Exercise guide

Exercise during and after cancer treatment: what helps, how much, and when to rest

Exercise is generally safe before, during and after cancer treatment, and it's one of the best-proven ways to ease cancer-related fatigue, anxiety and low mood and to keep you strong. People used to be told to rest. Now international guidelines say everyone should avoid being inactive and, where they can, build up to about 30 minutes of moderate activity 3 times a week, plus strength exercises twice a week. Exercise doesn't replace treatment, and it hasn't been shown to make chemotherapy work better.

This guide covers how much to do, exercise during chemotherapy and radiotherapy, lymphoedema and lifting weights, cancer in the bones, getting fit before surgery, and what a 2025 trial found about exercise and survival after bowel cancer. It also lists the signs that mean stop and contact your cancer team, such as a high temperature, signs of a clot, and new back pain with numbness or weakness.

The short version

Safe for most people, at most stages

An international roundtable convened by the American College of Sports Medicine (ACSM) found exercise generally safe during and after treatment, and says everyone should avoid being inactive. Macmillan and Cancer Research UK agree it's usually safe at any stage, with some situations that need care.

Sources 1, 2, 3

How much

The best-supported dose is moderate aerobic exercise, such as brisk walking, for at least 30 minutes at least 3 times a week, for at least 8 to 12 weeks. Adding strength exercise twice a week, 2 sets of 8 to 15 repetitions, gives similar benefits. The American Society of Clinical Oncology (ASCO) recommends aerobic and strength exercise during treatment given with the aim of cure.

Sources 1, 4

It eases fatigue

In 56 trials with 4,068 people, exercise reduced cancer-related fatigue, and across 113 studies it helped more than medicines did. ASCO and the Society for Integrative Oncology recommend exercise for fatigue during and after treatment.

Sources 5, 6, 7

Lifting weights doesn't cause lymphoedema

In 141 women with arm lymphoedema after breast cancer, slowly built-up weight lifting didn't increase swelling and halved flare-ups. In 154 women at risk, it didn't raise the chance of developing lymphoedema. NICE says there's no indication that activity causes or worsens it.

Sources 8, 9, 10

After treatment, it may help survival

In a trial of 889 people who had finished chemotherapy for colon cancer, a 3-year structured exercise programme lowered the risk of the cancer coming back, a new cancer or death by 28%. For other cancers, the evidence comes from observational studies, which can't prove cause and effect.

Sources 11, 12

Know when to stop and check

During treatment, contact your hospital straight away if your temperature is over 37.5°C or below 36°C, or you suddenly feel unwell. Your cancer team will tell you what to avoid with low blood counts, a central line or cancer in the bones. New back pain with weakness, numbness or bladder or bowel changes needs medical advice immediately.

Sources 13, 14, 15, 16

What cancer and its treatment do to your body

Cancer-related fatigue

Fatigue means feeling very tired, exhausted and lacking energy because of the cancer or its treatment. It can be worse than ordinary tiredness: people tire after less activity and can feel exhausted even after rest and sleep. Between 30% and 60% of people have moderate to severe fatigue during treatment, and 20% to 30% still have fatigue months or years after it ends.

Sources 17, 18, 7

Why moving helps

Becoming less active weakens your muscles, which makes fatigue worse, and Macmillan says physical activity such as brisk walking is one of the best ways to reduce it. Fitness tends to fall during chemotherapy, and what you can manage may change from day to day or week to week.

Sources 18, 1

Lymphoedema

Lymphoedema is swelling caused by a build-up of lymph fluid after treatment to the lymph nodes, most studied in the arm after breast cancer. Women with it were long told not to lift weights. NICE now says there's no indication that physical activity causes or worsens it.

Sources 19, 8, 10

Cancer in the bones

When cancer spreads to the bones (bone metastases), worries about fractures and the spinal cord have often kept people out of exercise trials and advice. Spinal cord compression, where cancer presses on the spinal cord, is more common with breast, lung and prostate cancer and myeloma.

Sources 20, 16

Where the evidence comes from

Almost 3.5 million people are living with cancer in the UK, but most exercise trials are in breast cancer and in women: 28 of the 56 trials in the Cochrane fatigue review were in breast cancer, and 78% of the 11,525 people in a large fatigue analysis were women. The lymphoedema findings apply to the arm after breast cancer. Blood cancers showed less benefit in the older fatigue review but a probable benefit in a later one.

