Some side effects of cancer or treatment need extra care, which means you may have to adjust how hard and long you exercise. Speak to your doctor, physiotherapist or exercise physiologist before you exercise. Check with your health professional first, but most people are able to exercise with a port or PICC line, a chemotherapy pump or a stoma.
Ask a nurse, exercise physiologist or physiotherapist to show you how to avoid bumping or disrupting it when moving.
Below are some side effects that may need extra care.
| Weak bones | If you have cancer in the bones (bone metastases or bone mets) or myeloma, you may be at risk of a break or fracture. Radiation therapy and hormone therapy may leave bones more fragile. Choose gentle activity such as walking and swimming, and avoid contact sports, running or jumping. Resistance exercise may help by strengthening the muscles around the bones. If you have osteoporosis, consult your doctor and ask for advice from a physiotherapist or accredited exercise physiologist. |
| Low white cell count (neutropenia) | Some cancers and treatments can weaken your immune system and cause your white blood cell count to drop. This can increase your risk of developing an infection. When your immune system is not working well (called being immunocompromised), it is important to clean any shared exercise equipment before use and avoid public spaces such as gyms, swimming pools and training venues until your white blood cell count returns to a safe level. |
| Low platelet count (thrombocytopenia) | Platelets stop bleeding in the body by forming clots. When the platelet count drops, you are at increased risk of bruising or bleeding. It is best to avoid contact sports, cycling and high-impact activities (such as jumping or boxing), as these could cause bruising or bleeding if you get knocked or fall over. |
| Skin irritation | Areas of skin affected by radiation therapy can be extremely sensitive and often uncomfortable. Choose activities and clothing to minimise fabric rubbing on affected areas. Chlorine can irritate the skin, so avoid the pool if you have a rash or your skin is red. |
| Surgical wound | You will need to wait for the wound to heal before starting any exercise, so follow your surgeon’s or doctor’s advice about when it is safe to begin. If you have post-surgery stiffness and pain, you may need an assessment from an oncology physiotherapist or other exercise professional. They can suggest specific exercises to reduce stiffness and pain in the affected area. Pain, weakness, stiffness and reduced movement are common after surgery, but they usually improve with time. |
| Poor balance and coordination | Surgery or cancer treatment may affect balance and coordination. This can make you unsteady and lead to a fall. Choose exercises to improve balance and muscle strength, or exercise sitting down. If your balance or coordination has been affected, avoid exercise such as riding a bike outside or using a treadmill, and avoid lifting free weights without a training partner. |
| Peripheral neuropathy | Some chemotherapy drugs damage nerves, causing pins and needles and numbness in the hands and feet (peripheral neuropathy). This means you could injure yourself without noticing. If you can’t feel your feet, you’re more likely to lose balance or fall, so walk on even surfaces. Ask an exercise professional how to lift weights safely. Some people may find exercise machines safer to use than free weights. |
| Heart damage | Some chemotherapy drugs and other treatments can cause damage to the heart (cardiotoxicity). In this case you will need specialised exercise advice before taking on exercise. |
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Kirsten Adlard, Accredited Exercise Physiologist, The University of Queensland, QLD; Dr Diana Adams, Medical Oncologist, Macarthur Cancer Therapy Centre, NSW; Grace Butson, Senior Physiotherapist, Peter MacCallum Cancer Centre, VIC; Kate Cox, 13 11 20 Consultant, Cancer Council SA; Wai Yin Chung, Consumer; Thomas Harris, Men’s Health Physiotherapist, QLD; Clare Hughes, Chair of Cancer Council’s Nutrition, Alcohol and Physical Activity Committee; Jen McKenzie, Level 1 Lymphoedema Physiotherapist, ESSA Accredited Exercise Physiologist, The McKenzie Clinic, QLD; Claudia Marck, Consumer; Dr David Mizrahi, Accredited Exercise Physiologist and Research Fellow, The Daffodil Centre at Cancer Council NSW and The University of Sydney, NSW; Prof Rob Newton, Professor of Exercise Medicine, Exercise Medicine Research Institute, Edith Cowan University, WA; Jason Sonneman, Consumer.
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