropathy and some specific balance exercises to try, see our section on neuropathy.

Deep breathing exercises several times a week

Deep breathing exercises can help improve your lung capacity, while also working to reduce stress and anxiety. These exercises can be done anywhere! Even 5-10 minutes per day will provide benefits.

If you experience shortness of breath, talk with your doctor before trying deep breathing exercises.

Patient perspective by Margee

Diagnosed: April 2021

Disease: Stage IV rectal cancer with liver mets

I have always loved to be fairly active. I walk in the neighborhood or on local park trails a couple of times a week. However, my main form of exercise is swimming. I started swimming competitively when I was 8 and really LOVE to workout! I have been swimming with a masters swim team in the Bay Area for more than 24 years. I need the accountability of a coached, organized workout and the camaraderie of others. COVID put a big crimp in swimming for a few months but by the time I was diagnosed in April 2021 with stage 4 rectal cancer with mets to my liver, we were back to 50 minute practices.

I am really thankful that I have pretty much been able to swim 3 times a week on my chemo weeks and 4 times a week on my “off” weeks. I am not able to maintain my pre-diagnosis intervals/times but I am able to still do something I LOVE! As I have had to change my intervals, I have made new friends in the “slower” lanes. Several teammates are following my cancer journey on CaringBridge and give me big hugs (masked for now) when they see me at the pool! Several teammates brought meals early on in my treatment! It’s so encouraging to be supported by my teammates and coaches!!

I had to take a break for my liver/colon resection and currently have some pretty good neuropathy going in my feet, calves and finger tips (side effect from Oxaliplatin). Since I can’t feel my feet very well, I have had to slow down a bit while on land, so that I don’t trip. I had a classic fall in the parking lot at the pool when I tripped on my shoelace. Thankfully nothing serious- my swim parka protected me! Sometimes I have to use a hiking pole when hiking-a little wobbly on my feet.

My advice to ANYONE is get outside (weather permitting) and get moving, even if it’s for 5 minutes. You could stretch, take a walk, go say hi to a neighbor or sit with a cup of tea! If you are used to exercising pretty strenuously, with the permission of your oncologist, GO FOR IT! You may need to adjust the intensity/intervals of your workout but I think you too will be thrilled to keep doing what you LOVE.

How do I get started?

After working, taking care of your family members, cooking, cleaning, and going to doctor’s appointments, you probably don’t feel like you have a lot of extra time to devote to exercise. That’s okay! Any amount of exercise has benefits, so start slow, build up gradually, listen to your body, and take a break when you need to. Set yourself small, achievable goals each week. Mix it up, and try different exercises to keep things fun! You might want to find an exercise buddy to help keep you motivated.

If you have a lot of energy, feel free to do more, but remember to not overdo it! Too much exercise can cause inflammation and affect your immune system. So listen to your body, and rest when you need to.

Here are some training plan examples:

Walk or swim for 30 minutes a day, five days a week. You can even walk in the pool for a low impact workout. Try adding in a 15 minute weight training session and a 15 minute yoga session twice a week
Do a 60-minute yoga or qigong session three times a week, go on a 30-minute walk twice a week, and do two 15-minute weight training sessions a week
Try 20 minutes of HIIT training 5 days a week, two 20-minute strength training sessions, and two 20-minute yoga sessions
Go to an aerobics class twice a week, do two 15 minute strength training sessions, and two 15 minute stretching videos
Go for a 45-minute run twice a week, as well as two 15-minute weight training videos and two 15-minute yoga sessions
Mix it up and combine several of the ideas listed above!

We asked hundreds of COLONTOWN Community members to recommend us their favorite exercise videos on YouTube:

Femfusion — Great for pelvic floor exercises
The Body Coach — Lots of awesome HIIT training videos
Pop Sugar Fitness — Fun cardio workouts
Yoga with Adrienne — Great beginner yoga videos
EMKFit — Upbeat dance workouts
Up to the BeAt Fit — Walking and dance workouts
Get Fit with Rick — Walking workouts
Fitness Marshall — Dance workouts
DoYogaWithMe — A website that has both free and paid yoga sessions
FitOn — Cardio workouts, strength training, stretching, and meditation videos
Grow with Jo — Walking, cardio, and dance workouts

Do you have a favorite website or YouTube channel that we left out? Come to COLONTOWN and share with us.

If you would like to attend in-person guided classes, Livestrong offers free or low-cost exercise classes for cancer patients at local YMCAs. Take a look at the program here.

Things to keep in mind

While exercise can be very beneficial for many cancer patients, there are certain circumstances where we advise you get some medical advice. Remember to consult your team before starting anything new.

Bone metastases

If you have bone mets, you may be at greater risk for a bone fracture or break. It’s important to avoid putting too much strain on affected bones. In this case, moderate exercise, such as walking, swimming or cycling may be your best options. Check with your team before starting anything new.

Low blood counts

If you’re on chemo and have very low white blood cell counts, take care of your immune system. It’s a good idea to avoid exercising in crowded places like public gyms, to avoid exposing yourself to illnesses.

Peripheral neuropathy

If you are experiencing peripheral neuropathy, issues with pain and balance may affect your ability to do certain types of exercises. However, the right kinds of exercises can be extremely beneficial for people experiencing neuropathy and can improve mobility and balance. If you experience pain when walking, try swimming, pilates, or yoga. There are also several videos in our section on neuropathy that contain exercises specifically designed for people in your situation. Check it out here!

Recovering from surgery

If you’re recovering from surgery, it’s important to follow your surgeon’s guidelines on exercise and physical activity. Avoid lifting weights in the first four to six weeks after surgery. Start slow and build up gradually. Ask for a referral to a physical therapist who can help recommend appropriate exercises for whatever stage you’re at in recovery. Remember to avoid heavy lifting after surgery, particularly if you have had a stoma fitted, as you are at risk of developing a hernia.

Dealing with chronic pain

Unfortunately, many cancer patients deal with chronic pain as a side effect from surgeries, radiation, or chemo. You may also experience pain from tumors pressing on nerves. Exercise, used in the right way, can be extremely beneficial for people experiencing chronic pain. It can reduce pain levels, improve mobility, and boost quality of life. In this case, consult with your team to find out which exercises are right for you. You can also work with a physical therapist to design a personalized exercise program based on your needs. Just ask for a referral!

Reduced mobility

If you have reduced mobility, many exercises might not be right for you. However, you can augment many exercises to fit your ability levels. If you use a wheelchair, you may already be exercising your arm muscles! You can add some upper body exercises, like bicep curls or arm circles to get your body moving. Chair yoga is also quite popular.

Some cancer centers have specialized exercise trainers who work with patients who need help getting started with exercise routines. If you think this would be helpful, ask your oncologist. If not, you may be able to get a referral to a physical therapist.