Sources 21, 5, 6, 1, 22

What the evidence says

Fatigue: exercise helpsStrong evidence

In a Cochrane review of 56 trials with 4,068 people, exercise reduced cancer-related fatigue at the end of the programme, whether it was done during or after treatment. Aerobic exercise clearly helped; strength training and other types didn't reach significance on their own. Benefits were seen in breast and prostate cancer.

Source 5

Fatigue: exercise compared with medicinesStrong evidence

Across 113 studies with 11,525 people, exercise and psychological therapies each reduced fatigue by a small amount, while medicines made no clear difference. The 2024 ASCO and Society for Integrative Oncology guideline recommends exercise (aerobic, strength or both) for fatigue during and after treatment, a strong recommendation based on moderate-quality evidence, alongside cognitive behavioural therapy (CBT) and mindfulness programmes. It recommends against L-carnitine, antidepressants and wakefulness drugs for fatigue.

Sources 6, 7

Fatigue in blood cancersEmerging evidence

In 9 trials with 826 adults with blood cancers, aerobic exercise probably reduced fatigue (moderate-certainty evidence).

Source 22

During breast cancer treatmentStrong evidence

In 32 trials with 2,626 women having treatment after breast cancer surgery, exercise probably improved fitness and slightly reduced fatigue (moderate-quality evidence), with little or no difference in cancer-specific quality of life or depression. Only a very small number of adverse events were reported.

Source 23

During radiotherapyEmerging evidence

In 9 trials (802 people) of exercise during radiotherapy for breast cancer, exercise reduced fatigue, with clear benefit from supervised combined aerobic and strength training.

Source 24

Does exercise help treatment work?Mixed evidence

In 242 women having chemotherapy for breast cancer, strength training improved the rate of completing chemotherapy, as well as strength and lean mass, without causing lymphoedema. But the ACSM roundtable judged the overall evidence on how well people tolerate treatment insufficient, and Cancer Research UK says some early studies suggest activity may help treatment work better but more research is needed. It hasn't been shown that exercise makes chemotherapy work better.

Sources 25, 1, 3

Weight lifting with lymphoedemaStrong evidence

In the PAL trial, 141 women with stable arm lymphoedema after breast cancer did slowly progressive weight lifting twice a week for a year, wearing a fitted compression garment. Arm swelling rose by 5% or more in 11% of the weight lifters and 12% of the comparison group, flare-ups were less common (14% against 29%), and symptoms and strength improved. There were no serious adverse events from the training.

Source 8

Weight lifting for women at riskStrong evidence

In 154 women 1 to 5 years after breast cancer surgery with at least 2 lymph nodes removed, new lymphoedema developed in 11% of the weight lifters and 17% of the comparison group. In women with 5 or more nodes removed, the figures were 7% against 22%.

Source 9

Cancer in the bones: expert consensusStrong evidence

An international working group says people with bone metastases should be supported and encouraged to exercise. It advises a risk assessment, contact with the medical team, and a programme from a qualified exercise professional with cancer training, with extra attention to posture, control and the area of the bone affected.

Source 20

Cancer in the bones: safety so farEmerging evidence

In 17 trials including people with bone metastases, 4 serious adverse events (0.5%) were put down to exercise, none of them related to the bone metastases, and nearly all trials included supervision. In 57 men with prostate cancer that had spread to the bones, 3 months of supervised training improved self-rated physical function and leg strength, with no fractures or extra bone pain.

Sources 26, 27

Before lung cancer surgeryStrong evidence

Exercise training before lung cancer surgery cut lung complications after the operation by more than half (risk ratio 0.45; 9 trials, 573 people; high-certainty evidence) and probably shortened the hospital stay by about 2 days. The trials reported no adverse events.

Source 28

Before bowel cancer surgeryEmerging evidence

In 251 people, a 4-week supervised programme of high-intensity exercise 3 times a week, nutrition, psychological support and help to stop smoking cut severe complications after surgery (17.1% against 29.7%). Walking distance 4 weeks after surgery didn't differ, and the trial stopped early because of the COVID-19 pandemic.

Source 29

After colon cancer: the CHALLENGE trialStrong evidence

889 people who had finished chemotherapy for colon cancer were randomly assigned to a 3-year structured exercise programme or to health-education materials. After a median of 7.9 years, the exercise group had a 28% lower risk of the cancer coming back, a new cancer or death (5-year disease-free survival 80.3% against 73.9%), and the results supported longer overall survival (8-year survival 90.3% against 83.2%). Muscle and joint problems were more common with exercise (18.5% against 11.5%). This is one trial, in one cancer.

