Exercise During Chemotherapy

Chemotherapy is a pharmaceutical treatment designed to kill cancer cells in the body. Over half of women diagnosed with breast cancer will receive chemotherapy as part of their treatment.1 Chemotherapy is usually given every 2 or 3 weeks for multiple cycles. There are many side effects that can occur during and after chemotherapy, including nausea, diarrhea, fatigue, and brain fog. These side effects can make it difficult to exercise during chemotherapy. The purpose of this blog will be to review how to navigate exercise during chemotherapy, what types of exercise can help with the side effects of chemotherapy, and when it is unsafe to exercise during chemotherapy.

The various side effects of chemotherapy make it difficult to want to exercise. The “4 P’s” is a guideline for how to navigate exercising during chemotherapy.

  1. Pace yourself: respect your energy levels. Do not try to do too much in one day.
  2. Planning: plan your rest breaks ahead of time to avoid burning out.
  3. Prioritizing: prioritize your main goals for the day.
  4. Posture: maintain good alignment of your neck, back, and shoulders.

 

Keeping these guidelines in mind will help you to conserve your energy levels and avoid burning out.

Research has shown that several side effects of chemotherapy can be lessened with exercise. Fatigue is one of the most common side effects of chemotherapy which can be improved by both aerobic and resistance exercises. The current recommendation for aerobic exercise is to engage in moderate-intensity (examples: brisk walk, biking) for 30 minutes, 3 times per week.2 The current recommendation for resistance exercise is to engage in moderate-intensity (examples: resistance bands, dumbbell weights) for 2 sessions per week, 2 sets of 12-15 repetitions targeting the major muscle groups.2 Another common side effect of chemotherapy is brain fog. Meeting guidelines for physical activity recommendations (>150 mins/week of moderate intensity exercise) during chemotherapy is associated with better cognitive function.2

There are certain instances when you should not exercise during chemotherapy or when you should modify the exercises that you do.

  • Fever: no exercise until fever has resolved for at least 48 hours
  • Vomiting or diarrhea: no exercise until vomiting and diarrhea have resolves for at least 48 hours
  • Peripheral neuropathy: avoid activities which rely greatly on balance and are high risk for falls
  • Low platelets: avoid activities that increase risk of bruising
  • Low WBCs: avoid areas with high risk of infection
  • Low hemoglobin: avoid higher intensity exercise and exercising for long periods

While these general recommendations can be helpful, please see your doctor or physiotherapist regarding any medical or rehabilitation concerns. A full assessment by a physiotherapist is needed to create a personalized exercise treatment plan.

 

References:

  1. Multi-agent chemotherapy estimates: SEER Patterns of Care/Quality of Care Studies, National Cancer Institute, 1987-2015.
  2. Campbell, K., Winters-Stone, K., Wiskemann, J., May, A., Schwartz, A., Courneya, K., Zucker, D., Matthews, C., Ligibel, J., Gerber, L., Morris, S., Patel, A., Hue, T., Perna, F., Schmitz, K. (2019). Exercise guidelines for cancer survivors: consensus statement from international multidisciplinary roundtable. Medicine & Science in Sports & Exercise 51(11):p 2375-2390