Low red blood cell counts: People with a low red blood cell count are anaemic, meaning the blood has a diminished capacity to carry oxygen. Patients who are anaemic can exercise but they should be careful and exercise at a low to moderate intensity, so that the feelings of fatigue and tiredness are not enhanced.

Immuno-suppression: Radiation and chemotherapy in high doses have a profound effect on the immune system. The immune system is often compromised leaving the patient vulnerable to infections. Because of compromised immunity, the exercise prescription must reflect a moderate activity level. The immune system is enhanced with moderate exercise and compromised with high intensity exercise. Sedentary behaviour has also been implicated with reduced immunity. Precautions also need to be taken to ensure that the exercise prescription isn’t placing the patient at increased risk of infection. Exercising in crowded gyms and pools is not recommended when the immune system is compromised.

Platelet counts: Cancer treatment can affect the ability of the blood to clot, therefore putting the patient at an increased risk of bleeding. Precautions need to be taken in activities that may produce bleeding such as contact sports and weight lifting. Patients are very susceptible to bruising and should be aware of their platelet counts when exercising.

Muscular Strength: Cancer patients may have increased energy demands. Due to the side effects of treatment, patients often become inactive and have a reduced appetite which can lead to loss of muscle tissue and diminished muscular endurance. Therefore exercises that enhance muscle mass can be highly beneficial, however patients should ensure a slow gradual progression when undertaking strength activities.

Fatigue: Fatigue is the most common treatment related side effect both during and after therapy. A large percentage of cancer patients experience overwhelming fatigue following treatment. Moderate exercise has been shown to reduce feelings of fatigue allowing patients to perform daily activities more efficiently. Both intensive exercise and sedentary behaviour have been shown to enhance feelings of fatigue and weakness in cancer patients.

Nausea, Diarrhoea and dehydration: Nausea is a commonly experienced treatment related side effect. People who experience severe nausea, diarrhoea and dehydration may need to stop exercise. Modifications may include reducing intensity and duration of exercise. Furthermore it is important to stay well hydrated before, during and after exercise and especially if the above symptoms are experienced. Activities that require balance such as treadmills should be avoided.

Surgery: Surgical patients often present with recent incisions and stitches, thus increasing the possibility of infection. Care needs to be taken with movements at the incision site and appropriate hygiene needs to be assured during exercise to avoid infection.

Radiotherapy: Patients who have received radiation therapy are likely to present with acute and chronic skin conditions. Skin reactions can be painful and care needs to be taken during exercise to reduce infection, eliminate skin irritation and prevent an excessive rise in body temperature. Swimming and exercises that have potential to exacerbate irritation should be avoided.

Please read these sections for more information on exercise:

• Exercise main page
• Developing an Exercise Program
• Managing Fatigue with Exercise
• Finding an Exercise Physiologist