Source 11

Other cancers: activity and survivalEmerging evidence

In 136 studies, people who were most active after diagnosis had a lower risk of dying from cancer, and in breast cancer the steepest falls in risk came with up to 10 to 15 MET-hours of activity a week (10 MET-hours is about 2.5 hours of brisk walking). These are observational links, so they can't show that activity was the cause.

Sources 12, 30

How much exercise

Doses are starting points. The roundtable's doses come from trials, mostly in breast cancer; build up to them from where you are.

The general dose

Moderate aerobic exercise at least 3 times a week, for at least 30 minutes, for at least 8 to 12 weeks. Adding strength training at least twice a week, at least 2 sets of 8 to 15 repetitions with a moderate weight, appears to give similar benefits (ACSM roundtable).

Source 1

For fatigue

Moderate aerobic exercise for 30 minutes, 3 times a week, for 12 weeks; or strength training twice a week, 2 sets of 12 to 15 repetitions with a moderate weight, for 12 weeks; or both (ACSM roundtable).

Source 1

For anxiety, low mood and physical function

30 to 60 minutes of aerobic exercise at a moderate to fairly hard effort 3 times a week for 8 to 12 weeks, or shorter aerobic sessions (20 to 40 minutes) combined with strength training 2 to 3 times a week. Strength training on its own wasn't shown to help anxiety or depressive symptoms.

Source 1

For lymphoedema, bone and sleep

With arm lymphoedema after breast cancer: strength training 2 to 3 times a week, 1 to 3 sets of 8 to 15, supervised at first and starting light. For bone: a year of supervised moderate to vigorous strength training plus impact work, 2 to 3 days a week, which may not be safe with fragile bones or cancer in the hip or spine; walking alone doesn't appear to be enough. For sleep: moderate walking for 30 to 40 minutes, 3 to 4 times a week.

Source 1

The UK guidelines

Cancer Research UK uses the UK adult guidelines for people with cancer: 150 minutes of moderate or 75 minutes of vigorous activity a week, strength exercises twice a week, balance and flexibility work twice a week, and less sitting. Macmillan adds that for some people, strength and balance work may be more helpful than aerobic activity, depending on the stage of cancer or treatment.

Sources 3, 2

How hard is moderate?

Moderate activity makes you feel warmer and breathe faster, but you can still talk. Vigorous activity makes you breathe very hard, so you can't hold a conversation.

Sources 3, 2

Our editorial starting point

Start with 10 to 15 minutes of gentle activity at a time, as Cancer Research UK suggests, and build towards 30 minutes 3 times a week plus two short strength sessions. Little and often works best, and you should finish an activity feeling energised, not exhausted.

Sources 3, 31

Who should check with their team first

Walking and gentle everyday activity are fine for most people at any stage. Talk to your cancer team before starting anything new if you're having treatment, have had recent surgery, have cancer in your bones, numb feet, lymphoedema, a stoma or a central line, have heart or lung problems, or feel extremely tired (our summary of the roundtable and charity advice).

Sources 1, 3, 2

Exercise and cancer-related fatigue

What helps most

Exercise and psychological therapies such as CBT and mindfulness programmes have the best evidence. Medicines haven't made a clear difference in trials.

Sources 7, 6

Pacing

Little and often. Some weeks you'll do less, for example just after chemotherapy, and it's best not to do too much even on a good day: if you do too much one day, you might feel very tired and sore the next. A fatigue diary helps you spot patterns and plan important activities for when you have more energy.

Sources 31, 3, 18

Other causes worth raising

Anaemia (a low red blood cell count), pain, eating problems, other health conditions, poor sleep, and anxiety or depression can all add to fatigue. Anaemia is treated with a blood transfusion, erythropoietin or an iron drip. Tell your team about your fatigue, because some of these causes can be treated.

Source 18

During chemotherapy and radiotherapy

Your cancer team knows your blood counts and treatment, so ask them before changing what you do. These are the situations UK charities and health services flag.

What exercise does during treatment

During breast cancer treatment, exercise probably keeps fitness up and eases fatigue a little, and during radiotherapy it reduced fatigue. ASCO recommends aerobic and strength exercise during treatment given with the aim of cure.

Sources 23, 24, 4

Low blood counts

With a low white blood cell count you're more likely to get an infection, and your cancer team may advise avoiding busy places such as gyms and pools; online classes are an alternative. With low platelets, your doctor may advise exercising gently and avoiding high-impact activities. With severe anaemia, Ireland's health service says don't start exercising until your red blood cell count is back to a safe level.

