Exercise During Cancer Treatment – A Case Study

A quick introduction to exercise and cancer…

Thought processes around using exercise for cancer recovery have progressed a lot over the years. 

Once upon a time, ‘rest’ was believed to be the best approach for cancer recovery, with the thought being that we must give the body time to heal before applying further physical loads to it. Oh how this medical belief was wrong! 

Things started to change in the late 1980’s when the theory was tested by some forward-thinking oncologists. Since then, researchers have found, time and time again, that rest is definitely not best. The field of exercise to aid cancer treatment has exploded, even gaining its own fancy niche within science; Exercise Oncology. There have been over 1,000 randomised control trials (gold standard research studies) in this field, and the research is very clear that physical activity is far superior to inactivity (1).


Exercise Oncology Evidence

Fast forward 40 years, and exercise is now promoted as being a staple component of rehabilitation following cancer treatment. Not only does it help to preserve fitness, strength and physical capacity, but the literature shows that it can help to support immunity, reduce the side effects of treatment (fatigue, nausea, pain), and reduce mental health symptoms such as anxiety and depression! (2)

But why only use exercise for improving wellbeing AFTER treatment has been completed? Why not implement it during, and gain these benefits throughout? 

This study published in 2016 found that completing exercise as an adjunct to cancer treatment significantly improved physical fatigue scores, general fatigue scores, and even improved factors such as motivation and overall activity levels (3). Similarly, another research study indicated that physical fatigue, emotional distress and quality of life was improved for those who walked for over 90 minutes per week during chemotherapy or radiation treatment, compared to those who didn’t (4).

What we’re saying is that there is no need to wait until cancer treatment is completed before integrating Exercise Physiology – we come across a few switched-on referrers who are well aware of this!

Exercise during cancer treatment

Meet Joanne (name changed for privacy)

Jen met Joanne in the midst of her treatment for multifocal grade 3 breast cancer. 

Joanne had already received a lumpectomy (surgical removal of cancerous breast tissue), the removal of lymph nodes, and at the time of starting the Exercise Physiology program, she was receiving chemotherapy treatment weekly. Each dose of chemo would cause 4 days of resulting fatigue. To add to all of this, a double mastectomy was booked and planned for 3 months ahead. 

Despite the significant physical challenges that she was living with day-to-day; fatigue, weakness, lymphedema (blockage of lymph nodes causing painful swelling in the arms), and achiness, Joanne was keen to get started with a structured exercise program. 

As is necessary with most cancer clients we see, Jen had to walk the fine line between managing her fatigue (and other) symptoms, while still eliciting a sufficient exercise response. 

The exercise physiology program involved components of fatigue management – pacing, symptom tracking, and sleep hygiene – as well as an exercise program that improved cardiovascular fitness, upper body strength and mobility, in preparation for the double mastectomy. 

And by the way – the whole program was administered via telehealth!


Fast forward a few months…

Joanne received her double mastectomy and recovered smoothly. But unfortunately for Joanne, there was more yet to come… Joanne was next to receive radiation therapy (5 days per week for 5 weeks), and to prepare for a hysterectomy towards the end of the year. 

Still working together with Jen, the goals shifted slightly – this time to remain physically active during the radiation therapy, continue the rehabilitation from her 2 mastectomies, and build stamina for the upcoming hysterectomy.

Joanne’s body went through a roller coaster ride over their time together – chemotherapy, radiation, and multiple surgeries. The program needed to be flexible to work around each different phase of Joanne’s treatment, and together they explored a wide range of exercise types to cater to her needs.


The Outcome?

With Jen’s problem-solving skills and program design creativity, Joanne managed to keep exercising through each of her treatments, gradually build back her physical capacity, and make a full return to work (4 days as per her pre-disability role) early into the following year! 

Well done Jen for a beautifully executed program, and well done to this clued-up insurer for providing Joanne with such valuable support throughout her treatment. 

We love seeing the “proof in the pudding” where science is concerned!


(Want to know more? We have a whole article about the progressions in exercise for cancer treatment, as well as how exercise helps with cancer!)



  1. https://www.cancer.gov/news-events/cancer-currents-blog/2019/cancer-survivors-exercise-guidelines-schmitz
  2. https://www.essa.org.au/wp-content/uploads/2015/10/ESSA-Optimising-Cancer-Outcomes-Through-Exercise1.pdf 
  3. https://www.sciencedirect.com/science/article/abs/pii/S0378512215300918 
  4. https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1523-5394.2001.009003119.x 


Author: Yolanda van Vugt 
Clinical Exercise Physiologist and Content Creator at Specialised Health


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