Is Exercise or Rest Better for Patients With Cancer or Chronic Illness?

Did you know that there is one thing you can do to reduce your stress levels, enhance your ability to perform the activities of daily living (ADLs), and potentially boost your immune system? Well, there is: it is called exercise. Exercise can increase your quality of life and enhance feelings of independence and self-confidence. There is no magic to it. You just need to do it!

The medical community, fitness professionals and physically active people with chronic disease all agree that the benefits of exercise are very significant. When engaged in at moderate levels, exercise allows the organ systems to positively adapt and improve metabolic efficiency, thereby allowing for more intensive cancer treatments, fewer side effects and better rest and sleep patterns.

Exercise doesn’t need to be intense to have these benefits. In fact, many cancer patients exhibit muscular weakness, decreased functional capacity, and fatigue, which prohibits them from engaging in intensive exercise. Too, cancer patients often feel lethargic during certain points of their chemotherapy and/or radiation cycles. This is very normal and indicates that the body and the cancer are being affected by treatment. Allowing the body time to heal and rest is just as important as building muscle and enhancing cardiovascular strength and endurance. Listen carefully to your body during any physical activity and act accordingly. Err on the conservative side when determining the time, type and intensity of an exercise activity, particularly if you are undergoing treatment.

Benefits of Exercise

Exercise affects individuals in very different ways. Remember that the long-term benefits of regular exercise outweigh the immediate discomforts when done properly. The wonderful thing about exercise is that the effects on both body and mind are substantial and long-lasting. The physiological effects of chronic illness and cancer treatment can be extremely damaging to normal tissue and normal body functions. This damage can occur differently in every patient, so it is important to listen to your body carefully and communicate anything unusual to your instructor, trainer and/or doctor. Adjustments are easy to make in any exercise program and will ensure your safety. Some of the physiological benefits of exercise include:

  • Enhanced restfulness and better sleep patterns
  • Maintenance or strengthening of cardiovascular system
  • Enhanced flexibility and range of motion
  • Correcting muscular imbalances resulting from cancer treatment
  • Detoxification through sweat and better circulation
  • Maintenance or regaining muscle tone and strength
  • Increased oxygen to brain and tissues
  • Reduced fatigue

The psychological effects of cancer treatment and treatment of other chronic diseases can sometimes prove to be as damaging as the physiological ones. In fact, they may be more important, as far as enhancing quality of life. Some of the benefits include:

  • Stress reduction
  • Relaxation
  • Improved sleep
  • Enhanced feelings of independence and self-confidence
  • Refocusing energies from illness to wellness
  • Mood elevation

Starting an Exercise Program

Check with your doctor(s) before beginning your exercise program. Ask if you should be aware of any special considerations. If you are going to join a program or work with a trainer, it is standard procedure for the program director or trainer to ask for a letter signed by your doctor giving you permission to start the program.

The key to most successful exercise programs is to start slowly and to develop and maintain a routine, particularly if you do not have an extensive exercise history. During any activity, if you experience any unusual physical symptoms, stop immediately. Some common symptoms to look out for are: shortness of breath, chest pain, dizziness, muscle pain, clamminess, headaches, irregular heartbeat, excessive sweating and any joint or limb pain.

When you are starting out, think about the type of exercise and surroundings that you enjoy most. Some people love the solitude of exercising alone, while others need a group to maintain motivation and prevent boredom. Exercising with others is a good opportunity to spend time with friends, family or other survivors, and to share the road to better health and wellness.

Walking is a great activity to begin with. Before you begin, get shoes that support your feet. If you are just starting, set a realistic goal. Even two to five minutes can be a good goal. As your strength increases, add a little more time. A long-term goal may be to work up to twenty minutes twice a week, and then thirty minutes three to four times a week. When you walk, keep your head held high, your shoulders back and abdominal muscles held in. Enjoy the scenery, and stop and smell the roses— that’s part of the pleasure!

