Why Exercise Matters for Those Facing Cancer
Exercise can play a powerful role in preventing cancer, easing treatment side effects and improving survival rates.
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Despite decades of public health campaigns, global physical activity levels remain low. According to the World Health Organization (WHO), over one-third of adults worldwide are not sufficiently active, and nearly two-thirds spend more than four hours per day engaged in sedentary behaviors. These figures are particularly concerning given mounting evidence linking physical inactivity with an increased risk of several non-communicable diseases – including cancer.
According to the International Agency for Research on Cancer, 25% of cancer cases worldwide are caused by obesity and a sedentary lifestyle. Specifically, physical inactivity accounts for ~10% of cases of breast and colon cancer. As non-communicable diseases rise in prevalence, lifestyle interventions such as regular physical activity are increasingly recognized not only as preventative measures but also as adjunct strategies during and after cancer treatment.
Not only does physical activity and exercise contribute to cancer prevention, but it also improves quality of life, increases aerobic fitness, has a positive influence on mental health and reduces the side effects of cancer treatment, fatigue and mortality in cancer patients.
Exercise can aid in cancer prevention
There is now a plethora of evidence that demonstrates an inverse relationship between physical activity and cancer incidence. Regular exercise may promote protection against several types of cancer, including breast, colon and possibly prostate, endometrial and lung cancer, reducing the overall incidence of these cancer types by 40%. A sedentary lifestyle can increase the relative risk of breast and colon cancer, whereas a 75% reduction in risk for breast cancer and 22% reduction in risk for colon cancer has been reported in those with increased physical activity.
“Regular physical activity and exercise can reduce the risk of developing many different cancers by a number of mechanisms,” said Dr. Mhairi Morris, a senior lecturer in biochemistry at Loughborough University specializing in cancer biology and exercise oncology.
Morris explained: “This can be by lowering the amount of sex hormones – like estrogen – in the bloodstream either directly, or indirectly by reducing adiposity. Through regulating metabolic hormones such as insulin and insulin-like growth factors, which act as growth factors for cancer cells. By reducing inflammation, which again reduces the levels of pro-inflammatory molecules that serve to promote cancer growth. Finally, by mobilizing certain immune cells that serve as the body’s first line of defense against cancer, for example, natural killer (NK) cells and T lymphocytes – both of which have intrinsic cancer-killing properties.”
Public health organizations including the American Cancer Society, WHO and American College of Sports Medicine recommend a minimum of 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity aerobic activity per week, or a combination of both, for maintaining health. Additional benefits may be achieved with up to 300 minutes of moderate-intensity activity per week. For cancer survivors, these may be more difficult to achieve and it should be an aim to build to these levels of physical activity following treatment.
Exercising through and beyond cancer treatment
Cancer patients often face a wide array of debilitating symptoms and side effects from treatment, many of which can persist long after therapy has ended. However, growing evidence demonstrates that physical activity can be a powerful, non-pharmacological tool to counteract these effects. Exercise has been shown to enhance quality of life, increase aerobic capacity, improve mental health, reduce cancer-related fatigue and even lower mortality risk.
“When someone engages in physical activity before and during chemo/radiotherapy, it builds both physical and mental strength and resilience. Physically, it can help them get fit for treatment, it mobilizes their immune cells which have intrinsic cancer-killing abilities, and it can help them withstand higher doses of therapy – although the mechanism behind this is not known,” Morris explained.
Despite these benefits, the idea of incorporating exercise into cancer care may initially seem counterintuitive to some patients. Faced with a life-threatening diagnosis, they may view physical activity as burdensome, requiring time and energy they feel they cannot spare. Nonetheless, exercise has emerged as a safe, cost-effective intervention that can be tailored to individual capabilities and integrated alongside conventional treatments to improve outcomes.
A recent randomized crossover trial has provided compelling evidence that structured exercise after surgery and chemotherapy for colon cancer significantly improves patient outcomes. The trial found five years post-treatment, those who followed a supervised exercise regimen had an 80% disease-free survival rate, compared to 74% in the group that only received health education materials. They also faced a 28% lower risk of cancer recurrence or new cancers. Further, at the eight-year mark, the exercise group showed a 37% reduction in risk of death and a 90% overall survival rate, compared to 83% in the education-only group.
One charity promoting the importance of exercise in those who are diagnosed with cancer is MOVE Against Cancer.
“Exercise is one of the most important things anyone diagnosed with cancer can do to enhance wellbeing and improve health outcomes both during and after treatment,” said Dr. Lucy Gossage, a consultant oncologist and co-founder and trustee of MOVE Against Cancer. “Our mission at MOVE is to support, inspire and empower every single person impacted by cancer to live an active and fulfilling life.”
