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Exercise Support

Regular exercise is safe and recommended before, during and after cancer treatments.
Recommendations
Exercise can help to manage and reduce many common side effects of cancer treatments. It can increase your energy, improve strength and fitness, enhance mood and optimize recovery.

It is safe for most people to exercise at any time after your diagnosis if you start slowly and increase your activity gradually. Inactivity and rest can lead to weakness, deconditioning and fatigue and should be avoided where possible.

What are the benefits of exercise for people with cancer?

Cancer treatments such as surgery, chemotherapy, radiation therapy and hormone therapy will often cause side effects that can impact your daily activities, physical function, ability to work and overall quality of life.

  • Regular exercise is important at every stage of your cancer treatment and recovery. It has been shown to:
  • Improve energy levels and reduce cancer-related fatigue
  • Maintain and improve fitness and strength
  • Reduce deconditioning caused by treatments
  • Increase flexibility and range of motion
  • Assist with weight control
  • Improve balance and lower your risk of falls
  • Maintain independence and normal daily activities
  • Increase strength of muscles and bones
  • Improve your mental health and self-esteem
  • Reduce the risk of other health conditions (e.g. heart disease, diabetes, high blood pressure and some cancers)
  • Improve your quality of life

How much exercise is recommended?

The exercise guidelines encourage you to start by moving more and sitting less. Take part in regular physical activity and return to normal activities as soon as possible after cancer diagnosis and treatments.

Gradually increase your exercise and aim to do some type of activity on most days of the week.

Once you are regularly active, it is recommended to build up to 150 minutes of moderate-to-vigorous aerobic exercise (e.g. walking, cycling, swimming) and two strength training (resistance) sessions per week.

How do I get started?

Most people are safe to begin walking or some type of low intensity exercise (e.g. swimming or cycling). If you are new to exercise or have not been active recently it is recommended that you check with your health care provider or an exercise physiologist before becoming more active.

For individual exercise advice or exercise safety screening, you can speak to an oncology trained qualified exercise professional at HealthLink BC for free by calling 8-1-1 from anywhere in BC. This service can help determine what amount and types of exercise are safe for you, can give you individual exercise recommendations and can support you in becoming more physically active and to stay motivated.


Common Questions
For most people, exercise can be very safe during cancer treatments. 

If you are unsure if exercise is safe for you, check in with your health care provider prior to getting started. It is recommended to start exercising as soon as possible after your diagnosis and to aim to stay as active as possible during and after cancer treatments.  

An exercise specialist with cancer-specific training can help to guide you on the types of exercises that are safe and appropriate for you. To get individualized exercise advice, you can speak to an oncology trained qualified exercise professional at HealthLink BC for free by calling 8-1-1 from anywhere in BC.

If you are currently exercising, it is recommended that you continue your activities, however, you may need to change how you are exercising if you have high levels of fatigue or pain present. Small changes can be made to your exercise plan to accommodate any treatment-related side effects that you experience.

If you are currently inactive, it is recommended to start with low intensity activity and do what you can. It is important to be consistent with your exercise and to gradually progress to doing something on most days of the week.  A slow, short walk is a great way to start and you can build up the duration and intensity (e.g. walking faster or adding hills) over time.

You can also read more by visiting the Canadian Cancer Society website.
Correctly prescribed exercise can help to manage and reduce many side effects of cancer treatments, including

  • Fatigue
  • Physical deconditioning
  • Lymphedema
  • Body weight changes
  • Bladder incontinence
  • Balance and stability
  • Mental health
  • Bone health
  • Muscular strength and size
  • Cognitive functioning & memory
  • Quality of life 
When getting started, it is important to begin slowly and to increase the amount of exercise that you are doing gradually. 

To get individualized exercise advice that is specific to your needs and the side effects that you are experiencing, an oncology trained exercise professional can help. HealthLink BC offers this service for free by calling 8-1-1 from anywhere in BC.
While exercise is safe and recommended for most people living with cancer, there are some situations where it is recommended that you delay starting exercise or modify your exercise. 

It is rare that exercise is not recommended. More commonly, small modifications are needed to ensure that it is safe.

