What is exercise?
Physical activity and exercise
Physical activity is a broad term for body movement that uses your muscles, and may speed up your breathing and heart rate. It includes exercise sessions as well as some everyday activities, like housework, gardening and walking the dog.
Exercise is usually structured physical activity that aims to improve health and fitness. It can include doing planned or specific movements (like you would in a yoga class or with an exercise physiologist), or other physical activity (like going for a bike ride or walk).
Most people take some time to get back into exercise, so try to be patient with yourself – it’s okay to try a little to start with and work up to what you need to do. Check in with your health care team before starting any exercise to make sure it is safe for you.
“I walk 3 or 4 times a week. It gives me extra energy and helps clear my mind. If I don’t do any walking, I really notice the difference in my energy levels and my mood.” Rima
The different types of exercise
Aerobic and cardio exercise
- Uses large muscle groups repeatedly and is usually done over an extended period.
- Causes your heart and breathing rates to rise.
- Increases your ability to use oxygen, which improves heart, lung and muscle fitness.
- With time, strenuous tasks become easier.
Strength and resistance training
- Makes your muscles work harder than usual against some sort of resistance.
- Strength or resistance training is also known as weight training.
- Over time, improves the size, quality and capacity of your muscles.
- Can help to stretch your muscles.
- Improve your flexibility or how far you can move – also called your range of motion.
- Include yoga and Pilates.
- Being able to stay upright or in control of your body movement.
- Often done by being still (static) but sometimes also by moving (dynamic).
- Improve stability, which can help to prevent falls.
Along with exercise, eating well is essential for health and wellbeing. See a dietitian and read Nutrition for People Living with Cancer for more information. You may also like to listen to our podcast Finding Calm During Cancer for relaxation and meditation exercises.
Exercising after a cancer diagnosis
Research shows that exercise benefits most people with cancer before, during and after treatment. Exercise can improve physical function and fatigue and help you regain strength to get back to your daily activities.
Benefits of exercise
Exercise is important for everyone’s overall health and wellbeing, but it has a range of general benefits for people with cancer. It may:
- improve how you respond to treatment (for some cancers)
- reduce the risk and severity of side effects of cancer treatments
- reduce complications from surgery and time spent in hospital
- help with recovery from treatment by increasing energy levels, reducing treatment-related muscle loss, strengthening bones, and improving mobility and balance
- improve sleep and fatigue, and relieve stress, anxiety and depression
- help maintain a healthy weight
- reduce the risk of developing or improve health issues, such as high blood pressure, heart disease, stroke, osteoporosis and type 2 diabetes
- reduce the risk of some cancers coming back, including breast, prostate, bowel and endometrial (uterine) cancers
- boost mood and self-esteem
- offer new ways to meet people and socialise.
Frequency of exercise
Aim to be as physically active as your abilities allow. Exercise for people living with cancer should be tailored to the type and stage of cancer and any side effects. Talk to an exercise professional (an accredited exercise physiologist or physiotherapist) or a clinical nurse consultant about how much and what type of exercise is best for you.
The Clinical Oncology Society of Australia (COSA) recommends that people with cancer who are relatively healthy and have been assessed as low risk, aim for and maintain per week:
- at least 2½ hours of moderate intensity aerobic or cardio exercise or 1¼ hours of vigorous aerobic or cardio exercise
- 2–3 strength or resistance sessions to build muscle strength.
It can take time to build up to this level of exercise. After treatment, aim to gradually increase exercise to Australia’s Physical Activity and Sedentary Behaviour Guidelines for Adults, which recommend you:
- move more and sit less
- aim to be active on most, preferably all, days of the week
- get a total of 2½ to 5 hours of moderate intensity or 1¼ to 2½ hours of vigorous intensity physical activity throughout a week
- do 2–3 strength or resistance training sessions a week, involving large muscle groups
- break up long periods of sitting as often as you can.
How exercise can ease side effects
Cancer treatment causes a range of physical effects that are different for different people. Exercise has been shown to help people cope with many of the common side effects, however some side effects need extra care if you are starting an exercise program.
Common side effects
Losing fitness can make fatigue worse, but low intensity exercise can help you stay fit. Try to keep active and build your muscles and adjust how hard and often you exercise. Some people find that short, frequent aerobic and cardio sessions are easier; others prefer strength and resistance training, where you can take a rest between sets.
Low red blood cell and/or haemoglobin count is a common side effect of cancer treatment. Symptoms include unexplained tiredness and fatigue. Combined with good nutrition, exercise has been shown to improve anaemia. For mild or moderate anaemia, try low intensity exercise, with a gradual increase in intensity and/or duration. If anaemia is severe, ask an exercise professional about what exercise to avoid until it improves.
Loss of muscle strength/muscle tightness
If muscles aren’t being used, they can get smaller and weaker. Lost muscle strength is a side effect of some hormone therapy and steroid treatment. Some treatments also leave muscles tight. Strength and resistance training improves muscle condition.
Starting an exercise program early in treatment may lower the risk of developing lymphoedema. For those with lymphoedema, regular exercise can reduce the severity of the condition and its symptoms.
Feeling anxious or depressed during and after treatment is common. Exercise helps the brain to produce chemicals (e.g. endorphins, endocannabinoids) that improve your mood.
Radiation therapy to the chest and some types of chemotherapy and targeted therapy drugs may damage the heart muscle, making it less effective at pumping your blood. Some hormone therapy drugs, low physical activity and poor nutrition may also increase the risk of heart problems. Aerobic and cardio exercise can help reduce the risk of long-term heart problems.