Sources 15, 32, 3

Lines and stomas

With a central line or PICC line (a thin tube into a vein for treatment), Macmillan advises avoiding swimming because of the risk of infection, and avoiding vigorous upper-body exercise, which could move the line. With a stoma, ask your doctor or specialist nurse which exercise is safe.

Sources 15, 3

Radiotherapy and your skin

If your skin reacts to radiotherapy, wear loose clothing when you exercise and avoid swimming until the reaction has gone, because pool chemicals can irritate it. Ask your radiotherapy team when you can swim again.

Source 15

Numb feet or poor balance

Some treatments damage nerves, causing numbness or tingling in the hands and feet (peripheral neuropathy). An exercise bike or swimming may suit you better than running or brisk walking, especially on uneven ground. Check your feet regularly for cuts or blisters, and ask for advice, or a physiotherapist, if you feel unsteady.

Sources 15, 3, 1

Lymphoedema and lifting weights

What NICE says

People at risk of lymphoedema after breast cancer should know that physical activity may improve their quality of life and that there's no indication it causes or worsens lymphoedema. NICE doesn't recommend compression as a way of preventing it, and anyone who develops it should be referred to a specialist lymphoedema service. If you have lymphoedema, NICE says there's no evidence that activity, including arm exercise, will make it worse.

Source 10

How to build up

Work the big muscle groups 2 to 3 times a week, starting light and building slowly, ideally with a fitness professional supervising at first: the roundtable found too little evidence to say whether starting on your own is as safe. In the PAL trial of women at risk, the first 13 weeks were supervised, followed by 9 months on their own.

Sources 1, 9

Compression garments

If you've been given a compression garment, Macmillan and Cancer Research UK say you usually need to wear it to exercise; speak to your lymphoedema specialist if it's uncomfortable. The roundtable found too little evidence to say whether a garment is needed during exercise.

Sources 15, 19, 1

Watch for changes

Check the swollen area, or the area at risk, during and after exercise. If anything changes, stop and contact your lymphoedema specialist. Macmillan also advises avoiding static holds such as the plank with lymphoedema, and says swimming can help.

Sources 19, 15

Daily routines

Cancer Research UK's routines for arm and leg lymphoedema start with deep breathing, use gentle moves repeated 5 to 10 times, and shouldn't hurt. Its leg exercises are best done at least twice a day, and walking, swimming or cycling help get the leg muscles moving.

Source 19

If cancer is in your bones

Get a plan first

With cancer in the bones, speak to your healthcare team before starting any exercise. The international consensus advises that your medical team shares key information, such as scan results, with a qualified exercise professional who has cancer training, who can then assess you and plan your programme.

Sources 20, 15

What to avoid

Unless your team says otherwise:

  • High-impact activities, such as running, football, tennis, squash, hockey and contact sports like judo and karate (Macmillan).
  • Bending forward at the waist again and again, as in toe touches and sit-ups (Macmillan).
  • Twisting the spine, as in yoga twists, the rowing machine and golf or tennis swings (Cancer Research UK).
  • Fast or loaded movements at the end of your range through the affected area (international consensus).

Sources 15, 3, 20

What's usually safe

Walking, dancing, climbing stairs, swimming, cycling and light resistance exercise, plus balance work such as tai chi to lower the risk of falls. For moves that load the bone where the cancer is, most experts in the consensus survey favoured starting with movement and no load, or light loads, and building slowly as long as pain and other symptoms don't get worse.

Sources 15, 20

Warning signs

New or worsening back or neck pain, especially with weakness, numbness, unsteadiness or bladder or bowel changes, can mean spinal cord compression: get medical advice immediately. Report new bone pain to your team.

Sources 16, 1

Getting fit before surgery

What prehabilitation is

Prehabilitation, or prehab, means getting ready for treatment in whatever time you have before it starts: being active, eating well, stopping smoking, cutting down on alcohol and looking after your mental health. Cancer Research UK says you can improve your fitness in as little as two weeks before treatment starts.

Sources 33, 2

What it does

Before lung cancer surgery, exercise more than halved lung complications, and ASCO says doctors may recommend it. Before bowel cancer surgery, a 4-week programme cut severe complications in one trial.

Sources 28, 29, 4

Our editorial starting point

In whatever time you have: brisk walks most days, building towards 30 minutes, strength moves for the legs 2 to 3 times a week, and harder intervals only if your team agrees. Ask whether your hospital runs a prehabilitation programme.

