The new ACSM/ACS guidelines stress that patients should avoid inactivity and engage in normal daily activities and exercise as much as possible during and after treatment. However, it’s important to be aware of certain risks and the potential need to make exercise modifications for different types of cancer patients.

Breast Cancer: lymphedema & fractures

  • For resistance training, start at very low resistance, adding resistance in small increments.
  • Watch for arm/shoulder symptoms, including lymphedema, and reduce resistance or stop specific exercises according to symptom response.
  • There is no upper limit on the amount of weight to which you can progress.
  • Yoga appears safe as long as arm and shoulder range of motion are taken into consideration.
  • Avoid high impact activities if you are at risk for fractures due to osteoporosis or neuropathy.

Prostate Cancer: fractures & pelvic floor exercises

  • Same guidelines as above.
  • For resistance training remain vigilant for the increased potential for fracture.
  • Watch for signs of lymphedema if lymph nodes were removed or radiated.
  • Pelvic floor exercises should be added for men who undergo radical prostatectomy.
  • Avoid high impact activities if you are at risk for fractures due to osteoporosis or neuropathy.

Colon Cancer: ostomy, stoma hernia & increased abdominal pressure

  • For aerobic activities, patients with an ostomy should be cleared by a physician prior to participation in contact sports.
  • For resistance training, start at low resistance and progress slowly to avoid a stoma hernia.
  • Watch for signs of lymphedema if nodes were removed or radiated.
  • Avoid excessive intra-abdominal pressure for patients with ostomies.
  • If an ostomy is present, modifications will be needed for swimming or contact sports.
  • Avoid high impact activities if you are at risk for fractures due to osteoporosis or neuropathy.

Gynecologic Cancers: lower limb lymphedema

  • There are no data on the safety of resistance training in women with lower limb lymphedema secondary to gynecologic cancer.
  • Proceed with extreme caution if you have had lymph node removal and/or radiation to lymph nodes in the groin.

Cancers that metastasized to the bone: fractures

  • For patients with metastatic bone disease, exercise programs need to be modified to avoid fractures.