Taking care when you exercise

Although it is important to be physically active, you may need to take extra care with the activities you choose. This will depend on your cancer and its treatment, the side effects you are experiencing and any other medical conditions you might have, such as heart problems or high or low blood pressure. In general, if you have had cancer you should check with your doctor or specialist nurse before starting any exercise. They also can provide advice if you have any of the following specific side effects:

 

Lymphoedema

Lymphoedema is a long-term condition that causes swelling. It develops when lymph nodes or vessels become damaged or blocked, or if they have been removed surgically. Lymphoedema can occur in any part of the body, but is most likely to affect an arm or leg and their surrounding areas.

Starting a suitable exercise programme early on in treatment can lower the risk of developing lymphoedema and regular exercise can reduce the severity of the condition and its symptoms. If you wear a compression garment on your affected limb, always wear it during exercise.

Compromised immunity

Certain cancers and treatments can affect the way the immune system works. When your white blood cell count is low (neutropenia) you are at increased risk of infection and it is important to limit physical contact with other people and clean any shared equipment before you use it. When your immunity is severely affected (indicated by blood test results) you should avoid gyms, swimming pools and other public spaces. It is good practice to get into the habit of washing and drying your hands thoroughly when you have finished in the gym.

Anaemia

Your red blood cells use haemoglobin to carry oxygen around your body. Anaemia – a low red blood cell and/or haemoglobin count – is a common side effect of cancer treatment. Symptoms include tiredness (fatigue), lack of energy (lethargy), pale skin, shortness of breath, a rapid heartbeat and feeling faint.

Low intensity exercise (such as walking) and good nutrition can improve mild or moderate anaemia. In cases of severe anaemia (shown by a blood test), your doctor can advise on whether you should postpone exercise until your blood test results improve.

Low platelet count

Platelets are blood cells that are essential for clotting. Clotting prevents excessive bleeding. A low platelet count (thrombocytopenia) occurs when the blood loses platelets faster than the bone marrow can replace them. Exercise, particularly against resistance, causes tiny injuries to your muscles and their network of blood vessels. This is normal process that heals spontaneously and goes mainly unnoticed. However, when your platelet count is low, the clotting process is not as effective. This can lead to broken blood vessels in the skin (purpura), abnormal bruising and potentially more serious effects. If you notice more bruising than normal, stop exercising and consult your doctor.

The forms of exercise you can undertake safely with this condition depend on how low your platelet count is (shown by a blood test). Your doctor will advise you.

Poor balance and coordination

If your cancer or its treatment has affected your coordination or causes dizziness, it is better to avoid activities that rely on balance and coordination, such as outdoor cycling or running on a treadmill. It is also safer to use resistance machines rather than free weights, such as dumbbells, if you exercise without a training partner.

Skin irritation

Areas of skin affected by radiotherapy can be very sensitive and prone to the effects of repeated friction. Choose activities and clothing to minimise fabric rubbing the affected areas. Chlorine can also irritate the skin, so avoid using swimming pools if you have a rash or your skin is red after radiotherapy.

Peripheral neuropathy

Some people lose sensation or experience pins and needles (paraesthesia) in their hands and feet following cancer treatments. This is called peripheral neuropathy and can either be a temporary or a long-term condition. If you have altered sensation in your feet make sure you wear appropriate shoes that are wide enough and supportive, particularly if your feet are prone to swelling. Check your feet regularly because loss of sensation can mask the signs of skin damage. If your hands are sensitive, it might help to wear a pair of training gloves when doing resistance exercises.

Peripheral neuropathy can lessen your body’s ability to sense pain or discomfort from more strenuous workouts. Gradually increase your exercise frequency and intensity to avoid complications and be careful with high-impact activities, strenuous, or prolonged weight-bearing exercise.

Bone weakness or pain

Some hormone treatments for breast and prostate cancer can increase the risk of bone breaks (fractures), as can osteoporosis (bone thinning) or primary or secondary bone cancer. In these cases, it is best to avoid contact sports and high-impact activities, such as fast-paced running and jumping. Weight bearing (resistance) exercises can improve bone health.