You will need to drink a lot of water during any activity you engage in. It is important to your overall health to stay hydrated, especially during treatment. The body continually loses water. Get in the habit of carrying a water bottle with you to remind yourself to hydrate.

If you aren’t familiar with the exercise facilities near you, look in the phone book. Try to find a place close to your home or work so that it will be easy to work into your routine. If you like a facility, schedule a tour before signing a contract to make sure that it is clean, the staff is friendly, and that you are comfortable there.

Ask your doctor for recommendations as well. There may also be community-based programs designed specifically for cancer survivors that are available at little to no cost. Take advantage of these programs if you can. The staff is generally more knowledgeable and compassionate regarding symptoms of fatigue, nausea, lethargy and weakness, and cosmetic concerns. They can better formulate an appropriate regimen, help alleviate apprehension and introduce you to people experiencing similar effects.

If you can afford to hire a personal trainer, that person can design a program to meet your specific needs. Consider the trainer’s education and level of experience. Does the person have an undergraduate degree in an exercise-related field or hands-on training in an area related to your needs (cancer and exercise, pilates, yoga, massage, working with older adults)? Has the trainer earned a nationally accredited fitness certification? The American College of Sports Medicine (ACSM) certification is considered the gold standard in the fitness industry. Other recognized certifications include the American Council on Exercise (ACE), and the National Academy of Sports Medicine (NASM).

Activities to Try

Whether you are an exercise veteran or are new to the fitness arena, it is important to try new things to keep your exercise routine fresh. The following practices require some instruction, which may be found in books, videos or in group classes if you don’t have a trainer. Give these activities a try—you may enjoy them so much it won’t even seem like exercise!


Joseph Pilates began developing his increasingly popular exercise method in the late 1890s in an effort to overcome ailments suffered from asthma, rickets and rheumatic fever. He studied Eastern and Western medicine, yoga, Zen meditation and exercise regimens of the ancient Greeks and Romans. The method proved so successful for him that at the age of fourteen he was able to pose for anatomical charts and had become a diver, skier and gymnast.

Pilates focuses on strengthening the abdominal, back and other postural muscles (those supporting the spine), which, together, are referred to as the “core”. The dance and rehabilitation communities have embraced this method for many years, and recently the mainstream fitness arena has exploded with enthusiasm for Pilates exercises.

Pilates exercises can be practiced on the floor or with specialized equipment. The main piece of equipment is called a reformer. This is an excellent practice for postural enhancement and can be as challenging and physically rewarding as any traditional resistance program.

Water Exercise

Water exercise classes and activities have gained continued popularity over the last several years. Exercising in the water is extremely beneficial to people with orthopedic issues. Many people who cannot exercise on land due to these issues have had a lot of success in the water.

If you are currently in radiation treatment, you should consult your doctor before going in a public pool, but most people have a far greater benefit than problems with skin issues.

Ask local facilities that have pools about the programs they offer. Go several minutes early the first time you attend a class to let the instructor know you are new, and share pertinent information about your current health status.

A good instructor will keep an eye out for you and suggest necessary modifications, and may even provide some one-on-one instruction to maintain your safety and ensure your success.

Physio Balls

Physio balls, also known as stability balls or exercise balls, are another fun way to incorporate exercise into your lifestyle and feel like a kid again! These large inflated rubber balls were previously used for back rehabilitation exercises, but have evolved into the mainstream fitness arena with great success. Working with physio balls enhances core strength, helps you stretch, and allows you to develop and maintain your balance.


Rollers are Styrofoam cylinders that help develop core stability, breathing, flexibility and postural enhancement. They are wonderful and easy to use. Rollers were previously used for rehabilitation purposes as well, but have also experienced a rebirth into the traditional fitness arena. Before you start using rollers, consult a fitness professional for basic instruction. Once you feel comfortable with the exercises, this is an ideal tool to use at home.


Editor’s Note: This article was authored by Jane Clark and has been adapted for by Harvey Gilbert, MD, with permission from Cancer Supportive Care.