Should you simply rest during cancer treatment, or put on your trainers and head out? We look at the evidence for the benefits of exercise when you have cancer – and what could work for you...
Even the fittest people can be diagnosed with cancer: Wimbledon champion, Martina Navratilova; figure skater, Scott Hamilton, and swimmer, Eric Shanteau, who won a gold medal at the 2012 Olympics, are among the many top sportspeople who have been successfully treated for cancer. All of them, not surprisingly, made a point of including exercise in their recovery programme - but what about the rest of us? Does exercise have a role to play in helping us recover and, if so, what sort of exercise is best?
Is rest best when you have cancer?
Well, that used to be the official line, not just for cancer patients but for anyone diagnosed with a serious medical condition or illness. But, by the 1960s, things were changing as it became clear that lack of physical activity could have a damaging physical and mental effect on people living with long-term illnesses. Exercise began to be included in recovery programmes for people being treated for certain types of heart disease and that approach has now been taken on board by many medical professionals treating patients for a range of conditions and diseases – including cancer.
Since the 1990s, exercise and movement programmes have increasingly been included in the recovery plan for cancer patients. But it’s not standard. While some hospitals automatically refer cancer patients to exercise programmes, others do not. And, in some cases, patients like one of our Facebook group members find out about these programmes only by chance:
‘I have self referred to the physiotherapist at (the) Cancer Centre, who is very enthusiastic about doing an assessment and starting me on an exercise programme as soon as I finish chemo…I happened to spot a leaflet while I was waiting for a blood test, none of the staff had mentioned it to me.’
Cancer and exercise – what’s the evidence?
There is now a solid body of evidence, stretching back over almost 30 years, which confirms that exercise can help recovery from cancer and cancer treatment.
And research continues. For example, in the US, a recent study carried out by Rutgers School for Nursing showed that aerobic exercises, including walking programmes, could help people who had been treated for cancer (especially breast cancer) fight fatigue, maintain a healthy weight, and reduce systemic inflammation.
In 2018, the Clinical Oncology Society of Australia recommended that exercise should be included as standard practice in cancer care. In April of this year, the Chris O’Brien Lifehouse cancer hospital in Sydney hosted a conference to share information on the subject ‘for a range of exercise and cancer supporters, including oncologists, exercise physiologists and those currently living with cancer and cancer survivors.’
According to the hospital, clinical trial evidence clearly shows that ‘…people involved with exercise interventions experience fewer and or less severe treatment-related side effects and have enhanced physical and psychological outcomes after a cancer diagnosis.’ In other words, when it comes to recovering from cancer, exercise can help you physically and mentally and your general well being.
In the UK, some hospital trusts offer exercise programmes and printed information for cancer patients and there have been pioneering schemes like this one in Southampton, looking at the benefits of pre-surgery exercise programmes for cancer patients. In 2014, Sheffield Hallam University Centre for Sport and Exercise Science (CSES) and Centre for Health and Social Care Research (CHSCR) announced plans to develop a cancer rehabilitation programme for patients and survivors living in Sheffield. The university developed the project in partnership with the National Centre for Sports and Exercise Medicine in Sheffield, Sheffield Teaching Hospitals NHS Foundation Trust and Weston Park Hospital Cancer Charity.
Charities and voluntary organisations have also played an important role in offering exercise and movement classes to people with cancer.
Breast Cancer Haven runs tai chi, yoga, qi gong, Nordic walking, and Pilates classes, for example, at its regional centres. Check here to see if there is a centre near you and what’s on offer. The charity also has a range of online programmes that you can follow if there isn’t a centre near you.
If you live in the Bristol area, you could be eligible to join Energise, a 12-week exercise based rehab scheme based in local leisure centres in Bristol and North Somerset, specifically for people living with or beyond cancer. Energise is run jointly by North Bristol NHS Trust, Everyone Active and Macmillan Cancer Support and accepts people at any stage from the point of cancer diagnosis – before, during or after treatment.
Macmillan is involved in similar programmes around the country, so do take a look at the charity’s website to find out if there is one near you. All this is great news for cancer patients and we can only hope that this type of programme will become available for everyone coping with cancer and cancer treatment, wherever they are.
Cancer and exercise – the feelgood factor
Many of our Community Forum and Facebook group members have their own stories of how exercise has helped them. Of course, we are all different and much will be depend on factors like your age, your cancer diagnosis, the type of surgery and treatment you’ve had, and your general fitness levels.
Coping with cancer treatment and even readjusting after it has finished can be overwhelming but an exercise programme, however modest, can shift your focus, as one of our members in Northern Ireland found:
‘I had a 2nd cycle (of chemo) on Wednesday and despite a low blood count and neutropenia I managed a respectable 5k at Parkrun this morning along the beach… It’s amazing what positive thinking and some fresh air can do for the soul!’
Another member confirmed that following an exercise routine brought tangible benefits and gave her a positive focus throughout treatment:
‘ I continued crossfit although chemo, op and radio (meant that) I had less energy and couldn’t lift due to picc line but my oncologist said I’d suffered less side effects due to exercise. I put on a stone as I used to train 4x a week before and missed some sessions but I’m back full pelt and increasing my deadlift back up. Still half way through radio but determined to lose this weight in time for wedding in April.’
Starting an exercise programme when you have cancerDo check with your specialist cancer team or GP before you start any exercise programme, especially if you have any other medical conditions. You need to be sure that you are exercising appropriately and safely, ideally with qualified professionals who are experienced in working with cancer patients.
How can I find out about exercise programmes for people with cancer?Here’s a checklist to help you find a class, programme or home-based routine that’s right for you:
- Get a hospital referral – If the hospital where you are having or had your cancer treatment hasn’t referred you to a physiotherapist and/or an exercise programme – ask for a referral, or contact them directly.
- Ask your GP for details of any local rehab or exercise programmes for cancer patients – and ask for a referral if necessary.
- Try a charity. Many cities and larger towns have their own cancer support charities and voluntary organisations that provide exercise programmes. Check with your GP or local library to find out what’s on offer in your area.
- Ask the community. Post a question on our Community Forum.
'I’m not sure that I’m ready for an exercise class…'
If you haven’t exercised for some time – even a long time – don’t worry, you can start gently at home and build up. Live Better With has a great range of simple exercise equipment, aids and books to help you devise a gentle but consistent exercise routine. The range includes special kits like this one for people with breast cancer.
And don’t forget that walking is one of the best forms of exercise, although you need to aim for a brisk walk, which increases your heart rate, rather than a gentle stroll! Running and jogging are good aerobic activities and, if you love water, go for a regular swim. (Make sure that the sort of stroke you normally use is suitable, especially after surgery, and if you have had radiotherapy, don’t use swimming pools for the first three months after treatment.)
Yoga and Pilates are excellent for flexibility and core strength but if you plan to practise at home, you could try having some individual sessions with a qualified, experienced teacher first, so that you keep to the safest, most helpful postures and sequences. If you find it helpful to have something to follow at home, we think you’ll love the Gentle Healing Yoga DVD, which guides you through suitable postures and includes a 15-minute meditation.
See also the Live Better With Expert Guide to Cancer and Exercise for more information and advice.