MOVE Against Cancer was founded by former international athlete Gemma Hillier Moses in 2016. In 2012, at the age of 24, Hillier Moses was diagnosed with Burkitt Lymphoma. She needed support to stay active during and after treatment and regain her fitness, but she found the support just didn’t exist. This led to the creation of MOVE to provide other young people diagnosed with cancer with the support she didn’t receive. Gossage came on board in the two years following MOVE’s founding, with the creation of the 5k Your Way (5KYW) initiative.
“The idea for 5KYW came when I was working with some teenage and young adult patients. Many of these patients receive long, tough courses of chemotherapy. During treatment, they do little other than sit in their hospital room. After treatment, we offer little to help them regain their fitness. I wanted to set up something that would help change this,” Gossage explained.
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“I knew that the best way to instigate change would be by including healthcare professionals in the change. What better way to do this than by creating a community within the wonderful community that is parkrun?”
Since launching the first 5KYW group in Nottingham, the initiative has grown and there are now over 100 groups across the UK and Ireland.
Limited uptake despite strong evidence
Although research consistently highlights the benefits of physical activity in cancer care, its integration into clinical practice remains limited. According to data from 2022, 36.7% of adult cancer survivors reported being physically inactive, and only around 7% of cancer patients meet recommended levels of physical activity. This gap may stem from fears that exercise could worsen their condition, as well as a lack of awareness about the physiological and psychological benefits of movement during and after treatment.
One way exercise uptake can be improved is through creating inclusive, evidence-based and community-supported opportunities for movement – such as 5KYW. “We focus on empowerment over performance and community over competition to help not just those affected by cancer, but also the wider population, to reframe movement as accessible and essential,” said Gossage.
“5KYW meetups are welcoming to people of all fitness levels, and we encourage first-time participants who may be nervous to walk a small part of the route or to volunteer, thereby lowering the barrier to entry. We emphasize the social aspect of movement, fostering a sense of belonging, support and mutual encouragement among participants.”
Fatigue is one of the most prevalent and distressing side effects of cancer and its treatment, significantly impacting daily functioning and quality of life. However, a wealth of evidence supports the role of physical activity in reducing fatigue among patients with breast, colorectal, ovarian, prostate cancers and multiple myeloma.
Empowering people with cancer to embrace movement is about more than exercise – it's about rebuilding confidence, breaking down barriers and highlighting the real, tangible benefits of staying active throughout recovery.
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Gossage explained: “We address psychological barriers: we recognize that fear, fatigue, body image issues and lack of confidence often prevent people – especially those recovering from cancer – from being active. We share real-life stories from our community to show that movement is possible and beneficial at any stage of recovery.”
Bridging the gap between evidence and practice
To incorporate exercise as a standard part of cancer treatment, a fundamental shift is needed in both clinical practice and research translation. Despite robust evidence supporting the benefits of physical activity for people living with and beyond cancer, its integration into oncology care remains inconsistent. A major barrier is the lack of education and confidence among healthcare professionals to discuss and prescribe exercise.
“Firstly, we need to empower and educate healthcare professionals. Clinicians should be trained in the benefits of physical activity for those living with and beyond cancer, so they feel confident discussing it with patients. If clinicians don’t prioritize exercise in their own lives, they may underestimate its importance to patients,” said Gossage. “However, evidence shows that most people with cancer want to know what they can do to improve their outcomes – and exercise is one of the few things within their control with strong evidence behind it.”
“It's important that we give patients explicit permission to be active, as many wait for reassurance that movement is safe and if they don’t receive this reassurance, they assume that it’s better to rest.”
Beyond implementation, scientific understanding is also advancing rapidly. The field has moved on from asking whether exercise is safe to exploring how it interacts with cancer biology. “We’re modeling the obesogenic breast cancer microenvironment and looking at how exercise influences this,” Morris explained. “Other studies are investigating how physical activity may reduce tumor hypoxia, modulate immune responses and even reprogram cancer metabolism. These insights open up the potential for exercise to act as a therapy sensitizer, improving tolerance and possibly even reducing chemoresistance.”
Looking ahead, the personalization of exercise regimens, much like personalized medicine itself, could be a game-changer. With emerging digital tools, patients could one day receive tailored exercise prescriptions based on their cancer type, stage, treatment and fitness level.
“We believe that every person with a cancer diagnosis should firstly be informed of the evidence for physical activity and then supported and empowered to be active in a way that works for them,” Gossage concluded.
