The Right Way for Cancer Patients to Exercise

August 8 marks National Fitness Day in China — a date established to commemorate the successful hosting of the Beijing Olympics, and to encourage the public to engage in regular physical activity and fitness.

But what about those who are physically weaker — cancer patients and survivors? Are they suitable for exercise? How can they stay active while ensuring safety? Here are five key questions to help you understand how to exercise safely and effectively without harming your body.


Q1: Can exercise during cancer treatment help reduce treatment side effects?

According to the ASCO Guideline on Exercise, Diet, and Weight Management During Cancer Treatment, engaging in aerobic and resistance exercises (such as barbell curls, sit-ups, squats, and single-arm dumbbell lifts) during active cancer treatment can help reduce treatment-related side effects, such as fatigue and loss of appetite. Exercise interventions during treatment have also been shown to improve cardiovascular and muscle function, maintain physical strength, and, in some patients, reduce anxiety and depression.

Moreover, studies show that exercise during treatment is associated with a lower risk of adverse events (such as allergic reactions). For instance, lung cancer patients who perform preoperative exercise training before surgery may experience shorter hospital stays and fewer postoperative complications.[1]


Q2: Is weight management important for cancer patients?

A study published in CA: A Cancer Journal for Clinicians found strong evidence of a causal link between overweight or obesity and 13 types of cancer, including postmenopausal breast cancer, colorectal cancer, kidney cancer, liver cancer, esophageal adenocarcinoma, ovarian cancer, pancreatic cancer, gastric cardia cancer, thyroid cancer, endometrial cancer, meningioma, multiple myeloma, and gallbladder cancer.[2]

Many cancer patients are already facing weight issues at the time of diagnosis. Being overweight or obese not only increases the risk of various cancers but is also associated with higher rates of cardiovascular disease and diabetes. Abdominal obesity, in particular, poses even greater risks. Maintaining a healthy body weight (BMI 18.5–24 kg/m²) can help lower the risk of multiple diseases.

Effective weight management requires balancing diet and physical activity — or, as people often say, “eat smart and move more.” Limit high-calorie foods, and engage in regular exercise to burn energy. However, since cancer patients need to maintain adequate physical strength to tolerate treatment, overexercising is not advisable. Both being “too heavy” and “too thin” are undesirable — the goal is to maintain a healthy weight. If a patient experiences sudden weight gain or loss, they should contact their primary physician immediately to identify the cause.


Q3: Should cancer patients continue exercising after treatment?

Whether cancer survivors can safely resume exercise after treatment depends on their individual condition and recovery progress.

Exercise may be recommended if:
The patient’s overall fitness and recovery are relatively good. In such cases, engaging in low-intensity physical activity can promote further recovery and improve well-being.

Exercise should be avoided if:
The patient is experiencing severe anemia, fatigue, or has unhealed surgical wounds. In these situations, exercise may do more harm than good and slow recovery. Instead, gentle stretching or light limb movements can help maintain energy and circulation without putting stress on the body.


Q4: What factors should cancer patients consider when exercising?

To minimize the risk of injury or complications, cancer patients should keep in mind two key principles:

Exercise progressively
Exercise intensity should match the patient’s current physical condition. At first, begin with light activities such as walking or yoga. As recovery improves, patients can transition to moderate aerobic exercise such as brisk walking. However, if a patient has bone metastases, they must avoid high-impact or high-intensity movements to prevent fractures or other injuries.

Exercise in moderation
Although exercise has clear benefits for cancer patients, overexertion can be harmful. Prolonged or intense workouts may cause muscle strain or fatigue, adding unnecessary stress to the body. Before starting an exercise program, patients are advised to consult their doctor for a professional assessment and to develop a personalized exercise plan suited to their condition.


Q5: How much exercise is appropriate for cancer patients?

Cancer patients should include warm-up and stretching before and after exercise to prevent strain. At the beginning, keep sessions short — about 15–20 minutes each time — and gradually increase to around 30 minutes based on individual strength and tolerance.
The best time for exercise is usually in the morning or afternoon. Avoid exercising right after meals or when hungry to prevent discomfort or dizziness.


References:
[1] Ligibel JA, Bohlke K, May AM, Clinton SK, Demark-Wahnefried W, Gilchrist SC, Irwin ML, Late M, Mansfield S, Marshall TF, Meyerhardt JA, Thomson CA, Wood WA, Alfano CM. Exercise, Diet, and Weight Management During Cancer Treatment: ASCO Guideline. J Clin Oncol. 2022 May 16; JCO2200687. doi:10.1200/JCO.22.00687.
[2] Sung H, et al. Global Patterns in Excess Body Weight and the Associated Cancer Burden. CA: A Cancer Journal for Clinicians. 2018; DOI:10.3322/caac.21499.