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Once cancer therapy has been completed, the next phase of cancer survivorship is recovery. A program of regular exercise is essential to aid in improved fitness, and early studies suggest physical activity may be important for reducing the risk of recurrence and extending survival for some cancer survivors.

Physical activity capabilities and effects differ among cancer survivors and depend on your diagnosis, treatment modalities, and the spectrum of cancer survival. Several clinical trials have assessed the effect of exercise interventions on quality of life and other psychosocial outcomes in cancer survivors. The exercise programs in these trials were primarily three days of moderate to vigorous activity per week that was progressively increased in duration to approximately 45-minute sessions during a period of three or four months. These studies show that such exercise programs can reduce anxiety and depression, improve mood, boost self-esteem, and reduce symptoms of fatigue.

Although you can likely adopt an exercise program independently, you may benefit from referral to an exercise specialist. You should seek individuals who have been certified by an exercise-related professional organization such as the American College of Sports Medicine, which in January launched a new cancer specialty certification in collaboration with the American Cancer Society.

A physical therapist is the appropriate resource if you have injuries, pain, or specific post-surgical issues, such as lymphedema or amputation. Exercise physiologists receive college training and are certified by various professional organizations to develop individualized exercise programs. Personal trainers are also popular choices if you want to increase your fitness and activity levels. Recommendations on the type, frequency, duration, and intensity of exercise should be individualized to your age, previous fitness activities, type of cancer, type of therapy, and comorbid illnesses.

Side effects of treatment may increase the risk for exercise-related injuries and adverse effects. Specific precautions include:

Survivors with severe anemia should delay exercise, other than activities of daily living, until the anemia improves.

Survivors with compromised immune function should avoid public gyms and other public places until their white blood cell counts return to safe levels. Survivors who have completed a stem cell transplant are usually advised to avoid such exposures for one year after transplantation.

Survivors suffering from severe fatigue from their therapy may not feel up to an exercise program, so they may be encouraged to do 10 minutes of stretching exercises daily.

Survivors with indwelling catheters should avoid water or other microbial exposures that may result in infections, as well as resistance training of muscles in the area of the catheter to avoid dislodgment.

Survivors with significant peripheral neuropathies or ataxia may have a reduced ability to use the affected limbs because of weakness or loss of balance. They may do better with a stationary reclining bicycle, for example, than walking on a treadmill.

For the general population, the American Cancer Society recommends at least 30 to 60 minutes of moderate to vigorous physical activity at least five days per week to reduce the risk for cancer, cardiovascular disease, and diabetes. These levels of activity have not been studied systematically in cancer survivors, but aside from specific circumstances related to treatment or other cancer-specific conditions, experts say there is no reason to think these recommendations would not also be beneficial for cancer survivors. Therefore, although daily and regular activity may be a goal, any steps you take to move from a sedentary to an active lifestyle are encouraged.

Adapted with permission of the American Cancer Society