Staying active throughout breast cancer treatment is incredibly important. Doctors and survivors alike agree that keeping your body in motion, even if only a little, is a big step to take in the journey against the disease and its physical, mental and emotional side effects.
However, this is often easier said than done.
According to a study done by the University of Iowa, fatigue is the most common side effect of chemotherapy and the idea of taking a yoga class, hiking a mountain, or running a marathon while well-intentioned, simply isn’t feasible for all women who are undergoing treatment. (1)
So what can you do when you want to be active, but are faced with the exhaustion that comes as a result of treatment?
In this article, we will share some of the best exercises that you can perform during your breast cancer treatment, depending on where you are and how you feel. These recommendations, based on science and the accounts of actual breast cancer survivors, have helped other women stay active on their road to recovery and are now meant to be a resource to you as you embark upon your journey.
Here’s what we’ll cover throughout this guide:
- Why is Exercising During Chemotherapy is Important?
- Rest for Success
- The Best Exercise for When You’re Exhausted During Breast Cancer Treatment
- The Best Exercise for When You Have Some, but Not Much Energy
- The Best Exercise for When You’re Feeling Good
Remember: Every person and body is unique. Chemotherapy affects people in different ways, and it’s important that you know what you’re capable of before starting any exercise regimen. So talk to your oncologist or doctor to make sure that exercise is right for you at this point in your treatment. They’ll have a clear understanding of where you are physically and what exercises are and are not right for you at your current stage of treatment.
Why is Exercise During Breast Cancer Treatment Important?
Exercise has been proven time and time again to have positive benefits for people going through breast cancer treatment. It not only provides physical benefits and healing to the body, but it’s also been shown to help increase happiness and reduce symptoms of depression.
Unfortunately, exercise can seem pointless when you are suffering from chemotherapy-induced fatigue. Many women talk about how difficult it can be to simply get out of bed in the morning while going through treatment, much less going outside for a walk or a run.
But exercise is actually a crucial element to getting better and allowing your body to heal. Several scientific reports have been published over the past several years stressing the necessity of motion throughout treatment. One such study that appeared in the American Journal of Physiology found that mice that exercised during cancer treatment had smaller tumors than those that didn’t. (3)
There is some evidence to suggest that the exercise helped metabolize the chemo medication and increased blood flow to the tumor, which allowed it to be healed more quickly. (4)
“Something as simple as moving affects how drugs are metabolized. We’re only just beginning to understand the complexities.”
University of Pennsylvania researcher Joseph Libonati, Ph.D.
Not only that, but according to the American Cancer Society, exercise can provide other powerful health benefits throughout the course of your treatment including: (5)
Another study by FitSteps for Life, found that exercising on the day of chemotherapy helped to reduce the side effects of the treatment. (6) Those who exercised on the day of chemotherapy had less nausea, less vomiting, and less nerve damage than those who did not. These patients also had a significantly better immunity.
In addition, exercise can help boost your mood and your overall morale. When you are fighting a battle, you need to keep up your spirit and working out, even for a little bit, can help you do that.
Breast cancer survivors often talk about how exercise, even in short amounts, was a key part of their journey to recovery. Yes, it has health benefits, but it also brings a sense of normalcy, routine and discipline at a time when your life is anything but normal or routine.
Jessica Rowley told Women’s Health Mag that she found that even though exercise was a challenge walking “helped tremendously.”(7) She emphasized that even the tiniest bit of movement was worth it. “Even if it was just around the block it made me feel so much better.”
The Importance of Rest During Chemotherapy
The benefits of exercise during chemotherapy are clear, but it’s also important to remember that it’s okay to rest while going through breast cancer treatment.
Fatigue is the most common side effect of most forms of chemotherapy and most patients say that it brings about an exhaustion unlike anything they have ever experienced before.
“Chemo fatigue can be a little tricky. It’s not like more rest and naps makes it go away.”
– Cancer survivor
Blogger Ann Silberman wrote that even the simple task of walking up and down steps was a challenge for her. Chemo caused so much exhaustion that simply moving around presented a challenge. (8)
Sound like you?
If chemo has worn you out to the point that walking around your own home is a full workout, then don’t do any more. Walk around your house. Take the stairs slowly, and deliberately. If pushing an elevator button is hard, then only focus on that.
Silberman wrote, “It took me a few minutes to push the button — one time. But I did it. Small victories.”
There is no shame in taking more time to rest. (9) The best way to get rest is to set aside periods during the day for light naps, and then adding two or three more hours to your nighttime rest.
Sleeping can sometimes help your fatigue, especially if extra sleep is paired with a little light exercise. Rest can reduce pain, help muscles to recover, rebuild cells, and fight off infections.
