Why treatment affects strength and fitness

During treatment, most people become less active for weeks or months. Add the effects of surgery, chemotherapy, radiotherapy, steroids or hormone therapy, plus weight loss or a poor appetite, and it is common to lose a significant amount of muscle. Many people notice they get out of breath on the stairs, find it harder to get up from a chair, or feel less steady on their feet.

This matters because muscle powers everyday life. It supports your joints, helps control blood sugar, protects your bones and makes daily tasks easier. Rebuilding it is one of the most important things you can do for your recovery.

What kind of activity helps?

Research in people recovering from cancer points to a combination of three things:

• Aerobic activity, such as walking, cycling or swimming: anything that raises your heart rate and makes you a little breathless while you can still talk.
• Strength exercises that work the major muscle groups, using your body weight, resistance bands or light weights.
• Balance and flexibility, which is especially important if you have numbness in your feet or have been inactive for a long time.

UK physical activity guidelines suggest adults aim for around 150 minutes of moderate activity a week, plus strength exercises on at least two days. These guidelines apply to people living with and beyond cancer too, but they are a destination, not a starting point. If you’re currently managing ten minutes a day, that is where your plan should begin.

Starting safely

The principle is simple: start at a level that feels comfortable, then build up gradually by adding a few minutes, a few repetitions or a little more resistance every week or so. Some muscle soreness when you start something new is normal. Sharp pain, or feeling unwell for a long time after exercise, is a sign to ease off.

Some situations need extra care or specific adjustments, for example:

• Recent surgery, especially abdominal surgery, where you may be advised to avoid heavy lifting for a period.
• Lymphoedema, or a risk of it. Strength exercise is generally considered safe and can be beneficial, but it should be built up gradually.
• Numbness or tingling in your hands or feet (peripheral neuropathy), where balance work and stable exercises help reduce the risk of falls.
• Cancer affecting the bones, a low blood count, a central line or a stoma. Check with your medical team about what is safe for you.
• Heart or lung conditions, or treatments that can affect the heart or lungs.

This is one of the main reasons a one-size-fits-all approach can fall short. The right programme for someone recovering from breast surgery is quite different from the right programme for someone who has had bowel surgery, or someone living with neuropathy.

Making it stick

Most people know that exercise is good for them. The challenge is doing it consistently when energy is low and motivation comes and goes. A few things make a big difference:

• Short sessions done regularly beat long sessions done occasionally.
• Fitting activity into your daily routine, such as a walk after breakfast, makes it a habit rather than a decision.
• Tracking your progress is highly motivating: seeing improvement keeps you going.
• Knowing exactly what to do each day removes the effort of planning it yourself.

This information is general and does not replace advice from your own medical team. If you have new or worsening symptoms, contact your GP or cancer team. In an emergency, call 999.