What sort of exercise is recommended?

If you don’t want to do it, without taking into account other factors that could come into the equation you are likely to struggle. You need to be aware of any side effects which may affect your choice. For example, if you have trouble with your balance or you have altered sensation in your hands and feet but want to walk, you could take some walking poles or go with a friend. Your physiotherapist or exercise instructor could also provide you with a seated programme and work with any restrictions you may have. Light strength work can included with equipment such as therabands. These are cheap, transportable and ideal for use at home. If your cancer has affected your bones you need to ensure you chose low impact exercise to avoid putting more pressure on your joints, or risk of fracture if the bones are frail, but at the same time still strengthening your heart and lungs, such as cycling or using a cross trainer. It is best to avoid impact sports and lifting heavy weights and ensure you wear supportive shoes and loose, comfortable clothing.

Going through treatment is a worrying time but it is good to try and exercise gently. A lot will depend on your type of treatment and your current fitness level. You need to be aware of picking up infections so gyms and swimming pools are not always the best options. Always ensure you are sensible and listen to your body. Those who are already active should not look at increasing your fitness level if still on treatment, but focus on maintaining what you have. Your fitness may drop but don’t be discouraged, the fact that you are managing to exercise is a great achievement. If you have never done exercise, it is still a good idea to try and do some gentle activity and walking/a home programme is usually the best prescription. Walking enables you to go at your own pace and distance. The key is to keep it gentle and easy so you can do little and often, even if it’s a walk to the end of the garden. Treatment can be tiring and some days you may struggle to get out of bed and feel completely exhausted. On these days, keep positive, rest and when you feel better try to do a small amount of exercise. People who are exercise driven or determined to make a change need to be cautious. Pushing yourself on the days when you feel better can have a negative effect. Hard exercise you do could end up being too much and result in you spending the next few days completely exhausted, resulting in no exercise and leading to a negative effect. By being sensible, it means you can exercise the next day or every other day which results in you having more active days instead of being exhausted and inactive. You need to feel energised not wiped out.

There are many variables that can determine which exercises or activities are effective and safe for your particular situation.  Every day can bring new challenges and new accomplishments, so it is important to be able to modify your physical activity to suit your needs at any given time.

• Exercise when energy levels are at their best
• Customize your exercise each day to allow for any physical or psychological side-effects you may be experiencing
• A walking programme is a great way to start physical activity. If fatigue levels high, start small and build up gradually. This could be as little as 5 minutes to begin with, adding on a few minutes each time.

Consult with a nutritionist to address weight loss, focus on gentle strength exercises to improve muscle mass. It is important that you seek out tailored advice on what is appropriate for you as your personal experience can affect what exercises would be best.

Once treatment has finished and you are feeling better, you can start looking at increasing your activity level by basing your starting point on what you have currently been doing. If you were unable to do any activity during treatment now is the time to look at what you can do.

The guidelines for staying healthy are 150 mins of moderate aerobic activity a week plus two or more strength days. Moderate means getting slightly out of breath such as a brisk walk or cycling.  You can still have a conversation but you are aware of your increased rate of breathing and are feeling warm. This can be broken down into smaller bouts of exercise to suit you. For example, six lots of five minutes may seem more achievable to begin with, before slowly building up to the 30 minutes for one day.

Strength/resistance days are where you work your main muscle groups: legs, back, chest, hips, abdomen, shoulders and arms. Try to do this 2/3 times per week, ideally not on consecutive days. Improving muscular strength and stamina can help to improve your quality of life by making day to day activities easier and more enjoyable.  Gaining strength can also reduce the chance of injury and can again empower you both physically and mentally.

While diet is often the most critical factor for weight loss, we cannot forget that the loss of lean muscle mass contributes towards this very significantly. When we don’t use our muscles, we simply lose them.

For some people this is far more than they have ever done or are capable of, so keep your goals achievable and realistic. There is no point setting the targets too high, keep them small so you are more likely to succeed and it will be much easier, more positive and you can then look at your next step to take your fitness a further.

Lifestyle plays a huge role in what we can do and there are many barriers which may need to be looked at. Not just side effects but motivation, financial, time, lifestyle, risk and fear. Exercising with a friend can help and there are lots of way to exercise which are free, not just walking and cycling but some local borough councils have set up exercise groups that a friendly, convenient and free of charge. Local exercise classes are a great way of meeting new people and can provide the support you need and give you some confidence or if you prefer to exercise in your own environment, there are a number of workout DVDs and home exercise programmes available.

Cancer charities and some centres often run classes specifically for those on and off treatment.  This environment can feel safe and supportive for patients and far less daunting.

Exercise can be daunting and walking is a good way to start. You can tailor it specifically to your needs in time, intensity and when it is convenient for you. Pedometers are a great way to increase you daily activity and can be picked up cheaply, or there are numerous phone apps which can help. It doesn’t matter how many steps you do a day, whether it’s a few hundred or more, you can build on this.

Try and aim to be consistent with your efforts by doing something every day. When energy levels very low, perform some stretches or practice deep breathing techniques or balance movements.