Is It Safe for Patients to Exercise During Treatment for Cancer?

Gabriele “Gabe” Grunewald was diagnosed with cancer in 2009 at the age of 22. The next day, the professional runner beat her own record in the 1,500 meters race.

Triathlete Sindy Hooper was diagnosed with pancreatic cancer in 2013. She went on to continue competing in Ironman competitions.

As much as exercise helps reduce the odds of receiving a cancer diagnosis, athletes are not immune to the disease. But cancer is not a death sentence for grueling workouts.

“I personally had patients...that are professional level athletes that tell me ‘If I can’t continue this type of training and be an athlete, I’d rather die,’” said Susan Gilchrist MS, MD, associate professor in the department of clinical cancer prevention and the department of cardiology at MD Anderson Cancer Center in Houston. “Because that’s their life. It’s important to them to maintain their exercise training.”

When consulting a new cancer patient who’s attached to their extreme exercise routine, it’s important to remember that, despite the toll cancer treatment can take on the body, it’s better to stay active during treatment.

“Anyone who tells you (exercising during treatment) could be bad, my answer is show me the data,” said Kathryn Schmitz, professor at Penn State University’s College of Medicine and immediate past president of the American College of Sports Medicine. “It is much more dangerous to do nothing...There will be doctors very afraid to allow you to exercise. Others who've read the literature know exercise is perfectly fine and healthy.”

Schmitz was part of the group that devised the new recommendations and clinical guidelines for exercise during and after chemotherapy, which is to be released in October. The number one piece of advice in this set of guidelines remains the same as previous ones: avoid inactivity.

According to Gilchrist, who runs MD Anderson’s Healthy Heart program, geared toward building and maintaining the fitness of patients and survivors of cancer at risk for cardiovascular disease,  breast cancer patients specifically can lose 20 to 30% of their fitness levels while going through chemotherapy, as well as suffer loss of skeletal muscle mass. The solution? A regular exercise routine during treatment. Gilchrist said that with exercise that drop in fitness can be as low as 5%. But it’s important to make sure patients aren’t overexerting themselves.

“You have to listen to your body and create the schedule,” Gilchrist told Cancer Network. “That’s hard for athletes during chemo. You can’t be that structured. You have to give yourself a break. If you work out when your body says ‘this is not the day,’ you’re going to hurt yourself.” 

When advising a patient with cancer who is also a competitive athlete, Schmitz recommends telling them to listen to their bodies. Taking 10 minutes to exercise and then monitoring how they feel can help prevent a patient from overtraining. More importantly, they need to find doctors who will listen to them.

Schmitz added that it’s important for patients to be aware that overtraining may delay treatment by exhausting the body and affecting the number of blood cells needed for chemotherapy. Instead of pushing themselves, she said patients should allow themselves days of easier workouts if they need them during treatment.

In addition, patients should consider their mental wellbeing as they go through intense treatment. She added that many athletes who get cancer often experience anger and betrayal for doing the right things to prevent the disease and getting it anyway. She encourages yoga to help with insomnia during treatment and meditation to help with being mindful.