Getting or keeping active

Getting or keeping active

Research shows that being physically active before, during, and after cancer treatment can be helpful. The same is true if your treatment is ongoing. Or when you are living with, and managing, advanced cancer.

For most people, it is safe to do physical activity or exercise. But it really important to check with your doctor or treatment team and ask what is suitable for you. Everyone is different and some of us need to consider other health issues.

Being active can mean many things. It is not just about running or lifting weights. It is about finding a way to move that works for you. There are lots of ways to get moving; keeping busy around the house, going for a short walk, gardening or dancing are just a few ideas. Even taking a few extra minutes to use the stairs for the upstairs toilet can help! Getting or keeping active does not need to be expensive.

Why is physical activity important for people with cancer?

Cancer treatment is aimed at destroying cancer cells but can lead to a variety of challenging side effects. Physical activity can help reduce or manage these side effects and improve your overall wellbeing.

• Managing Weight Changes: Both weight loss and weight gain can happen during cancer treatment. Physical activity can help you maintain a healthy weight, preserve muscle mass, and improve metabolism.
• Easing fatigue: Cancer-related fatigue (CRF) is a common side effect that can really impact daily life. Exercise or gentle activity can increase energy levels and reduce CRF.
• Pain management: Exercise can help manage pain by releasing endorphins, the body’s natural painkillers, and by improving muscle strength and flexibility.
• Improving Sleep Quality: Many cancer patients find their sleep is affected. Regular physical activity may improve your sleep patterns and sleep quality.
• Boosting mood: Cancer diagnosis and treatment can take a significant toll on mental health, leading to anxiety and depression. Exercise has been shown to have a positive impact on mood, reducing stress and improving wellbeing.
• Strengthening Bones: Some cancer treatments can weaken bones, increasing the risk of osteoporosis. Weight-bearing exercises can help maintain bone density and strength.
• Quality of life: Exercise or gentle activity can improve your overall quality of life, offering a sense of control and independence when living with or beyond cancer.
• Treatment and recovery: Keeping active in a way that works for you can improve your recovery time and make treatment more manageable.

Understanding physical activity and exercise

Physical activity includes all of your movement in a typical day. Things like:

• Activities of daily living: Getting dressed, bathing, moving around the house.
• Household chores: Cleaning, gardening, laundry.
• Leisure activities: Playing with children or grandchildren, walking the dog.

Exercise is usually planned with a goal in mind – to improve or maintain fitness in some way. Examples of exercise include:

• Aerobic exercise: Walking, running, cycling, swimming, dancing.
• Strength training: Lifting weights, using resistance bands, bodyweight exercises.
• Flexibility exercises: Stretching, yoga, Pilates.
• Balance exercises: Tai chi, standing on one leg.

How much activity do I need?

Everyone is different, and it’s important to take advice from your healthcare team. The right kind of activity can depend on the type and stage of cancer you have or had, your treatment plan, current fitness level, other health conditions and side effects.

Recommendations from your healthcare team are best, but general guidelines can provide a good starting point.

The UK physical activity guidelines recommend:

• 150 minutes of moderate aerobic activity each week (activity that raises your heart rate but still allows you to talk) or 75 minutes of vigorous aerobic activity each week.
• Strengthening activities that work all major muscle groups on twice a week.
• If you’re over 65 or have balance concerns, balance exercises twice a week can help.

These guidelines are a goal to work towards, not a starting point. You can build up too them slowly.

What’s the difference between physical activity and exercise?

Physical activity is any body movement that uses energy. It includes everyday activities you might not even think of as “exercise,” such as:

• Getting out of bed
• Brushing your teeth
• Walking
• Climbing the stairs
• Cleaning
• Doing the shopping

Exercise is a type of physical activity. It’s more structured and usually done for the purpose of improving or maintaining fitness. Exercise can include things like:

• Walking or running
• Dancing
• Sit-to-stand exercises
• Exercise classes
• Yoga

Both can help support your health and wellbeing, especially when done regularly. What matters most is finding a way to move that works for you and feels manageable.

Getting Started

• Start Slow: Begin with what feels manageable and listen to your body. Pay attention to how you feel and do not try to push yourself too hard. Overdoing it can have the opposite effect. Keeping a diary can help you track energy levels.
• Choose something you enjoy: The activity that you want to do is more likely to become a habit than the activity you think you should Enjoyment is important!
• Break your day up with movement: A few gentle stretches in bed in the morning, a short lunchtime walk, or a few minutes of housework can all help you get moving and feel better.
• Join a group: There may be a local group (such as 5k Your Way) or an online class that suits your needs. Some are even led and designed by people specially trained to support those affected by cancer.
• Building muscle: Cancer and its treatments can weaken our muscles. But building strength can reduce fatigue and unwanted weight loss, support bone health and, most importantly, help us stay independent.
• Rest: Allow for lots of rest and recovery between your exercise sessions.
• Stay hydrated: Drink plenty of fluids before, during, and after exercise, especially if you experience dehydration from treatment.
• Good Nutrition: Maintain a healthy diet to provide your body with the energy and nutrients it needs to support physical activity.
• Find a Support System: Exercise with a friend, family member, or cancer support group. Having a workout friend can provide motivation and accountability.
• Track Your Progress: Keep a record of your activity levels. This can help you stay motivated and track your improvements over time. You can use a fitness journal, app, or wearable device.
• Be Patient and Kind to Yourself: It may take time to see results. Do not get discouraged if you do not feel better immediately. Consistency is key.
• Celebrate Successes: Acknowledge and reward yourself for achieving your goals, no matter how small. Be proud of the small wins.
• Start Gently: Include exercises that work all the major muscle groups. Examples include:
  • Wall press-ups
  • Sit-to-standing-up
  • Seated knee extensions
  • Bicep curls (with tins, bands, or light weights)
  • Overhead arm presses

Remember: any movement counts. Even small steps can make a big difference.