Loss of bone strength
Cancer and its treatment, particularly hormone and radiation therapy, can have long-term effects on bone strength. Early menopause and reduced levels of physical activity may also cause bones to weaken and break more easily (osteoporosis). Resistance training and exercises where you support your own body weight can help keep your bones strong.
Some hormone therapy and cancer treatments can cause joint pain. Exercise can improve muscle size and strength, flexibility and range of motion, and increase your ability to move, which can help protect your joints and reduce pain.
Weight gain is a common side effect of many treatments, including some types of hormone therapy, and steroids given to manage the side effects of chemotherapy or immunotherapy. People with cancer may also gain weight due to inactivity. Exercise can help you manage weight gain and assist in weight loss, when necessary.
Quality of life
Studies show that physical activity can help improve wellbeing, sexuality, brain fog, sleep issues, anxiety, fatigue, pain and how you feel about yourself in general.
Side effects that need extra care
If you have cancer in the bones (bone metastases or bone mets) or myeloma, you may be at risk of a break or fracture. Radiation therapy and hormone therapy may leave bones more fragile. Choose gentle activity such as walking and swimming, and avoid contact sports, running or jumping. Resistance exercise may help by strengthening the muscles around the bones. If you have osteoporosis, consult your doctor and ask for advice from a physiotherapist or accredited exercise physiologist.
Low white cell count (neutropenia)
Some cancers and treatments can weaken your immune system and cause your white blood cell count to drop. This can increase your risk of developing an infection. When your immune system is not working well (called being immunocompromised), it is important to clean any shared exercise equipment before use and avoid public spaces such as gyms, swimming pools and training venues until your white blood cell count returns to a safe level.
Low platelet count (thrombocytopenia)
Platelets stop bleeding in the body by forming clots. When the platelet count drops, you are at increased risk of bruising or bleeding. It is best to avoid contact sports, cycling and high-impact activities (such as jumping or boxing), as these could cause bruising or bleeding if you get knocked or fall over.
Areas of skin affected by radiation therapy can be extremely sensitive and often uncomfortable. Choose activities and clothing to minimise fabric rubbing on affected areas. Chlorine can irritate the skin, so avoid the pool if you have a rash or your skin is red.
You will need to wait for the wound to heal before starting any exercise, so follow your surgeon’s or doctor’s advice about when it is safe to begin. If you have post-surgery stiffness and pain, you may need an assessment from an oncology physiotherapist or other exercise professional. They can suggest specific exercises to reduce stiffness and pain in the affected area. Pain, weakness, stiffness and reduced movement are common after surgery, but they usually improve with time.
Poor balance and coordination
Surgery or cancer treatment may affect balance and coordination. This can make you unsteady and lead to a fall. Choose exercises to improve balance and muscle strength, or exercise sitting down. If your balance or coordination has been affected, avoid exercise such as riding a bike outside or using a treadmill, and avoid lifting free weights without a training partner.
Some chemotherapy drugs damage nerves, causing pins and needles and numbness in the hands and feet (peripheral neuropathy). This means you could injure yourself without noticing. If you can’t feel your feet, you’re more likely to lose balance or fall, so walk on even surfaces. Ask an exercise professional how to lift weights safely. Some people may find exercise machines safer to use than free weights.
Some chemotherapy drugs and other treatments can cause damage to the heart (cardiotoxicity). In this case you will need specialised exercise advice before taking on exercise.
You may find this checklist helpful when thinking about the questions you want to ask your doctors and exercise professionals about exercise during or after cancer treatment.
Questions for your health team
- Can I exercise while I’m having this treatment?
- Are there any types of exercise I should avoid?
- I have a stome/port/PICC line and/or chemo pump. What precautions should I take?
- I haven’t exercised much before. Do I need to have any general health checks first?
- Can you recommend an exercise professional who has experience helping people with cancer?
- Can you help me to get a chronic disease management plan, and a referral to an exercise physiologist or physiotherapist?
Questions for your exercise professionals
- What are your qualifications? Are you accredited? By which organisation?
- Have you completed any training focused on exercise for people with cancer?
- Can you talk to my medical team about my exercise program?
- What will you consider when preparing an exercise program for someone with my medical history?
- How will I know that I am doing the exercises correctly?
- What should I do if I feel pain when exercising?
- Can I start slowly?
- What if I feel too unwell to exercise?
- How long might it be before I start to see some benefits from this exercise program?
- How many appointments are we likely to need?
- How can I exercise safely to avoid COVID-19?
Exercise for People Living with Cancer
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Expert content reviewers:
Kirsten Adlard, Accredited Exercise Physiologist, The University of Queensland, QLD; Dr Diana Adams, Medical Oncologist, Macarthur Cancer Therapy Centre, NSW; Grace Butson, Senior Physiotherapist, Peter MacCallum Cancer Centre, VIC; Kate Cox, 13 11 20 Consultant, Cancer Council SA; Wai Yin Chung, Consumer; Thomas Harris, Men’s Health Physiotherapist, QLD; Clare Hughes, Chair of Cancer Council’s Nutrition, Alcohol and Physical Activity Committee; Jen McKenzie, Level 1 Lymphoedema Physiotherapist, ESSA Accredited Exercise Physiologist, The McKenzie Clinic, QLD; Claudia Marck, Consumer; Dr David Mizrahi, Accredited Exercise Physiologist and Research Fellow, The Daffodil Centre at Cancer Council NSW and The University of Sydney, NSW; Prof Rob Newton, Professor of Exercise Medicine, Exercise Medicine Research Institute, Edith Cowan University, WA; Jason Sonneman, Consumer.
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The information on this webpage was adapted from Exercise for People Living with Cancer (2023 edition). This webpage was last updated in September 2023.