Please note

that these recommendations have been produced specifically to help people with, or at risk of, a long term condition, aiming to do moderate activity only.

Cancer prescription

Cancer and Physical activity

Cancer affects everyone differently. Common emotional symptoms include sadness, fear, anger, anxiety and depression when receiving a diagnosis of cancer. Friends, family and cancer services provide many people with the support and guidance during this time of difficulty. Strong scientific evidence shows that keeping active during and after treatment of cancer reduces the loss of vital physical function needed for normal daily activities such as house work, shopping and childcare. 1 Fatigue, a symptom meaning tiredness and lack of energy, is one of the most troubling symptoms of cancer or its treatment. Many people, wrongly believe, that they should store energy by choosing to rest whilst undergoing treatment. This worsens physical function and adds to further tiredness. 2 Many troublesome symptoms of advanced cancer and its treatment can be reduced in people who remain active too. 3

Activity, during treatment, has a positive effect on anxiety and self- esteem. 4 Following treatment, quality of life, depression and anxiety is significantly improved in people continuing to be active. 5 Try combining your activity time with family and friends or using it as an opportunity to reflect on things and listen to your favourite music.

Physical Activity Recommendations for inactive adults with Cancer

Aim to do the following three types of activity:
  • Aerobic activity at relative moderate intensity for at least 150 minutes (2 hours and 30 minutes) a week – one way to approach this is to do 30 minutes on at least five days each week.
  • Muscle strengthening activity on two or more days a week which work all major muscles groups (legs, hips, back, abdomen, chest, shoulder and arms)
  • Flexibility exercises on a daily basis
Do not worry if you struggle to meet the Guideline, because by trying to become more active, you are still gaining some health benefits.

The Three Types of Acticity and Cancer

You may find the following weekly approach useful if you have been inactive for a while.

Aerobic activity

aerobic

Aerobic activity, also known as endurance activity, is when large muscle movements, maintained over a period of time, make the heart and lungs work harder.

Activity? – Any type that you can maintain comfortably is ideal. Choose exercises that you enjoy, such as walking, cycling or group fitness classes. Aerobic activity is very important for your heart and circulation.

How long (duration)? – You can split your total activity amount into minimum bouts of 10 minutes if needed. If you have been inactive for a long time, start with short daily amounts and increase this as your body allows and you feel more confident. Remember not to sit for hours. A regular break from sitting every hour is healthy.

How hard (intensity)? – Try to progress gradually over time to a relatively moderate-intensity activity. The ‘talk test’ is a simple way to measure moderate intensity. Whilst you are working, you can still talk, but not sing, during the activity. Getting out of breath when increasing your activity level as it is a normal body response to exercise.

How often (frequency)? – if you aim to do 30 minutes per day then do this at least 5 times per week so that you can reach a total of 150 mins a week. Distribute sessions over the week and aim to have no more than 2 consecutive days without physical activity. When you start any new activities make sure you give your body enough time to recover and adapt between sessions.


Muscle Strengthening

strengthening

Simple strength training on at least 2 days a week is important for health. Improved muscle tone can also help you gain better shape and improve the way you look and feel. Some activities, such as climbing stairs, digging the garden or walking up hill, combine aerobic and muscle strengthening types.

These activities should work all the major muscle groups in your body such as legs, hips, back, chest, abdomen, shoulders and arms. When strengthening a muscle group,

begin by familiarising the movement with little or no load. If you are using weights such as dumbbells, try to do at least 1 set of 8-12 repetitions per activity. The correct weight choice is the one which is hard to complete by the end of the set. A repetition is one complete movement of an activity, like doing a sit up or bicep curl.

See the special notes in the ‘Safety consideration’ section below if you have lymphoedema (a long term swelling, usually of an arm or leg, because of cancer, or the effects of treatment).


Flexibility Exercises

stretching

Daily flexibility exercises can prevent pain, stiffness, and injury of muscles and joints. People often experience a sense of wellbeing and relaxation during flexibility exercises. Yoga, Tai Chi and Pilates are examples of some activities which combine strength and flexibility as well as balance training. Balance training is especially important if you are at increased risk of falling because of dizziness, frailty or sensation loss in the feet due to some cancer and their treatments.


Safety considerations

  • Some people, including friends and family are concerned that exercise is harmful during or after treatment but they are rare, mild and similar to people without cancer. 6
  • If you have led a very sedentary lifestyle, begin by doing low intensity exercise of short duration, e.g. 10 minutes.
  • Stop exercising if you feel dizzy, sick, unwell or very tired.
  • See a doctor if you are having chest pain, black outs or breathlessness on mild exertion.
  • If you have cancer affecting the bones or you have been told that your bones are weak then avoid high impact or contact activities and speak to your specialist for further advice.
  • Progress strengthening exercises in small and gradual increments to prevent lymphoedema (a long term swelling, usually of arms or legs, in cancer). If you have already have lymphoedema, avoid strenuous repetitive exercise in the affected limb and wear a compression garment.
  • Some cancer and treatments can increase your chance of falls by increasing dizziness, weakness and loss of sensation in the feet. If this is a new symptom and unexpected then check with your doctor. If not, then carry out balance exercises and avoid activities requiring considerable coordination (e.g. treadmill).

Please see the following safety considerations if you have other long term health conditions.

Disclaimer
This leaflet has been provided for information only. ALWAYS check with your doctor if you have any concerns about your condition or treatment. Prescription4exercise.com is not responsible or liable, directly or indirectly, for ANY form of damages whatsoever resulting from the use (or misuse) of information contained in or implied by this information.
Further reading
  • ACSM’s Guidelines for Exercise Testing and Prescription, American College of Sports Medicine, 2009
  • Swedish National Institute of Public Health. Physical Activity in the Prevention and Treatment of Disease. Professional Associations for Physical Activity, Sweden, 2010. Cancer. 257-270. www.fyss.se
  • www.macmillan.org.uk
  • www.cancerresearchuk.org

References:

  1. Speck RM et al. An update of controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv. 2010. 4: 87-100
  2. The importance of physical activity for people living with and beyond cancer: A concise evidence review. Macmillan Cancer 2011.
  3. Speck RM et al. An update of controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv. 2010. 4: 87-100
  4. Start Active, Stay Active – a report on physical activity for health from the four home countries ‘ Chief Medical Officers. UK Department of Health, July 2011.
  5. Speck RM et al. An update of controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv. 2010. 4: 87-100
  6. Speck RM et al. An update of controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv. 2010. 4: 87-100

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