Exercise may be the furthest thing from the mind of a cancer patient. However, exercise that focuses on functional fitness will help your client carry out the activities of daily living and return to the activities that they enjoy. A well-designed program can also decrease the side effects of surgery and treatment and improve quality of life.

Common Side Effects

According to a 2009 study, aerobic exercise can help mitigate such cancer treatment side effects as cancer-related fatigue, depression, anxiety, sleep disturbances, and nausea while simultaneously increasing aerobic capacity. There are also benefits to physical activity in mitigation of such symptoms as bone loss common with hormonal therapy, physical wasting (known as cachexia), peripheral neuropathy, lymphedema, and not surprisingly, body composition changes.

Each person is unique and heals differently. Moreover, there are many types of cancers, treatments, and late-term side effects, each one affecting survivors in different ways. It is important, therefore, for your client to work with a Cancer Recovery Specialist who can design the best program for their unique situation and fitness level.

Programming Suggestions

For cancer survivors who were active before surgery, it is imperative to slowly work back up to the previous level of activity. It is not wise to go back to a gym and continue with a pre-cancer exercise routine. Cancer survivors need to have patience; returning to your pre-cancer fitness level takes time and cannot be rushed. It is important to understand the implications of the particular surgery and the corrective exercises needed to improve recovery.

Before beginning a cancer exercise program, your client must receive medical clearance. But in general, an exercise routine should include aerobic exercise, strength training, stretching, and posture and balance exercises. It is important to note that many exercises and movements may not be recommended based on a person’s fitness assessment, medical conditions, and particular surgery.

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A good way to start an exercise program is through relaxation breathing, which can help reduce stress and anxiety. Have your client inhale for five seconds and fill the torso up with air, then exhale from the lower abdomen for five seconds, pressing the navel in towards the spine. They should imagine all of the tension and stress leaving the body with each exhalation.


As soon as your client receives medical clearance, they should start walking. Chemotherapy and radiation therapy can cause fatigue. It may seem counter-intuitive, but physical activity can help a cancer patient boost their energy and improve their ability to tolerate treatments. Your client might be able to walk only a short distance at first. Every day, have them walk farther until they are able to walk for 30-45 minutes.


Stretching should be performed every day for a year or longer depending on the particular situation. Stretching will help improve posture and range of motion. Your client can warm up for 5-10 minutes by marching in place or use a stationary bicycle while swinging their arms. They should perform the stretching exercises 2-5 times per day in the beginning of the recovery and use only smooth, controlled non-bouncy movements. All movements should be done slowly and with great concentration. Hold the stretch until there is a little tension, but not to the point of pain. The goals are to restore joint mobility and break down residual scar tissue.

Strength Training

After your client has achieved an acceptable range of motion, posture, and has medical clearance, it will be time to add strength training. Exercise gently, focusing on slow and progressive improvement. Control and good form are essential. Strength training can improve quality of life by making activities easier and more enjoyable and can empower your client physically and mentally.

Once a cancer survivor starts to exercise, they will have less pain, less stiffness, and more energy, and they will be motivated to continue. Cancer survivors who participate in exercise programs say that it is empowering and gives them a sense of control and accomplishment, an additional psychological benefit that personal trainers can help provide with their guidance.


Mustian, K. M., Sprod, L. K., Palesh, O. G., Peppone, L. J., Janelsins, M. C., Mohile, S. G., & Carroll, J. (2009). Exercise for the management of side effects and quality of life among cancer survivors. Current sports medicine reports8(6), 325–330. retrieved from: .

Ferioli M, Zauli G, Martelli AM, et al. Impact of physical exercise in cancer survivors during and after antineoplastic treatments. Oncotarget. 2018;9(17):14005-14034. Published 2018 Feb 8. doi:10.18632/oncotarget.24456. retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5862633/

Carol Michaels

Carol is a nationally recognized, highly educated cancer exercise specialist and consultant and has been a fitness professional for more than 20 years. She is the 2016 Idea Personal Trainer of the Year recipient. Check out the course that she worked with NFPT to develop: Cancer Recovery Specialist.