Sources 1, 33

After treatment, and survival

The CHALLENGE programme, from its protocol

We read the summary of the final trial report, so the programme details here come from the trial's published 2008 protocol and may differ from what was delivered. It planned for a physical activity consultant to help each person add at least 10 MET-hours a week of recreational activity (about 2.5 hours of brisk walking), up to 27 MET-hours (about an hour of brisk walking every day). Support sessions were planned every 2 weeks for the first year, face to face for the first 6 months alongside supervised exercise sessions, then monthly to 3 years, with free gym access and a pedometer.

Sources 30, 11

What CHALLENGE does and doesn't show

It's one large trial in colon cancer, with a lot of support. It shows that a structured programme added to standard treatment can improve survival in that setting. It doesn't show the same for other cancers, or that exercise can replace treatment.

Source 11

Other cancers

In observational studies, people who are more active after diagnosis live longer, especially after breast and bowel cancer. NICE tells people treated for breast cancer that a healthy lifestyle, including regular physical activity, is linked with a lower risk of the cancer coming back. Cancer Research UK lists breast, bowel, prostate, and cervical, womb and ovarian cancers as ones where activity after diagnosis may lower the risk of dying.

Sources 12, 10, 3

Lowering the risk of cancer

Being active lowers the risk of breast, colon, womb (endometrial), kidney, bladder, oesophageal and stomach cancers. It's also linked with more melanoma, so the roundtable advises sun-safe habits when you're active outdoors.

Source 34

Cardio

Start with 10 to 15 minutes at a time and build towards 30 minutes 3 times a week (Cancer Research UK and the ACSM roundtable), using the bike if your feet are numb or your balance is poor.

Strength

Twice a week, 2 sets of 8 to 15 (ACSM roundtable), starting light with sit-to-stands and wall push-ups and building slowly, which matters most with lymphoedema.

Balance

With numb feet or after a fall, do these next to a counter: 3 holds of 20 to 30 seconds on each leg, then heel-to-toe walks and side-steps (our suggestion).

Gentle movement and breathing

These follow Cancer Research UK's lymphoedema routines (deep breathing first, then each move 5 to 10 times, without pain); after surgery, do only what your team has said is safe.

Workouts to follow

On low-energy days the 10-minute starter workout counts; the easy cardio workout covers the aerobic dose, and the beginner home or band workout covers strength twice a week.

10-minute starter workout

A 10-minute session for low-energy days: marching, sit-to-stands, wall push-ups, step-ups and bridges, then a short walk. Doing a little counts.

10 minBeginner7 movesA bench or box, A wall

Easy cardio workout

A steady 30 to 45 minute cardio session at talk-but-not-sing pace: walk, cycle, row or cross-train, counting toward weekly activity guidelines.

40 minBeginner3 movesCardio machine, A wall

Beginner home workout

A gentle 20-minute beginner home workout with a chair, a wall and a band: sit-to-stands, wall push-ups, band rows, step-ups and dead bugs.

20 minBeginner11 movesA bench or box, A wall

Resistance band workout

A full-body resistance band workout: squats, presses, pull-aparts, band walks, good mornings and flyes.

25 minBeginner7 movesA band, An anchor point

Chair exercises for seniors: a seated workout

A 20-minute seated workout for older adults who cannot stand for long: marching, leg and arm strength, posture, and sit-to-stands that lead back to standing.

20 minBeginner11 movesA bench or box, Something with weight

Balance exercises routine

Balance practice in 10 minutes: tandem stance, single-leg stands, marches, heel walks, tree pose and floor transfers.

10 minBeginner7 movesA wall, A bench or box

Build-up interval walk

A 25-minute walk with short faster bouts: notice your heart and breathing speed up, then settle. A gentle way to get used to the feelings of effort.

25 minBeginner5 movesCardio machine, A wall

Low-impact cardio workout (no jumping)

A 25-minute standing cardio circuit with no jumping: marching, step jacks, sit-to-stands, punches, step-ups and wall push-ups, with a seated option for most moves.

25 minBeginner9 movesA bench or box, A step

Strength and balance workout

Strength and balance in one session: squats, Romanian deadlifts, push-ups, rows, step-ups, back extensions, carries and single-leg balance.

45 minBeginner14 movesA wall, A dumbbell

Breathing exercises to relax

A 6-minute breathing routine: slow breathing, crocodile breathing, alternate nostril breathing, box breathing and 4-7-8 breathing.