The following are common symptoms or conditions that normally indicate you should speak to your healthcare provider prior to becoming more active for clearance:

  • Recent surgery. While most surgeons recommend that you return to normal activities of daily living as soon as possible after a cancer surgery, restrictions can apply for up to 12 weeks for returning to exercise or weight training. Check with your surgeon or health care provider to understand your activity restrictions and how long these apply for.
  • Multiple or uncontrolled health conditions (heart disease, diabetes, lung conditions, high blood pressure, neurological issues)
  • Anemia (low red blood cell count / hemoglobin)
  • Unrelieved pain, nausea/vomiting, diarrhea or any symptoms that cause you concern

Precautions should be taken if you have the following:


  • Low white blood cells / compromised immune system: Public exercise facilities, like gyms and swimming pools, may not be appropriate at this time due to an increased chance of infection. Ensure you wipe down the equipment that you are using before touching it and where possible exercise at home or in facilities designed specifically for cancer survivors. 
  • Moderate or high fatigue levels: Exercise is recommended and beneficial, however, you should start slowly and progress slowly. 
  • Bone metastasis: When bone metastasis are present correctly prescribed exercise can be safe and beneficial. The type of exercise that is recommended will depend on the location, type and severity of your bone metastasis. An exercise specialist with cancer specific training can recommend appropriate and safe exercises for you. More information on how to find an exercise specialist can be found in the "How to Find an Oncology Trained Exercise Professional" section of the "More Resources" tab above.
  • Advanced cancer: An advanced cancer diagnosis can present multiple complications for becoming more physically active. Correctly prescribed exercise has been shown to be very beneficial for advanced cancer patients. An exercise specialist with cancer specific training can recommend appropriate and safe exercises for you. More information on how to find an exercise specialist can be found in the "How to Find an Oncology Trained Exercise Professional" section of the "More Resources" tab above.
  • Lymphedema: It is safe to exercise with lymphedema, however, you may need to wear a compression garment and modify the types of exercise that you perform. A physiotherapist or your health care provider can help provide you with more information.  More information on how to find a physiotherapist can be found in the "How to Find an Oncology Trained Exercise Professional" section of the "More Resources" tab above.
  • Poor shoulder movement: It is common after breast cancer treatments to have reduced range of motion in your shoulders. Exercise can help with this, however, it is important to speak to an exercise professional or physiotherapist if you cannot move your arm as well as you did prior to treatment as they will be able to advise on safe exercises to perform.  More information on how to find an appropriate professional can be found in the "How to Find an Oncology Trained Exercise Professional" section of the "More Resources" tab above.
  • Ostomy: It is advised that you avoid exercises that increase intra-abdominal pressure when being active with an ostomy. Check with your surgeon or health care provider to understand your activity restrictions. An exercise specialist with cancer specific training can recommend appropriate and safe exercises for you. More information on how to find an exercise specialist can be found in the "How to Find an Oncology Trained Exercise Professional" section of the "More Resources" tab above.
  • Severe peripheral neuropathy: If your feet or hands are numb, precautions may need to be taken to ensure that you can exercise safely. Walking poles can be a great way to increase your balance when you are outside and adaptations can be made to your strength training to ensure you are safe.
  • Osteoporosis: Exercise is safe and recommended with osteoporosis. You may need to modify your activity, depending on your specific physical condition. A physiotherapist or exercise physiologist can help provide you with more information.  More information on how to find appropriate professional can be found in the "How to Find an Oncology Trained Exercise Professional" section of the "More Resources" tab above.
If you are unsure about your exercise safety, speak to your health care provider, a physiotherapist or an exercise specialist prior to starting. More information on how to find appropriate professional can be found here.
Most people with cancer will experience fatigue and a reduction in energy at some point.  Usually, this coincides with treatments such as chemotherapy and radiation therapy. Research studies show that consistent exercise, performed on most days, is one of the most effective ways to increase your energy and reduce fatigue. Both aerobic exercise and strength training exercises have been shown to be effective at reducing fatigue. 

It is important to note that inactivity can lead to higher levels of fatigue, muscles wasting and reduced function, and it is recommended to try to do something physically active each day. For some, this can initially be as little as 2 – 10 minutes of walking performed multiple times throughout your day. Even small amounts of activity are beneficial, so it is recommended that you start with something that you can tolerate and progress this as your body allows.

