Cancer Recovery

Exercise used to be contraindicated during cancer treatment. That position has been entirely reversed by the evidence. Today, exercise is recommended throughout all phases of cancer care — and an Accredited Exercise Physiologist is trained to prescribe it safely.

What Does Exercise Physiology Address?

Cancer and its treatment impose significant physical burdens on the body. Chemotherapy, radiation, hormone therapy, and surgery each carry their own set of side effects — fatigue, muscle loss (sarcopenia), cardiovascular decline, peripheral neuropathy, lymphoedema, reduced bone density, and impaired immune function among them. The cumulative effect of treatment — compounded by the enforced inactivity that once accompanied it — can leave people significantly deconditioned well before treatment ends.

Cancer-related fatigue (CRF) deserves particular attention. It is the most commonly reported side effect of cancer treatment, affecting up to 90% of patients undergoing chemotherapy or radiation. It is distinct from ordinary tiredness — it is not relieved by rest, is disproportionate to activity level, and can persist for months or years after treatment ends. For a long time, the intuitive response was to recommend rest. The evidence has shown that this is counterproductive.

Exercise physiology addresses CRF, muscle preservation, cardiovascular maintenance, bone health, psychological wellbeing, and quality of life across all phases of cancer care: prehabilitation (before treatment begins), during active treatment, and in the recovery and survivorship phases. The approach and dose differ substantially across these phases — which is precisely why clinical prescription is required rather than general activity advice.

How Exercise Physiology Helps

Counterintuitively, appropriately dosed exercise during cancer treatment reduces fatigue rather than worsening it. The mechanism appears to involve improved cardiovascular efficiency, mitochondrial adaptation, reduced systemic inflammation, and neurological factors. Across multiple trials, structured exercise during chemotherapy and radiation has consistently produced clinically meaningful reductions in cancer-related fatigue — effects that rest does not produce and that no pharmacological intervention reliably matches.

Resistance training during and after treatment preserves muscle mass at a critical time when sarcopenia is both common and clinically significant. Muscle mass influences treatment tolerability, recovery speed, and in some cancers, survival outcomes. Maintaining it through a period when the body is under substantial metabolic and inflammatory stress requires careful prescription — but the evidence strongly supports it as a priority.

In the survivorship phase, exercise addresses the long tail of treatment effects: persistent fatigue, deconditioning, weight changes, cardiovascular risk (elevated by some chemotherapy regimens), bone density loss from hormone therapy, and the psychological burden of treatment. Exercise is also associated with reduced risk of cancer recurrence in several cancer types, including breast and colorectal cancer — a finding that has elevated it from a supportive measure to a potential therapeutic one.

What to Expect

The first step is understanding your treatment type, current phase, and any restrictions or precautions from your oncology team. This shapes every aspect of the program — exercise type, intensity, volume, and timing relative to treatment cycles. Programs are adaptive: what is appropriate in week one of chemotherapy may differ significantly from week twelve, and the program needs to flex around that.

Fatigue is monitored carefully and used to guide load decisions. Sessions are dosed, not maximised — the goal is a level of exercise that produces benefit without exceeding the body’s current recovery capacity. As treatment progresses and concludes, the program evolves to reflect improving capacity and changing goals. Remote delivery is available for those with limited mobility or who prefer to exercise at home during treatment.

• Liaison with oncology team — understanding treatment type, phase, and restrictions
• Conservative progressive program adapted around treatment cycles
• Fatigue monitoring — exercise is dosed, not maximised
• Muscle mass preservation through appropriate resistance training
• Flexibility to adjust as treatment response and capacity change

Is Exercise Physiology Right for You?

Whether you’re in active treatment or in the survivorship phase, exercise physiology offers structured, safe, and clinically appropriate support. Every cancer presentation is different — the right program depends on your diagnosis, treatment, current capacity, and goals. Get in touch to discuss your specific situation and whether supervised exercise physiology is appropriate for where you are right now. No referral is needed to make contact.