6 minBeginner5 movesNo equipment

Prostate cancer, advanced cancer and getting help

Prostate cancer and hormone therapy

NICE says men starting hormone therapy (androgen deprivation therapy) should be told that fatigue is a recognised side effect, and offered supervised strength and aerobic exercise at least twice a week for 12 weeks to reduce fatigue and improve quality of life. Our guide to exercise for men covers the trials.

Source 35

Advanced cancer

Physical activity is safe with advanced cancer and has many of the same benefits. Most light activity, such as a short walk, is safe: start slowly, sit and lie down less, and use resistance and balance exercises to help with getting out of a chair or bath and climbing stairs. You can ask your cancer doctor or palliative care team to refer you to a physiotherapist or clinical exercise physiologist.

Source 15

Who can help

Physiotherapists, clinical exercise physiologists and cancer exercise specialists can tailor a plan, and some GPs, cancer centres and support groups run exercise referral schemes. Cancer Research UK mentions the charity Move Against Cancer for getting active with others. The ACSM asks clinicians to assess, advise and refer people to home, community or rehabilitation exercise.

Sources 2, 3, 36

When to stop and get help

Stop exercising and get advice straight away

Macmillan says stop and speak to a doctor straight away if you suddenly get:

  • Dizziness, chest pain, a racing heart, breathing problems or feeling sick.
  • Unusual back or bone pain, or unusual muscle pain.
  • A headache that doesn't go away.
  • Call 999 for chest pain that feels tight or squeezing or spreads to your arms, neck or jaw, severe difficulty breathing, or collapse.

Sources 15, 37

Contact your hospital team straight away

Use the 24-hour number you were given, or NHS 111 if you can't reach them, if during treatment you have:

  • A temperature over 37.5°C or below 36°C, or you suddenly feel unwell even with a normal temperature.
  • Signs of infection, such as feeling shivery, a sore throat, a cough, diarrhoea, or needing to pee a lot or pain when peeing.
  • Throbbing or cramping pain, swelling and warmth in a leg or arm, or sudden breathlessness, sharp chest pain or coughing up blood, which can be signs of a blood clot.

Sources 13, 14

Spinal cord compression: get advice immediately

Spinal cord compression is when cancer presses on the spinal cord. Contact your hospital team straight away, even at the weekend, and go to A&E if you can't reach anyone, if you have any of these:

  • Back or neck pain that is new, severe or getting worse, worse when you move, cough or strain, or that disturbs your sleep.
  • Problems controlling your bladder or bowel.
  • Unsteadiness, difficulty walking, leg weakness or your legs giving way.
  • Weak arms or hands, or trouble gripping.
  • Numbness or pins and needles that is new or quickly getting worse.

Source 16

Lymphoedema

Signs of infection (cellulitis) or a blood clot in a swollen limb need urgent medical attention. If the swollen or at-risk area changes during or after exercise, stop and contact your lymphoedema specialist.

Sources 10, 19

What's normal

Some soreness or stiffness for 2 to 3 days after exercise, and tiredness during it, is common. If you feel very sore or very tired, do a bit less next time.

Source 15

Myths

"Rest is best during treatment"Strong evidence

The roundtable says everyone should avoid being inactive. Inactivity weakens muscles and makes fatigue worse, and exercise reduced fatigue in 56 trials.

Sources 1, 18, 5

"Lifting weights will bring on or worsen lymphoedema"Strong evidence

In the PAL trials, slowly built-up weight lifting didn't increase swelling in women with lymphoedema, halved flare-ups, and didn't raise the risk in women at risk. NICE says the same.

Sources 8, 9, 10

"With cancer in the bones you can't exercise"Emerging evidence

An international consensus says exercise should be supported, with a risk assessment and expert planning. In 17 trials, no serious adverse events were related to the bone metastases.

Sources 20, 26

"Exercise can cure cancer or replace treatment"Strong evidence

CHALLENGE improved survival when exercise was added after chemotherapy for colon cancer. Exercise isn't a treatment on its own, and for other cancers the survival evidence is observational.

Sources 11, 12

"Exercise makes chemotherapy work better"Mixed evidence

Unproven. One trial found more women completed chemotherapy with strength training, but the roundtable judged the evidence on treatment tolerance insufficient, and Cancer Research UK says more research is needed.

Sources 1, 3, 25

"You have to be fit or sporty to benefit"

Start with 10 to 15 minutes of gentle activity and build up. Macmillan says doing something is better than doing nothing.

Sources 3, 2

"Feeling exhausted means you should stop moving"Strong evidence

Exercise is a first-line treatment for cancer-related fatigue in the evidence and the guidelines. Pace it so you finish feeling energised, not exhausted, and rest when you need to.