- Melatonin, which prevents more damage done to cells during chemo
- Cortisol, which regulates your immune system
- A resistance to heart disease, diabetes, anxiety, and depression
You aren’t going to have a lot of energy with chemotherapy. So don’t push yourself beyond what you’re capable of doing. If you feel exhausted and can’t move, then follow your instincts.
Setting Your Exercise Expectations and Knowing Your Limits
For people who were previously very active before they had cancer, it can be difficult and frustrating to be limited by the fatigue that comes from chemotherapy treatment. It’s important to remember that when you’re getting ready to exercise that you may need to lower your expectations.
Running for 30 minutes may seem easy when your body is healthy, but it can be a serious challenge after weeks of chemotherapy.
If your chemo is every three weeks, plan on being able to exercise for only half of that interim. With more and more rounds of treatments, expect to suffer from more and more fatigue.
Most breast cancer patients write that they struggle to lift weights and do standard exercise routines due to their fatigue. One young patient wrote that she couldn’t use her weight dumbbells, which were under 25 pounds.
But, that doesn’t mean you should give up exercising altogether. On the contrary, it just means that you need to start by lowering your expectations and working your way back up.
Brittany Colston, who writes the blog “Breast Cancer Party of 4,” said that “working out through breast cancer has helped me a lot.” She took baby steps, walking around the block in her neighborhood at first. After a little while, those short walks grew to longer, 3-mile walks Colston took with her husband.
Eventually, Colston said, she started waking up at 5 a.m. to walk with her friend on a golf course. “Walking became something that I did to find relief, but it turned into something that I LOVED to do!”
For women who worked out before they had breast cancer, it might be difficult to keep up the pace. Full workouts are not the best idea when your body has taken on water weight because of the medication. The water weight stresses your joints out and causes you to be more fatigued in less time.
Chnoic Clarke, an American Family fitness instructor, found that she could still work out while undergoing chemotherapy. She told local news outlet WTVR that exercise was “her physical and her mental outlet.” Even though she had to stop working out every day with chemo, Clarke was able to keep up some of her routines on a regular basis.
For many patients, the amount of exercise you can do depends on the kind of chemotherapy you’re receiving. One user wrote that Taxotere, a chemo drug, “makes huge demands on your body.” She was forced to stop lifting weights and found that any kind of exercise was “more taxing.”
So talk to your doctor about your specific chemotherapy treatment and see what levels of fatigue you should be expecting.
Additionally, chemotherapy is known to lower your immunity. Most people join a gym or go outside to motivate themselves to exercise, but chemo patients probably should not, according to Cancer Research UK. (10)
Public places, especially gyms, harbor germs and bacteria that can affect even healthy people, putting people with weakened immune systems at a much higher risk of getting sick.
Cancer patients who develop serious infections sometimes have to put their chemo on pause so they can recover.
The Best Exercise For When You’re Exhausted During Breast Cancer Treatment
According to scientific studies and patient experiences, walking is the best way to exercise during breast cancer treatment. It’s easy on joints and muscles, it boosts circulation and helps build strength at the best pace while requiring the least amount of energy.
The American Cancer Society writes, “Cancer survivors may need to exercise less intensely and increase their workout at a slower rate than people who haven’t had cancer.” The Society highly recommends walking as baby steps: it is a way to ease your body into working out.
Benefits of Walking
Josie Gardiner, a personal trainer who works with cancer patients, said that walking is the best exercise during chemotherapy because it is the safest. (11) It does not put too much pressure on your joints and muscles, but it helps maintain healthy circulation and heartbeat.
According to experts, walking is:
There is no set time limit for how much you should walk, because everyone’s strength, especially during chemotherapy, varies. However, if you are just starting a routine, aim for somewhere in between five and thirty minutes of walking time. (12) You can walk outside, in a mall, or around your house, wherever you feel most comfortable.
If you live in an area that doesn’t have great walking trails or the weather isn’t suitable for walking, consider using a treadmill. Treadmills decrease the impact on your joints, which can help you feel better if you find that you’re feeling stiff and sore.
A study that looked at breast cancer patients and walking found the best results occurred under these conditions: (13)
- Doing it 5 consecutive days a week
- Having a warm up and cool down period for 5-10 minutes
- The first 5-6 weeks of walking should be at a slower pace/lower intensity
The study recommends slowly increasing the level of intensity and pace.
According to breast cancer survivors, finding someone to walk with is also an incredibly important part of staying consistently active. These friends or family members will keep you accountable and can help encourage you on days when you’re not feeling strong.