Common Challenges

Many people who have had cancer treatment face challenges when trying to be physically active. Here are some ideas for overcoming some of these barriers.

Fatigue:

• Plan exercise for times of the day when you have the most energy.
• Break up exercise into shorter sessions. For example, take two or three short walks through the day.
• Listen to your body and rest when you need to.
• Plan gentle activities like walking, yoga, or Tai chi.

Pain:

• Choose low-impact activities that are less likely to worsen pain.
• Use pain medication as prescribed by your doctor.
• Apply heat or cold to painful areas before or after exercise.
• If possible, work with a physical therapist to develop a pain management exercise plan.

Nausea:

• Exercise on an empty stomach or after taking anti-nausea medication.
• Avoid very difficult or intense activities that can make nausea worse.
• Exercise in a cool room or environment.

Weakness:

• Start with light weights or resistance bands for strength training.
• Perform exercises in a seated or supported position.
• Gradually increase the difficulty as you get stronger.

Lymphoedema:

• If possible, ask a lymphoedema specialist or physical therapist for guidance on safe and appropriate exercises.
• Wear compression garments if recommended.
• Avoid activities that cause too much strain on the part of your body affected.

Neuropathy:

• Choose non-weight-bearing exercises like swimming or cycling to reduce stress on the feet and hands.
• Wear supportive shoes to protect your feet.
• Be mindful of balance and coordination.

Reduced Range of Motion:

• Perform gentle stretching and range-of-motion exercises to maintain joint flexibility.
• Work with a physical therapist to address specific issues.

Depression or Anxiety:

• Try activities you find enjoyable or manageable.
• Exercise in nature or with a friend for added benefit.
• Consider mind-body exercises like yoga or Tai chi.

Immunosuppression (a weakened immune system):

• Avoid public gyms or crowded places to reduce the risk of infection.
• Exercise at home or outdoors.
• Practice good hygiene.

The Evidence for Movement

• A study by the University of Rochester Medical Centre found that people who did yoga after completing cancer treatment showed lower levels of inflammation than the control group. Inflammation has been linked to an increased risk of cancer returning, so reducing it can be helpful. (1)
• Another study, also by the University of Rochester Medical Centre, found that regular yoga classes helped ease fatigue and maintain quality of life compared to people who were given a placebo activity instead. (2)
• A study of more than 2,600 cancer patients in Brazil found that even light activities like housework or carrying shopping improved survival. Avoiding lengthy periods of sitting or lying down made a significant difference. (3)
• The International Multidisciplinary Roundtable stated that exercise was generally safe for cancer survivors, and that every survivor should avoid ‘inactivity.’ Either aerobic or resistance training, or a combination of both, could improve outcomes like anxiety, depression, fatigue, and quality of life for cancer patients. (4)
• A large study of 1,466 patients with lung cancer (42.8% were Stage 3 or 4) found that people who were physically active survived an average of four years longer than those who were inactive, even in advanced stages. (5).

Advanced cancer

If you are living with cancer, movement and exercise can be an important part of reducing pain and fatigue, increasing your quality of life and independence. Where possible, speak to your treatment team about local online resources they can signpost you to.

Key Takeaways

• Keeping active is a positive part of cancer care for most people.
• Ask your healthcare team before starting a new exercise.
• Find activities you enjoy and can do regularly.
• Start slowly and gradually increase your activity level.
• Listen to your body and rest when needed.
• Celebrate your progress and seek support from others.

By following these guidelines and working closely with your healthcare team, you can use the power of physical activity to improve your health and wellbeing throughout your cancer journey.

Resources and Support

5k-your-way

Bone Metastasis: Symptoms, Diagnosis, and Treatments

Supervised Exercise Safe for People With Bone Metastases

Exercise for individuals with bone metastases: A systematic review – ScienceDirect

Home – Move Against Cancer

Physical activity, exercise, and primary breast cancer | Breast Cancer Now

Learn more about exercise guidelines for people with cancer here:

Exercise guidelines for people with cancer | Cancer Research UK | Coping physically

NHS Cancer Rehabilitation:

Some NHS trusts offer cancer rehabilitation services, which may include physiotherapy, occupational therapy, and exercise programs.

References

1. Effects of yoga vs placebo on inflammation among cancer survivors: A nationwide multicenter phase III randomized controlled trial (RCT). | Journal of Clinical Oncology
2. The effect of YOCAS©® yoga on cancer-related fatigue and quality of life in older (60+) vs. younger (≤ 59) cancer survivors: Secondary analysis of a nationwide, multicenter, phase 3 randomized controlled trial – PubMed
3. Sedentary lifestyle as a predictor of early death in older adults with cancer: A prospective cohort study with 2692 patients. | Request PDF
4. Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable – PubMed
5. Impact of self-reported physical activity and health promotion behaviors on lung cancer survivorship