Sources 6, 7, 31

"Swimming is always the gentle option"

Not with a central or PICC line, during a radiotherapy skin reaction, or with a low white cell count when your team has advised avoiding public pools.

Sources 15, 32

Questions people ask

Is it safe to exercise during cancer treatment?

Usually, yes. International guidelines say exercise is generally safe during and after treatment and that everyone should avoid being inactive, and Macmillan and Cancer Research UK agree. Some situations need care or a pause, such as low blood counts, a fever, a central line or cancer in the bones, so talk to your cancer team before starting anything new.

How much exercise should I do during or after cancer treatment?

The guidelines suggest building up to 30 minutes of moderate activity, such as brisk walking, at least 3 times a week, plus strength exercises twice a week. The UK target is 150 minutes a week with strength work twice a week. Start with 10 to 15 minutes at a time and build up; on bad days, a little still counts.

Does exercise help cancer fatigue?

Yes. In 56 trials, exercise reduced cancer-related fatigue during and after treatment, and it helped more than medicines did. Guidelines recommend it, so pace yourself to finish feeling energised rather than exhausted. Tell your team about your fatigue too, because causes such as anaemia, pain, poor sleep or low mood can sometimes be treated.

Can I exercise during chemotherapy?

Yes, adjusting to how you feel: in trials during breast cancer treatment, exercise kept fitness up and eased fatigue a little. Expect to do less in some weeks, for example just after a cycle. Your team may advise avoiding gyms and pools when your white cell count is low and keeping it gentle with low platelets, and contact your hospital straight away if your temperature is over 37.5°C or under 36°C.

Can I exercise during radiotherapy?

Yes: exercise during radiotherapy for breast cancer reduced fatigue in trials. Wear loose clothing over treated skin and avoid swimming while you have a skin reaction, because pool chemicals can irritate it. Ask your radiotherapy team when you can swim again.

Can I lift weights after breast cancer? Will it cause lymphoedema?

Lifting weights doesn't cause or worsen lymphoedema when it's built up slowly. In trials, women who lifted twice a week had no more swelling and fewer flare-ups, and women at risk were no more likely to develop it; NICE says the same. Start light, ideally with supervision at first, wear your compression garment if you've been given one, and contact your lymphoedema specialist if the area changes.

Can I exercise if cancer has spread to my bones?

Often, yes, with a plan. Experts say exercise should be supported after your team has assessed the risk, ideally with a physiotherapist or exercise professional who knows cancer, and trials found no serious problems linked to the bone metastases. Avoid high-impact activities, twisting and repeated bending forward unless your team says otherwise, and get medical advice straight away for new back pain with numbness, weakness or bladder or bowel changes.

Can exercise stop cancer coming back?

For colon cancer, one large trial says it helps: after chemotherapy, a 3-year structured exercise programme cut the risk of the cancer returning, a new cancer or death by 28%. For other cancers, studies link being active with longer survival, but they can't prove cause and effect. Exercise adds to treatment; it doesn't replace it.

Should I exercise before cancer surgery?

If you have time, yes. Exercise before lung cancer surgery more than halved lung complications, and a programme before bowel cancer surgery cut severe complications in one trial. Fitness can improve in as little as two weeks, so ask your team whether a prehabilitation programme is available.

When should I not exercise during cancer treatment?

Don't exercise if you feel unwell or have symptoms that worry you, and contact your hospital straight away if your temperature is over 37.5°C or under 36°C. Stop and get advice for sudden dizziness, chest pain, a racing heart, breathing problems, or unusual bone or back pain. Follow your team's advice about low blood counts, lines and radiotherapy skin reactions.

What is the best exercise after cancer treatment?

A mix of aerobic activity, such as walking or cycling, and strength training, with balance work if treatment affected your nerves or balance. Choose what you enjoy, start gently and build up. A physiotherapist, clinical exercise physiologist or cancer exercise specialist can tailor a plan.

I'm on hormone therapy for prostate cancer. What should I do?

NICE recommends that men starting or having hormone therapy are offered supervised strength and aerobic exercise at least twice a week for 12 weeks, to reduce tiredness and improve quality of life. Our guide to exercise for men covers the evidence, including what to do if the cancer has spread to the bones.

