Exercise during cancer treatment: 5 things to know
November 17, 2025
Medically Reviewed | Last reviewed by Karen Basen-Engquist, Ph.D., on November 17, 2025
For years, doctors have recommended exercise to reduce people’s risk of developing cancer and to help cancer survivors thrive after treatment ends. Yet, until recently, the benefits of exercising during treatment were a bit less clear.
But recent research has given us a clearer picture of how physical activity can benefit patients in active treatment. Spoiler alert: it’s good news!
To learn more about exercise during cancer treatment, we spoke with Karen Basen-Engquist, Ph.D., director of MD Anderson’s Center for Energy Balance in Cancer Prevention and Survivorship.
What are the benefits of exercise during cancer treatment?
In 2022, the American Society of Clinical Oncology (ASCO) issued the first-ever evidence-based exercise guidelines for adults in active cancer treatment. To develop its guidelines, ASCO assembled a panel of experts who analyzed more than 100 clinical trials examining the link between exercise and cancer treatment.
What they found left little doubt that staying physically active improves symptoms and side effects in patients undergoing chemotherapy, radiation therapy, or both. It also helps those who have surgery recover faster with fewer complications.
“The science shows that exercising during cancer treatment eases fatigue, anxiety and depression while improving quality of life and physical function,” Basen-Engquist says. “Staying active helps patients continue engaging in the regular activities of daily life.”
Then, in 2025, the New England Journal of Medicine published the results of the first randomized controlled trial to show that exercise increased disease-free and overall survival for colon cancer patients who had completed chemotherapy. While previous studies showed the benefits of exercise for survival after cancer, none of these studies were randomized controlled studies. This type of study provides “the highest level of evidence” because it reduces bias, or other factors that might affect an outcome, Basen-Engquist explains.
“We're very excited to see the results of this study, and consider the potential effects on cancer care,” she says.
ASCO guidelines and new research offer reassurance that exercise is safe and good for patients during cancer treatment. Still, in the minds of many, exercise and cancer don’t seem to go together — especially when treatment leaves you feeling run down or depressed, Basen-Engquist says.
“Your natural inclination when you're feeling like that is not to say, ‘Hey, let's go out and take a walk,’” she says. “But it can be helpful. It can actually help improve some of the symptoms that you might be experiencing, particularly fatigue.”
The benefits of exercise don’t end after cancer treatment, either. Research has also found that people who exercise after completing cancer treatment see benefits to their quality of life, fatigue, physical functioning and mood.
How does exercise counteract cancer?
No one knows with certainty, but Basen-Engquist points out that exercise reduces levels of inflammation and insulin, which are linked to some cancers.
Exercise also induces angiogenesis, or the creation of new blood vessels, which could mean that more blood-driven anti-cancer medicine can be delivered to cancerous tumors.
“Exercise may make chemotherapy more effective,” she says.
Immune function also benefits. While cancer weakens the immune system, exercise boosts the circulation of immune cells that attack cancer. It may even help powerful immunotherapy treatments work better.
How much exercise do I need during cancer treatment?
Exercise during cancer treatment looks different for each person. The amount of physical activity you can handle is based on factors like:
- Cancer type
- Treatment
- Side effects
- Fitness level
General guidance suggests getting 150 minutes of exercise per week.
“Spread that 150 minutes over multiple days,” Basen-Engquist says. “I tell patients to aim for 30 minutes a day, five days a week, which equals 150 minutes.”
It’s also OK to break up your daily exercise session. For example, instead of one 30-minute workout, you could do 10 minutes of exercise in the morning, 10 minutes after lunch and 10 minutes in the evening.
What types of exercise should I do during cancer treatment?
The ASCO guidelines recommend regular aerobic and resistance exercises for patients whose cancer has not spread beyond its initial site.
Aerobic exercise helps strengthen the heart and lungs. Examples of aerobic exercise include:
- Walking
- Jogging
- Cycling
- Dancing
- Swimming
Aerobic exercises should be performed at moderate intensity, Basen-Engquist says. This is a pace that allows you to talk but not sing. That’s compared to vigorous intensity, where you can’t say more than a few words without pausing for a breath.
Resistance exercise strengthens muscles. Examples of resistance exercise include:
- Lifting weights
- Using resistance bands
- Body weight exercises
“Both types of exercise can work together to help cancer patients maintain health and well-being,” Basen-Engquist says.
How to start an exercise routine during cancer treatment
Ready to start adding physical activity to your routine during treatment? Here are a few tips Basen-Engquist shares with patients.
Start slowly
If you don’t have an exercise routine, jumping right to 150 minutes of physical activity can feel overwhelming — and may put you at risk of injuries and muscle strains. Instead, start small and increase your physical activity over time. If your energy level is low, adjust how long or hard you exercise until you feel better.
“People will often need to start slow with exercise, especially if they are feeling unwell or have been inactive for quite a while. It’s OK to start with light activity and build up to short bouts of moderate aerobic activity,” Basen-Engquist says. “You can add in resistance exercise as you get more comfortable with your aerobic exercise routine, or some people find starting with resistance exercise is easier for them.”
Visit MD Anderson’s Physical Activity page for an example of a weekly workout schedule that gradually increases.
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Connect with MD Anderson resources
MD Anderson patients can talk to their care team to learn more about physical activity programs and resources available to them.
For example, the Integrative Medicine Center offers exercise and physical activity consultations and hosts weekly yoga and chair yoga classes for patients and caregivers.
Survivors can also participate in the Active Living After Cancer Program, a 12-week physical activity program designed for those who have finished cancer treatment.
Listen to your body
Remember: there’s a difference between lacing up your walking shoes on a day you feel sleepy and heading to the gym when you’re in pain.
For example, vigorous exercise isn’t recommended for patients with:
Instead, give your body time to rest and recover. Then, when you are ready to add physical activity to your schedule, start slowly and build up gradually.
“Even if you can only manage a few minutes of walking, do it,” Basen-Engquist says. “Small steps lead to big results.”
Request an appointment at MD Anderson online or call 1-877-632-6789.