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Exercise during chemotherapy and radiotherapy

Moderate exercise while on chemotherapy is safe and reduces fatigue, helps people finish their planned doses, and may protect the heart and nerves.

More than a hundred randomised trials, summarised in Cochrane reviews and the 2019 ACSM roundtable, show that supervised aerobic and resistance exercise during chemotherapy reduces cancer-related fatigue, preserves cardiorespiratory fitness and muscle, improves quality of life and, in several trials (for example PACES in breast cancer), increases the proportion of patients completing chemotherapy at full dose. Signals for reduced chemotherapy-induced neuropathy and cardiotoxicity exist but are from smaller trials. No trial has shown harm from moderate exercise in patients with stable blood counts. Home-based and remotely supervised formats retain most of the benefit for fatigue.

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Structured aerobic + resistance

How it works

Exercise counteracts the deconditioning and inflammatory cascade of cytotoxic treatment, maintains muscle protein synthesis, and improves perfusion and mitochondrial function in heart and peripheral nerve.

Strengths
  • Consistent benefit on fatigue and fitness across tumour types
  • Better relative dose intensity in several trials
  • Safe with sensible precautions (platelets, neutrophils, bone metastases)
Limitations
  • Survival effect during treatment unproven
  • Trials are small and heterogeneous in dose and supervision
  • Access to exercise physiologists is patchy

Latest papers

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Query for this technology: (TITLE:"Exercise during chemotherapy and radiotherapy" OR ABSTRACT:"Exercise during chemotherapy and radiotherapy") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Exercise during chemotherapy and radiotherapy, not a curated reading list.

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