Sources

  1. Campbell 2019 · Exercise guidelines for cancer survivors: consensus statement from an international multidisciplinary roundtable (ACSM, Medicine and Science in Sports and Exercise)
  2. Macmillan Cancer Support · Physical activity and cancer (reviewed November 2023)
  3. Cancer Research UK · Exercise and cancer (reviewed May 2025)
  4. Ligibel 2022 · Exercise, diet and weight management during cancer treatment (ASCO guideline, Journal of Clinical Oncology)
  5. Cramp 2012 · Exercise for cancer-related fatigue in adults: 56 trials (Cochrane review)
  6. Mustian 2017 · Medicines, psychological treatments and exercise for cancer-related fatigue: 113 studies (meta-analysis, JAMA Oncology)
  7. Bower 2024 · Management of fatigue in adult survivors of cancer (ASCO and Society for Integrative Oncology guideline update, Journal of Clinical Oncology)
  8. Schmitz 2009 · Weight lifting in 141 women with breast cancer-related lymphoedema: the PAL trial (RCT, New England Journal of Medicine)
  9. Schmitz 2010 · Weight lifting for 154 women at risk of breast cancer-related lymphoedema: the PAL trial (RCT, JAMA)
  10. NICE NG101 · Early and locally advanced breast cancer: diagnosis and management (last updated April 2025)
  11. Courneya 2025 · Structured exercise after adjuvant chemotherapy for colon cancer: the CHALLENGE trial of 889 people (RCT, New England Journal of Medicine; abstract)
  12. Friedenreich 2020 · Physical activity and survival after a cancer diagnosis: 136 studies (systematic review and meta-analysis, JNCI Cancer Spectrum)
  13. Macmillan Cancer Support · Infection (reviewed March 2022)
  14. NHS · Chemotherapy, including side effects (reviewed February 2025)
  15. Macmillan Cancer Support · Exercising safely when you have cancer (reviewed November 2023)
  16. Macmillan Cancer Support · Metastatic spinal cord compression (reviewed September 2024)
  17. Cancer Research UK · Tiredness with cancer (fatigue)
  18. Macmillan Cancer Support · Tiredness (fatigue) (reviewed July 2023)
  19. Cancer Research UK · Exercise, positioning and lymphoedema (reviewed May 2026)
  20. Campbell 2022 · Exercise for people with bone metastases: expert consensus for health care providers and exercise professionals (JCO Oncology Practice)
  21. Macmillan Cancer Support · Cancer statistics fact sheet (2025 estimate)
  22. Knips 2019 · Aerobic exercise for adults with blood cancers (Cochrane review)
  23. Furmaniak 2016 · Exercise for women having treatment for breast cancer: 32 trials (Cochrane review)
  24. Lipsett 2017 · Exercise during radiotherapy for breast cancer: fatigue and quality of life (systematic review and meta-analysis, The Breast)
  25. Courneya 2007 · Aerobic and resistance exercise during breast cancer chemotherapy: 242 women (RCT, Journal of Clinical Oncology)
  26. Weller 2021 · Exercise for people with bone metastases: 17 trials (systematic review, Critical Reviews in Oncology/Hematology)
  27. Galvão 2018 · Exercise in 57 men with prostate cancer that had spread to the bones (RCT, Medicine and Science in Sports and Exercise)
  28. Granger 2022 · Exercise training before surgery for non-small cell lung cancer (Cochrane review)
  29. Molenaar 2023 · Four weeks of prehabilitation before bowel cancer surgery: the PREHAB trial of 251 people (RCT, JAMA Surgery)
  30. Courneya 2008 · The Colon Health and Life-Long Exercise Change (CHALLENGE) trial: the published protocol (Current Oncology)
  31. Macmillan Cancer Support · Being physically active during treatment (reviewed November 2023)
  32. HSE (Ireland's health service) · Cancer treatment and physical activity
  33. Cancer Research UK · Preparing for treatment and life afterwards (prehabilitation) (reviewed April 2024)
  34. Patel 2019 · Physical activity, sedentary behaviour, and cancer prevention and control (ACSM roundtable report, Medicine and Science in Sports and Exercise)
  35. NICE NG131 · Prostate cancer: diagnosis and management (last updated December 2021)
  36. Schmitz 2019 · Exercise is medicine in oncology: engaging clinicians to help patients move through cancer (CA: A Cancer Journal for Clinicians)
  37. NHS · Heart attack: symptoms and when to call 999

Exercise education, not a diagnosis or treatment plan, and clinical review of these guides is pending. Stop and get advice for chest pain, unusual breathlessness, dizziness or fainting, or new pain, and check with your doctor or midwife first if they have told you to limit activity. Health disclaimer.