What to Keep in Mind
The ability to walk for an extended period can vary day by day. Some days you’re able to get out for 30 minutes, and sometimes it’s hard to just step over the doorstep. On the difficult days, be willing to let your body rest and try again tomorrow.
Know your body and don’t extend yourself beyond what it is capable of doing right now.
Protect Your Skin
Keep in mind that chemo can sometimes cause sun sensitivity, so make sure your arms and legs are covered if you’re planning on walking for an extended period in the sun. If necessary, invest in a big hat to keep the sun off your face.
Invest in Walking or Running Shoes
Walking in a pair of old or beat-up tennis shoes can set yourself up for injury, especially if your body is in a weakened state from treatment. Investing in a good pair of walking or running shoes can help protect your feet, legs and joints from injury, allowing you to continue exercising throughout the course of your battle.
Staying hydrated is important in any form of exercise, but it’s especially vital for people going through chemotherapy. The treatment itself can leave you feeling dehydrated, but the side effects it causes (vomiting and diarrhea) can also remove water from your system.
This being the case, you need to ensure that you’re drinking enough water throughout the course of your exercise, even if you don’t feel as if it’s all that strenuous.
The Best Exercise For When You Have Some, But Not Much Energy
When you’re feeling better during your chemo treatment, and you feel like you can do a little more, consider spicing up your workout routine with a little light-strength training. It’s important to lift some light weights and keep your muscles toned and your bones healthy.
Not all days are the same during chemotherapy. While many patients agree that they are completely exhausted during the first few days after receiving the drug infusion, they typically find the worst of the fatigue fades away after 72 hours.
Once the initial tiredness fades away, with your doctor’s approval, you should be able to try and push yourself just a little more physically.
Benefits of Weight Training
Women with breast cancer who are undergoing chemotherapy can lose bone density, often in dangerous amounts. While lifting weights can’t restore that bone density, it can help maintain the density you have.
It can also keep the important major muscles in your arms, shoulders, and back from atrophying or getting weaker.
Cancer in and of itself can cause muscle loss. When fighting cancer, the body releases chemicals known as cytokines, which can result in a loss of appetite, weakness and weight loss. Additionally, chemotherapy produces similar side effects like nausea and vomiting that can lead to further weight and muscle loss.
By the time treatment is over, the treatments and disease have taken such a toll that some women report they have difficulty standing up or lifting even light objects. However, with a little preventative exercise, these symptoms can be alleviated.
In addition, weight training boosts metabolism, which also helps the chemo drugs flush through your system and hopefully weaken your tumors.
Weight Training Recommendations
Women’s Health Mag recommends these exercises for women starting weight training: (14)
- Single Arm Rows (taking one light dumbbell weighing 3-5 pounds, face the floor. Position one arm on a table and the other holding the weight. Extend your arm all the way down, then lift it with the weight to your side. Repeat.)
- Seated Shoulder Press (Sitting down, hold one dumbbell in each hand. Make a “W” formation with your arms, then lift the weights over your head. Repeat.)
- Step-Ups (Holding a dumbbell in each hand, let them rest by your sides. Step up onto a stair or a box, one leg at a time. Repeat.
What to Keep in Mind
Weight training is not for every cancer patient: Always consult your doctor before adding a weight training regimen.
If you are attempting weight lifting, try adding some balance exercises into the mix. A study from Breast Cancer Research and Treatment found that as little as one round of chemotherapy can have an impact on gait and balance, putting patients at a higher risk for falls. (15)
Depending on how you feel and what your doctor recommends, try some simple exercises that allow you to build up your balance and counteract the symptoms of your treatment. Simple stretching or walking in a straight line as if you’re on a tight rope can help.
Chemo, radiation, and surgery can make movement difficult in your arms and shoulders, and scar tissue can make it uncomfortable to move in places that used to be easy.
This being the case, you should start any exercise by properly stretching. Cancer survivors recommend especially stretching areas that had surgery in order to get blood flowing to sensitive areas.
“Stretch your pecs until you [get] full range of motion.”
– Breast cancer survivor
Once you’re fully warmed up, you can start lifting some light weights, but only for a small amount of time. Don’t lift more than what you’re capable of and stop immediately if you start feeling shortness of breath or tightness in your chest.
The Best Exercise For When You’re Feeling Good
The Clinical Oncology Society of America (COSA) recommends 150 minutes a week of moderate exercise for chemotherapy patients. (16) Running, or another similar aerobic exercise, typically provides the strongest benefits while also being the most convenient.
While exercises vary for different patients, making the transition from walking to running as a moderate cardio activity could be good for a day when you feel your best.