Tips for getting started

  • Pace yourself. Start with a small amount of walking that you can currently tolerate and build up slowly over time. By adding a small amount each week, you will allow your body to adapt to the change and tolerate a larger amount. 
  • Consistency is key. The most important thing when starting is to initially only do what you can tolerate well (both at the time and afterwards) and then add small amounts to this each day.
  • Your response to exercise is very important.  If exercise causes you to have a large increase in fatigue (or an ‘energy crash’) it is likely that you worked too hard.  Try reducing the time, distance and/or intensity the next time you are active. Similarly, exercise should not lead to pain, nausea or dizziness.
  • Have a daily routine and exercise at the time of day when you feel your best. 
  • Record your exercise and your fatigue levels. By keeping a diary you will be able to see how much exercise you are doing and how your fatigue levels are responding.  If you are exercising correctly, you should see your total amount of weekly exercise increase and your levels of fatigue reduce. 
    • You can track fatigue with a 0-10 scale, with 0 being “no fatigue” and 10 being “extreme fatigue”.  Your fatigue will vary throughout the day, so try tracking your average fatigue level each day.
  • If you are unsure what you should be doing, seek help from an exercise professional. More information on how to find an exercise specialist can be found in the "How to Find an Oncology Trained Exercise Professional" section of the "More Resources" tab above.
For more information on how to exercise well with cancer-related fatigue, visit our fatigue exercise handout.

To get individualized exercise advice that is specific to your fatigue and current situation, an oncology trained exercise professional can help. HealthLink BC offers this service for free by calling 8-1-1 from anywhere in BC.
Strength training, also called resistance training or weight training, is a type of exercise that works the muscles by using a force (weights, body weight, bands, machines) and aims to increase muscle strength, function and size.  It is different from walking, swimming and aerobic exercises, which aim to improve the capacity of the heart and lungs.  Strength training is generally performed by moving against resistance a certain number of times (sets and repetitions) for the purpose of building muscular strength.

It is recommended that people with cancer engage in at least two strength training sessions per week, working all of the major muscles in your body.

Why is it important?

To perform basic activities of daily living we require a certain amount of muscular strength.  This includes activities like walking around, getting out of a chair, lowering your body onto the toilet seat, getting in and out of bed, opening doors and dressing. Regular strength training can build up our muscles to be able to easily perform these activities. 

Beyond the basic activities, strength training can improve your ability to go for a walk or hike, play with your children or grandchildren, engage in more vigorous physical activity and sports and to tolerate more physical efforts.  Increasing muscle mass can help you to improve your overall function and quality of life.

Examples of strength training

  • Body weight: You can use the weight of your body to provide resistance and to build up strength. Some examples include basic movements like standing up from a chair and sitting back down (chair squats) and standing a little less than arms length away from a wall, lowering your chest  down towards the wall and then pushing away (wall pushups). Body weight exercises can be performed anywhere (at home, work, a park, the gym).
  • Weights, resistance bands, dumbbells: Weights and bands are low cost and portable and can be a great way to build up muscle mass and strength. Some examples include holding weights while you perform a chair squat to strengthen your lower body, pulling a resistance band in a rowing motion to strengthen your back muscles or curling weights up and down to strengthen your arm muscles. These types of exercises can be performed anywhere and a balanced program can work all muscles in your body.
  • Gym machines, cables: Most gym facilities have resistance machines and cable pulleys that are designed to strengthen your muscles. Many of these machines are easy to use and can work all muscles in your body. If you are new to the gym environment, ensure you seek proper instruction from an exercise professional prior to starting.  If you currently have low white blood cell counts, it is not recommended to expose yourself to this environment until this is back to normal levels.
Please visit our exercise handouts for more information.

To get individualized exercise advice and a strength training plan, an oncology trained exercise professional can help. HealthLink BC offers this service for free by calling 8-1-1 from anywhere in BC.
 
The current exercise guidelines for people with cancer recommend performing 150 minutes of moderate-to-vigorous intensity exercise per week and strength training at least two times per week.

