Safety and Exercise

Author: Christina Lombardi, PT DPT
Last Reviewed: May 20, 2022

Physical activity (exercise or movement) can help people with cancer and cancer survivors. Exercise can improve cardiovascular endurance (how well your body works), fatigue, mental health, and quality of life. Exercise may also lower the chance of cancer coming back (recurrence) or growing. Staying active should be a part of your cancer treatment and survivorship.

Getting Started

There are some safety issues to think about before starting an exercise program. Start by talking to your provider about when it is safe to exercise and how you can get started. A PT (physical therapist) can help make an exercise program to meet your needs and goals. A PT will help by showing you an exercise routine, watching to make sure you are doing the exercises correctly and safely, and talking to your provider about how you are doing.

Safety Concerns

Things to think about to make sure you are being safe while exercising are:

  • Fatigue: Exercise can help lessen fatigue, a common side effect of cancer treatment. Based on how you are feeling, you may need to keep your activity at a low intensity and/or exercise for a shorter amount of time. You will need to listen to your body and do what works best for you.
  • Balance: Some cancers and treatments can cause changes to your balance, which can lead to falls and getting hurt. Peripheral neuropathy, which is damage to the nerves in your hands and feet that can lead to numbness and tingling, can make it harder to balance.
    • If you have trouble with your balance, ask for exercises to help with this. Doing exercises with your hand(s) on a sturdy surface such as a countertop may help. You may also want to try a stationary bike instead of a treadmill at first. You can also exercise while someone else is with you to help prevent falls.
  • Infection Risk: If your white blood cell count is low, you may want to avoid a public gym or pool. If you go to a public gym or pool, make sure to clean the equipment before and after use. Make sure to wash your hands after you are done.
    • Survivors who have had a bone marrow transplant are usually told to not go to public gyms and pools for at least one year after the transplant.
  • Low blood counts:
    • A low red blood cell count (anemia) can lead to a lower level of oxygen in your blood.
    • A low platelet count (thrombocytopenia) can make you more likely to have bruising or bleeding.
    • Ask your provider if your blood counts are a concern for exercising. To protect yourself from bleeding, do not do contact sports or activities that may lead to a fall. Be careful when using a new piece of gym equipment and ask for help to prevent bruising or bleeding.
  • Listen to your Body: Always remember that you know YOUR body best. It is important that you listen to your body while exercising. Stop if you are too tired or if something hurts.

Being active is helpful for people getting cancer treatment and survivors. Sometimes, all it takes is that “first step” and that “first leap” to get moving. Talk to your healthcare provider before starting an exercise routine. Your well-being and safety are most important.


Evidence-based physical activity guidelines for cancer survivors: Current guidelines, knowledge gaps and future research directions by L.M. Buffart, D.A. Galvão, J. Brug, M.J.M. Chinapaw, R.U. Newton

Controlled Physical Activity Trials in Cancer Survivors: A Systematic Review and Meta-analysisby: Kathryn H. Schmitz, Jeremy Holtzman, Kerry S. Courneya, Louise C. Mâsse, Sue Duval and Robert Kane

Cancer Rehabilitation: An Overview of Current Need, Delivery Models, and Levels of Care by: Andrea L.Cheville MD, MSCE, Karen Mustian PhD, MPH, KerriWinters-Stone PhD, David S.Zucker MD, PhD, Gail L.Gamble MD, Catherine M. AlfanoPhD

Nutrition and physical activity guidelines for cancer survivors by: Cheryl L. Rock PhD, RD Colleen Doyle MS, RD Wendy Demark, Wahnefried PhD, RD, Jeffrey Meyerhardt MD, MPH Kerry S. Courneya PhD, Anna L. Schwartz FNP, PhD, FAAN, Elisa V. Bandera MD, PhD, Kathryn K. Hamilton MA, RD, CSO, CDN, Barbara Grant MS, RD, CSO, LD, Marji McCullough ScD, RD, Tim Byers MD, MPH, Ted Gansler MD, MBA, MPH

Cancer Rehabilitation by Michael D. Stubblefield

Principles of Cancer Rehabilitation Medicine Clinical Disciplines by Michael D. Stubblefield David C. Thomas , Kristjan T. Ragnarsson


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