Benefits of Running
Running has time and time again been proven to provide powerful physical and mental benefits that can make a dramatic impact on your health throughout the course of your breast cancer treatment.
Physically, running can help you maintain a healthy weight while you’re undergoing chemotherapy. Anti-nausea drugs that allow you to eat well, general inactivity due to fatigue and the steroids in specific cancer drugs can all contribute to weight gain during breast cancer treatment. Running provides a good way to burn excess calories without pushing yourself beyond your physical limits. Additionally, aerobic exercises like running initiate what is known as “afterburn,” which is when your body continues to burn calories after you’ve completed a workout.
In addition, running helps keep your muscles and joints active and strong, which helps prevent pain, bone loss, heart problems and more.
Psychologically, studies are continuing to show that running helps improve your mood by releasing dopamine into the brain. In fact, one study that appeared in Medicine & Science in Sports & Exercise found that just 30 minutes of running could instantly improve the mood of someone experiencing major depression. (17)
Clinical depression affects approximately 10% of patients diagnosed with cancer, and many women report struggling with bouts of sadness and melancholy throughout the course of their treatments. (18) Running has been shown to help reduce those symptoms and improve overall mood which, in turn, may contribute to a more favorable treatment outcome. (19)
Jackie Scully writes in Breast Cancer UK: “Running makes me feel alive – and I’m still just a beginner. Running puts me in control of my body, my happiness and my health, connects me with amazing people, and helps me change the lives of those affected by breast cancer.” (20)
Invest in Shoes
As we’ve mentioned above, having a good pair of running shoes is absolutely essential to keeping yourself active and injury-free. You wouldn’t put old, worn-out tires on your car and expect it to drive without any problems; in the same way you shouldn’t expect that old, worn-out shoes won’t cause any issues. If you aren’t wearing good sturdy shoes, you might hurt yourself, injure your feet, or fall, which can be serious as you’re going through chemotherapy.
Run with Someone
There are multiple benefits gained from running with a friend or a partner. The first is that you have accountability and someone who will help encourage you and push you to stay active, even on days when you’re not feeling great or simply don’t feel like running.
Practically, having a running partner or group is wise as you’re undergoing chemotherapy. If you were to injure yourself or get out and find that you couldn’t make it home, not having someone around could turn very serious very quickly.
Consider sticking to a treadmill, especially if it is dangerous for you to go outside because of skin sensitivity or low immunity.
What to Keep in Mind
Not everyone has good days and that’s okay. Don’t exhaust yourself or force your body to do something it’s not prepared to do. Remember, if you are running a fever, have an infection, or you feel nauseous, you don’t have to go out for a run.
In fact, if you are struggling with severe chemo symptoms, it’s better that you don’t work out.
During chemotherapy, your body takes on water weight and loses energy very quickly. Even if you’re feeling good, you might go out for a run only to find that you didn’t have as much strength as you thought.
Make your sessions short and achievable. Set goals that will extend you, but remember that your number one priority is to keep your body healthy, so exercise in a way that will help you achieve that goal.
Take Care of Your Body
If you didn’t run much before your breast cancer diagnosis, be sure to take all the precautions necessary to ensure that you won’t injure yourself right out of the gate.
As we’ve mentioned before, investing in a good pair of running shoes is so important to help you avoid injury while running. Find a pair that fits you well and matches your foot type. It’s often helpful to meet with a shoe fitting specialist in your area who can help you find the perfect pair of shoes for you. Most outdoor or running stores have that ability.
Second, remember that chemotherapy can impact your balance and that the treatment makes your body much more susceptible to injury. So while you’re running, be deliberate and safe to avoid falling. Avoid trails and rough sidewalks that could cause you to trip or injure your legs.
Don’t Feel Limited to Running
Running is a great, easy option for staying active in the midst of breast cancer treatment, but don’t feel like it’s your only option. If you feel strong enough, take your exercise outdoors and try some different varieties. (21) Swimming is an excellent aerobic exercise that is light on the joints, good for the skin, and provides a good workout for major muscles.
Are you missing out on hanging out with friends? Take the opportunity presented by a good day and arrange a game of tennis, or some kind of team sport. (21) This will provide you with both variety and companionship, which are good for morale.
Essentially, find a workout and a routine that works for you. You’re much more likely to stay consistent in your workout regimen if you’re doing something that you actually enjoy.
In the end, both research studies and breast cancer survivors believe that staying active throughout your chemotherapy treatment is incredibly important for your physical, mental and emotional health.
The exercise you choose does make a difference, but our recommendations above are far from the rule. Talk to your doctor and find out what works for you and your body while you’re going through treatment.
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