# Exercise during chemotherapy and radiotherapy

Source: https://onco.cc/technologies/exercise-during-chemotherapy/  
OnCo record `exercise-during-chemotherapy` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

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

## Summary

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.

## Fields

- Kind: Technology
- Status: established
- Last checked: 2026-09-08
- Principle: 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

## Notes

- Lung cancer: Asthma + Lung UK says lung function tests and scans do not always show how breathless you feel, because the way you breathe, your lifestyle and how you think and feel about breathing all affect breathlessness, and that breathing techniques and changing position can be learned. Cancer Research UK says walking and stairs are easier with breathing control, to match your breathing to your steps, to avoid holding your breath when climbing or bending, and to breathe out on effort (blow as you go).
- Lymphoma: Lymphoma Action's exercise material and its fatigue material point the same way, treating graded activity as a treatment for fatigue rather than something to attempt once the fatigue has lifted, and its late effects page lists regular suitable exercise among the things that lower the long-term risks of heart problems and thin bones.

## Sources

- ACSM roundtable 2019 (Med Sci Sports Exerc): https://doi.org/10.1249/MSS.0000000000002116
- PACES trial (JCO 2015): https://doi.org/10.1200/JCO.2014.59.1081
- Asthma + Lung UK: breathlessness: https://www.asthmaandlung.org.uk/symptoms-tests-treatments/symptoms/breathlessness
- Asthma + Lung UK: how can I manage my breathlessness?: https://www.asthmaandlung.org.uk/symptoms-tests-treatments/symptoms/breathlessness/how-can-i-manage-my-breathlessness
- Cancer Research UK: coping with breathlessness when you have lung cancer: https://www.cancerresearchuk.org/about-cancer/lung-cancer/living-with/coping-with-breathlessness
- Lymphoma Action: exercise and lymphoma: https://lymphoma-action.org.uk/information-and-support/living-and-beyond-lymphoma/exercise-and-lymphoma
- Lymphoma Action: cancer-related fatigue: https://lymphoma-action.org.uk/information-and-support/side-effects-lymphoma-and-treatment/cancer-related-fatigue

