Is it safe to exercise during chemotherapy?
For most people, yes. International cancer exercise guidelines conclude that exercise is generally safe during and after treatment and that everyone should avoid inactivity. Exercise can reduce fatigue, anxiety and depression and help maintain fitness. Programmes are adjusted around treatment cycles, blood counts and symptoms, and some situations need medical advice first.
Why exercise during chemotherapy?
Chemotherapy often causes fatigue, loss of fitness and muscle strength, weight changes, low mood and reduced quality of life. Exercise can counter many of these effects and help people keep doing everyday activities.
An international multidisciplinary roundtable concluded that exercise training and testing are generally safe for cancer survivors, including during treatment, and that every survivor should avoid inactivity. There was enough evidence that aerobic, resistance or combined training can improve anxiety, depressive symptoms, fatigue, physical function and health-related quality of life 1.
What did a trial during chemotherapy show?
A randomised trial in Canada assigned 242 women with breast cancer starting chemotherapy to usual care, supervised resistance exercise or supervised aerobic exercise for the duration of chemotherapy 2. Aerobic exercise improved self-esteem and aerobic fitness, and resistance exercise improved self-esteem, muscle strength, lean body mass and the rate of completing planned chemotherapy 2.
Exercise did not cause lymphoedema or significant adverse events in the trial. Changes in fatigue, depression and cancer-specific quality of life favoured exercise but were not statistically significant 2.
How much exercise is recommended?
World Health Organization physical activity guidelines, which also apply to adults living with chronic conditions including cancer survivors, recommend 150 to 300 minutes of moderate-intensity aerobic activity a week, or equivalent vigorous activity, plus muscle-strengthening activities on two or more days a week 3.
During chemotherapy, many people cannot reach these amounts at first. Doing some activity is better than none, and amounts can be built up as tolerated.
How can exercise be adjusted around treatment?
Energy often dips in the days after each treatment and improves before the next cycle. Planning lighter activity, such as short walks and gentle stretching, on low-energy days and more structured sessions on better days helps maintain consistency.
Resistance exercise can use body weight, bands or light weights. Walking, cycling and swimming, when appropriate, are common aerobic options.
When should exercise be avoided or modified?
Seek advice before exercising if you have a fever, signs of infection, very low blood counts, significant anaemia causing breathlessness, uncontrolled pain, nausea or vomiting, or dizziness.
People with bone metastases, recent surgery, a central line or port, severe neuropathy affecting balance or heart or lung problems need an individualised plan. Avoid public swimming pools and crowded gyms when your immune system is very low.
Who can help design a programme?
Physiotherapists and exercise professionals with oncology experience can assess fitness, adapt exercises to side effects and progress programmes safely. Your oncology team can advise on blood counts and any treatment-specific precautions.
Supervised programmes can improve confidence and adherence, especially for people who were inactive before diagnosis.
Can exercise help after chemotherapy ends?
The end of chemotherapy is often a time when people expect to feel better quickly, yet fatigue, reduced fitness and low confidence can persist for months. Continuing or starting regular exercise after treatment supports recovery of strength and stamina and helps people return to work, family roles and activities they enjoy.
Many cancer rehabilitation services offer programmes after treatment that combine exercise with advice on fatigue, sleep, nutrition and emotional wellbeing. Building activity up gradually, and discussing any lasting side effects such as neuropathy or heart effects with the care team, keeps exercise safe.
Which symptoms mean I should stop exercising?
Stop and seek medical advice for chest pain, severe breathlessness, palpitations, fainting, sudden severe pain, new swelling in a limb or fever.
Unusual bleeding or bruising may indicate low platelet counts and should be reported promptly.
Frequently asked questions
Will exercise make chemotherapy fatigue worse?
Usually not. Regular, moderate exercise often reduces fatigue over time. Adjust intensity on difficult days.
Can I lift weights during chemotherapy?
Yes, with appropriate loads and guidance. Resistance exercise can help maintain strength and muscle mass.
Is walking enough during chemotherapy?
Walking is a good start. Adding strength exercises gives additional benefits.
Should I exercise on the day of chemotherapy?
Light activity may be fine if you feel well. Many people prefer rest on treatment day and resume the following days.
Sources
- Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable — Medicine & Science in Sports & Exercise (2019)
- Effects of aerobic and resistance exercise in breast cancer patients receiving adjuvant chemotherapy: a multicenter randomized controlled trial — J Clin Oncol (2007)
- World Health Organization 2020 guidelines on physical activity and sedentary behaviour — British Journal of Sports Medicine (2020)
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