If you currently walk daily, this is a great starting point! However, you might not be meeting the guidelines due to the following considerations:

  1. Exercise intensity. Walking can be moderate-to-vigorous intensity, however this depends on your currently physical condition and the type of walking that you do. For some people, moderate intensity might only be achieved if you walk briskly and include some hills.  This will vary between individuals. You can use many different methods to measure the intensity of your walking, such as heart rate, rate of perceived exertion (RPE) and the talk test. An exercise professional can guide you on these areas. A quick and easy way to check your intensity is the talk test:
    • Low intensity activity – You can talk and sing easily and your breathing will not interrupt this. 
    • Moderate intensity activity - you can to talk, but not sing.  
    • Vigorous intensity activity – you can say a few words but then need to pause for a breath. You cannot sing.
  2. Strength training. Walking is not strength training and while you will feel yourself becoming stronger by walking, specific strength training exercises are still recommended at least two times per week.
Please visit our exercise handouts for more information.
 
Lymphedema is a build-up of fluid. When the flow of lymph fluid is impaired, excess lymph accumulates, usually in an arm or leg, causing lymphedema. 

For more detailed information on lymphedema and treatments, visit our Lymphedema page.

Exercise, both aerobic and strength exercises, has been shown to be safe for people with or at-risk of developing lymphedema. However, you may need to take some precautions to ensure that it is appropriate for your condition. More information about the precautions that you may need to take can be found in our Lymphedema patient handout

For more information on how to exercise with lymphedema, consult with your health care professional or a physiotherapist. 

For information specific to breast cancer and lymphedema, visit our breast cancer lymphedema information
 
Exercise has been shown to be safe for people with cancer at all stages, before, during and after treatments.  It is recommended to begin or maintain regular exercise as soon as possible after your cancer diagnosis.  

There may be times when exercise is not recommended for you.  This is less common. If you have concerns about starting exercise or are unsure if it is safe for you, consult with your health care provider or with a qualified exercise professional with cancer-specific training.

Please visit our exercise handouts for more information on exercise and cancer.

To get individualized exercise advice or a safety screening prior to starting exercise, an oncology trained exercise professional can help. HealthLink BC offers this service for free by calling 8-1-1 from anywhere in BC.
 
It is common to feel stiff in your muscles and joints during and after cancer treatments.  General movement and exercise can help to improve this.  If you are currently inactive, it is recommended that you start moving more regularly and build up to exercising on most days of the week.  This should help you improve general body flexibility.  

Additionally, stretching can help you improve your range of motion in specific areas.  It is recommended that stretches be performed on days that you are exercising. To stretch safely, ensure that your body has been warmed up by doing some activity first (such as 2-3 minutes of walking on the spot).  When stretching, aim to hold the stretch for 20 – 30 seconds and avoid bouncing or rocking.  

To get individualized exercise advice and a flexibility exercise plan, an oncology trained exercise professional can help. HealthLink BC offers this service for free by calling 8-1-1 from anywhere in BC.
 



More Resources

For more information, click here.‎

HealthLink BC 8-1-1 Telephone Line: A free-of-charge provincial health information and advice phone line available in British Columbia. To access this service, call 8-1-1 and ask for “Physical Activity Services for cancer” to be connected with a qualified exercise professional with cancer-specific training. 8-1-1 is available Monday to Friday from 9am to 5pm from anywhere in BC.

If you are a Physician or Nurse Practitioner and would like to refer a patient directly to the HealthLink BC Physical Activity Services for Cancer, please complete the referral form and a Qualified Exercise Professional will contact your patient directly.

The Canadian Cancer Society website has information about all types of cancer, cancer treatment and side effects, coping with cancer and cancer prevention.

The Canadian Cancer Society community services locator allows you to find services (including exercise and rehabilitation services) in your community.
 

For Patients/Public

Good places to start

More exercise and physical activity websites

Practice guidelines

Research studies

Other Tools & Resources

For Researchers/Clinicians

Good places to start

Practice guidelines – Cancer Survivors

Practice guidelines – Cancer Prevention 

 
Exercise Physiologist

  • HealthLink BC – Qualified exercise professional
    • Call 8-1-1 and ask to speak to Physical Activity Services for cancer (free service)
  • CSEP – Find a member
    • Search for “cancer” and select a CSEP-CEP
Physiotherapist

Kinesiologist 

 


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