## Connected records

- cancers: [Advanced-stage classical Hodgkin lymphoma (stage III to IV)](https://onco.cc/cancers/advanced-stage-classical-hodgkin-lymphoma/), [Breast cancer (all types)](https://onco.cc/cancers/breast-cancer/), [Burkitt lymphoma](https://onco.cc/cancers/burkitt-lymphoma/), [Colorectal cancer](https://onco.cc/cancers/colorectal/), [Cutaneous T-cell lymphoma (mycosis fungoides and Sezary syndrome)](https://onco.cc/cancers/cutaneous-t-cell-lymphoma/), [Diffuse large B-cell lymphoma](https://onco.cc/cancers/dlbcl/), [Early-stage classical Hodgkin lymphoma (stage I to II)](https://onco.cc/cancers/early-stage-classical-hodgkin-lymphoma/), [Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma)](https://onco.cc/cancers/malt-lymphoma/), [Follicular lymphoma](https://onco.cc/cancers/follicular-lymphoma/), [Gallbladder cancer](https://onco.cc/cancers/gallbladder/), [Hodgkin lymphoma](https://onco.cc/cancers/hodgkin-lymphoma/), [HR-positive / HER2-negative breast cancer](https://onco.cc/cancers/breast-hr-positive/), [Lung cancer (all types)](https://onco.cc/cancers/lung-cancer/), [Mantle cell lymphoma](https://onco.cc/cancers/mantle-cell-lymphoma/), [Marginal zone lymphoma](https://onco.cc/cancers/marginal-zone-lymphoma/), [Nodal marginal zone lymphoma](https://onco.cc/cancers/nodal-marginal-zone-lymphoma/), [Nodal T-follicular helper cell lymphoma, angioimmunoblastic type (angioimmunoblastic T-cell lymphoma)](https://onco.cc/cancers/angioimmunoblastic-t-cell-lymphoma/), [Nodular lymphocyte-predominant Hodgkin lymphoma (nodular lymphocyte-predominant B-cell lymphoma)](https://onco.cc/cancers/nodular-lymphocyte-predominant-hodgkin-lymphoma/), [Non-Hodgkin lymphoma (all types)](https://onco.cc/cancers/non-hodgkin-lymphoma/), [Non-small-cell lung cancer](https://onco.cc/cancers/nsclc/), [Pancreatic ductal adenocarcinoma](https://onco.cc/cancers/pancreatic/), [Peripheral T-cell lymphomas (including cutaneous T-cell lymphoma)](https://onco.cc/cancers/peripheral-t-cell-lymphoma/), [Primary CNS lymphoma](https://onco.cc/cancers/primary-cns-lymphoma/), [Primary mediastinal (thymic) large B-cell lymphoma](https://onco.cc/cancers/primary-mediastinal-b-cell-lymphoma/), [Prostate cancer](https://onco.cc/cancers/prostate/), [Relapsed and refractory classical Hodgkin lymphoma](https://onco.cc/cancers/relapsed-refractory-hodgkin-lymphoma/), [Sezary syndrome](https://onco.cc/cancers/sezary-syndrome/), [Small-cell lung cancer](https://onco.cc/cancers/sclc/), [Splenic marginal zone lymphoma](https://onco.cc/cancers/splenic-marginal-zone-lymphoma/), [Triple-negative breast cancer (TNBC)](https://onco.cc/cancers/tnbc/), [Waldenström macroglobulinaemia](https://onco.cc/cancers/waldenstrom/)
- fronts: [Chemotherapy](https://onco.cc/fronts/chemotherapy/), [Diet, Exercise & Lifestyle](https://onco.cc/fronts/nutrition-lifestyle/), [Recovery & Rejuvenation](https://onco.cc/fronts/rejuvenation/), [Supportive Care & Survivorship](https://onco.cc/fronts/supportive-care/)
- technologies: [Cardio-oncology](https://onco.cc/technologies/cardio-oncology/), [Exercise & lifestyle oncology](https://onco.cc/technologies/exercise-oncology/), [Exercise is the best-evidenced thing on this front, and most survivors are not doing it](https://onco.cc/technologies/rejuv-access-exercise-programmes/), [Geriatric assessment](https://onco.cc/technologies/geriatric-assessment/), [The exercise prescription after cancer: the dose the guidelines state](https://onco.cc/technologies/exercise-prescription-after-cancer/), [What actually works after treatment](https://onco.cc/technologies/rejuv-frontier-what-works/)
- terms: [Body composition (lean mass, fat mass, visceral fat)](https://onco.cc/terms/body-composition/), [Cancer-related fatigue (tiredness)](https://onco.cc/terms/cancer-related-fatigue/), [Fatigue after lymphoma treatment, and why it is a symptom to report](https://onco.cc/terms/lymphoma-living-fatigue/), [MET-hours per week](https://onco.cc/terms/met-hours/)
- bottlenecks: [Not enough oncologists, nurses, pathologists, physicists](https://onco.cc/bottlenecks/b-workforce/), [Toxicity and quality of life are undervalued](https://onco.cc/bottlenecks/b-toxicity-qol/)
- key papers: [Effect of Low-Intensity Physical Activity and Moderate- to High-Intensity Physical Exercise During Adjuvant Chemotherapy on Physical Fitness, Fatigue, and Chemotherapy Completion Rates: Results of the PACES Randomized Clinical Trial](https://onco.cc/key-papers/paper-van-waart-j-clin-oncol/), [Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable](https://onco.cc/key-papers/paper-campbell-med-sci-sports-exerc/)
- roadmaps: [Diet, exercise and lifestyle roadmap: causes established → interventions that disappointed → exercise proven as treatment](https://onco.cc/roadmaps/nutrition-lifestyle-roadmap/)

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JSON: https://onco.cc/api/v1/entities/exercise-during-chemotherapy.json