Exercising Through Cancer Treatment: The Importance of Strength-Based Exercise

Cancer treatment challenges every part of the body—from immune health to mental resilience. But one of the most powerful tools available during treatment can be exercise. And not just gentle stretching or walking. Strength/resistance training is proving essential in helping people combat fatigue, preserve muscle mass, and improve treatment outcomes.

In this blog, we will explore how strategic, strength-based exercise can support those going through chemotherapy, radiation, surgery, and immunotherapy—and how you can safely include it in your routine.

Why Exercise During Cancer Treatment?

Beyond managing side effects like fatigue and anxiety, exercise actually improves treatment response. A growing body of evidence shows that resistance and strength training can reverse muscle wasting (sarcopenia), improve insulin sensitivity, enhance cardiovascular health, and even reduce cancer recurrence risk.

The American College of Sports Medicine now recommends progressive resistance training 2–3 times per week for most people with cancer, even during active treatment (Campbell et al., 2019).

Lifting weights during cancer treatment

Exercise and Chemotherapy: Combatting Fatigue with Strength

Chemotherapy often leads to:

• Muscle loss

• Extreme fatigue

• Reduced metabolic function

Strength training during chemo has been shown to:

• Maintain or build muscle, even when the body is breaking it down for energy.

• Reduce fatigue by stimulating mitochondrial activity

• Improve glucose regulation, helping mitigate steroid-induced weight gain

A meta-analysis found that resistance training was more effective than aerobic exercise alone for maintaining lean body mass during chemotherapy (Cavalheri et al., 2020).

Recommended Exercises:

• Dumbbell or resistance band circuits (e.g., squats, rows, overhead presses)

• Bodyweight training (push-ups on knees, step-ups, lunges)

• Machine-based resistance work (leg press, chest press, lat pulldown)

• Short, moderate-intensity HIIT intervals (e.g., 30s cycling with 60s rest)

Exercise and Radiation Therapy: Strengthening the Foundation

Radiation can create stiffness, localised fatigue, and limited mobility—especially in targeted areas like the chest or neck. But strength training helps:

• Preserve posture and upper-body mobility, especially for breast or head/neck radiation

• Improve bone density, reducing long-term osteopenia risk

• Mitigate fatigue through metabolic efficiency

Research in Cancer Nursing found that a combined aerobic and resistance program significantly reduced fatigue and improved strength in women undergoing radiation therapy for breast cancer (Drouin et al., 2006).

Recommended Exercises:

• Shoulder and chest mobility work paired with light upper-body resistance training

• Lower-body strength sessions: squats, glute bridges, calf raises

• Full-body kettlebell circuits (with supervision) for endurance and strength

• Pilates or barre-based strength for flexibility and control

Exercise and Surgery: Prehab and Post-op Strength

Prehabilitation (exercise before surgery) is one of the best predictors of surgical recovery. Postoperatively, resistance training can help:

• Prevent muscle atrophy (loss) during recovery

• Improve functional mobility (sit-to-stand, stair climbing)

• Reduce post-op complications by improving circulation and lung capacity

The Lancet Oncology noted significant reductions in surgical complications among patients who completed 3–6 weeks of prehab including resistance work (Moran et al., 2020).

Pre-surgery Exercises:

• Resistance band circuits targeting legs, back, and core

• Breath training with inspiratory devices for abdominal/thoracic surgery

• Exercises for maintaining strength with minimal joint strain

Post-surgery Progressions:

• Begin with mobility → progress to light resistance → then compound bodyweight movements

• Core-focused rehab for abdominal surgeries (pelvic tilts, bird-dog)

• Seated strength workouts using resistance bands or ankle weights

Exercise and Immunotherapy: Building Resilience Inside Out

• Modulate immune system responses

• Maintain muscular and cardiovascular health during long treatment cycles

• Combat anxiety and improve mood

A 2021 review highlighted that muscle tissue can function like an endocrine organ, releasing anti-inflammatory proteins during strength training that may help regulate the immune system (Pedersen & Febbraio, 2012).

Recommended Exercises:

• Full-body resistance workouts (2–3 days/week) using moderate weights (8–12 rep range)

• Supervised HIIT cycling or rowing for mitochondrial health

• Circuit-style strength training with rest intervals to manage fatigue

• Yoga sculpt or Pilates resistance for a joint-friendly challenge

Strength with Sensibility

You don’t need to hit the gym hard to see benefits—but you do need to challenge your body safely. Here’s how:

• Get medical clearance and work with an cancer-trained exercise specialist

• Start with low to moderate intensity (RPE 4–6 out of 10)

• Rest and recover—allow at least one day between strength sessions

• Fuel your body with protein-rich meals post-workout

• Track symptoms and adapt – skip intense days if nausea, fever, or low counts arise

Strength training during cancer treatment isn’t about muscle gain for aesthetics—it’s about power and physical function.. When integrated safely and strategically, resistance training becomes a form of medicine, enhancing the body’s resilience to treatment and supporting long-term recovery.

Wherever you are in your cancer journey, gentle movement and building strength can support your recovery. With the right guidance, feeling stronger is truly possible.

References

1. Campbell, K. L., et al. (2019). Exercise Guidelines for Cancer Survivors. Medicine & Science in Sports & Exercise. https://doi.org/10.1249/MSS.0000000000002116

2. Cavalheri, V., et al. (2020). Exercise training for people with cancer: A Cochrane review. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD010756.pub2

3. Drouin, J. S., et al. (2006). Randomized controlled trial of exercise and fatigue in breast cancer patients. Cancer Nursing. https://doi.org/10.1097/00002820-200611000-00005

4. Moran, J., et al. (2020). Prehabilitation in elective surgery: A narrative review. The Lancet Oncology. https://doi.org/10.1016/S1470-2045(20)30059-2

5. Pedersen, B. K., & Febbraio, M. A. (2012). Muscles, exercise and obesity: Skeletal muscle as a secretory organ. Cell. https://doi.org/10.1016/j.cell.2012.02.043