Is exercise a part of cancer treatment?

Wendy Vermaak explains why exercise should be viewed as an essential part of cancer treatment.

What comes to mind when you think of cancer treatment? Is it chemotherapy, radiation, surgery, prosthetics and reconstruction, immunotherapy, or oral medication? These treatments play a vital  role in recovery and cure, yet they often  come with uncomfortable, unpleasant, or even painful side effects.

However, a key area that should form part of standard care for cancer treatment and recovery is movement: physical activity and exercise.

A major advantage of exercise as part of cancer treatment is that it doesn’t carry the same negative side effects. In most cases, it can be performed with little to no cost. 

Just as chemotherapy or radiation is prescribed in specific doses, exercise can be carefully prescribed and adjusted to achieve optimal benefits. Beyond improving how the body feels: stronger, fitter, and more capable, exercise enhances quality of life across all phases of the cancer journey: prehabilitation, active treatment, early survivorship, and long-term survivorship.

Evidence-based benefits

Exercise stimulates the release of myokines (substances produced by muscles during movement) which play an important role in tumour suppression, metabolic regulation, and immune function. 

Improved circulation and oxygenation during exercise may also enhance the effectiveness of certain treatments, such as chemotherapy, by helping deliver and direct the treatment more effectively to cancer cells.

Exercise produces positive responses across multiple systems in the body, including the respiratory, cardiovascular, muscular, neural, skeletal, and autonomic systems. 

There is strong evidence supporting exercise as an effective intervention for cancer-related fatigue, improved quality of life, enhanced physical functioning, reduced anxiety and depression, and better management of lymphoedema.

In addition, exercise improves pain tolerance related to cancer and treatments while enhancing overall physical functioning, bone health, and sleep quality. 

Gains in muscular strength can also positively influence and help prevent motor and sensory neuropathies.

Importantly, exercise helps guard against muscle degeneration and improves cardiovascular efficiency, which may reduce the impact of cardiotoxicity associated with certain chemotherapy drugs. It can also support better lung function, improving ventilation and oxygen transport throughout the body.

Personalised exercise

Because cancer treatment is highly individualised, exercise prescription should be equally personalised. Programmes should be tailored according to the phase   of the cancer journey, whether prehabilitation, active treatment, or survivorship, and adjusted based on your needs, abilities, and medical considerations.

Exercise as part of cancer treatment empowers you, the patient, allowing you to take an active role in your care, rather than only receiving treatment passively. Like any medical intervention, exercise follows specific principles to ensure the best outcomes, both for treating cancer and managing treatment-related side effects.

One such framework is the FITT principle. This includes:

F   = Frequency (how many days per week you exercise)

I   = Intensity (how hard the exercise is)

T   = Time (how long each session lasts, whether measured in minutes or sets  and repetitions)

T   = Type (the kind of exercise performed)

For this reason, it’s recommended to consult a biokineticist. These healthcare professionals are skilled in designing safe and effective programmes that combine aerobic exercise, resistance training, flexibility, and balance individually tailored for you. A structured plan can be developed, incorporating progression, adaptation, and account for any necessary precautions or contraindications.

Start before you need to

Exercise plays a meaningful role in cancer prevention and survival. Evidence shows that regular physical activity can help reduce the  risk of several cancers, including bladder, breast, colon, endometrial, oesophageal, kidney, and stomach cancers. 

From a survival perspective, exercise has been linked to improved outcomes and reduced mortality rates in breast, colon, and prostate cancers.

General guidelines recommend avoiding inactivity and aiming for at least 150 minutes  of moderate aerobic exercise per week, along with two sessions of resistance training. These guidelines provide a foundation for improving overall health and supporting the body through treatment and recovery.

Ultimately, exercise is a powerful, evidence-based component of cancer care. When appropriately prescribed and supported, it not only complements medical treatment but also equips you with a sense of control, resilience, and improved well-being throughout your cancer journey from prevention, prehabilitation, active treatment, and survivorship.

Wendy Vermaak is a biokineticist and has a specialised exercise oncology certification from Maple Tree Cancer Alliance (USA). She has a keen interest   in exercise oncology, chronic conditions, falls prevention, and balance rehabilitation.

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