Exercise After Cancer: What London Patients Need to Know

By Matt Butterworth, ESSA Accredited Exercise Physiologist | Vitruvian Exercise Physiology, London

TL;DR: Exercise is safe and beneficial for during and after cancer treatment, when properly supervised. Research demonstrates that structured physical activity can reduce cancer-related fatigue, improve quality of life, and may enhance treatment outcomesThe mechanisms include effects on systemic inflammation, immune function, metabolism, and hormone regulationA clinical exercise physiologist can assess your current capacity and guide engagement with physical activity that is appropriate to your individual situationVitruvian Exercise Physiology works with cancer patients across London - visit our cancer service page or contact us to find out more

One of the common things we hear from patients coming to us after a cancer diagnosis is some version of the same advice: “I was told to rest and take it easy.”

That advice is understandable. Cancer treatment is physiologically demanding. The body is under stress, and rest feels like the natural response. For short periods around surgery or intensive treatment, some degree of reduced activity may be appropriate.

But the evidence on exercise and cancer recovery in London and internationally has shifted substantially over the past decade. For many people, carefully structured physical activity during and after treatment is not just safe. It may be one of the most evidence-supported contributions to their recovery. The challenge is that patients frequently do not receive this information.

This article explains what the research shows, how exercise relates to common treatment side effects, and what a supervised clinical exercise physiology approach looks like for people affected by cancer.

Why is exercise relevant to cancer recovery?

Exercise is relevant to cancer recovery because of the range of physiological effects it produces, which directly address some of the most significant consequences of both the disease and its treatment.

Research demonstrates that exercise may offer anti-tumour effects, enhance the effectiveness of cancer treatments, and can help manage many of the side effects patients experience during and after chemotherapy, radiotherapy, and surgery. Regular physical activity is also associated with a reduced risk of developing certain cancers - including breast, colon, and prostate cancer - through effects on systemic inflammation, metabolism, immune function, and hormone balance.

These are not fringe observations. A 2024 perspective published in the British Journal of Cancer - the Physical Activity and Cancer Control (PACC) framework - documented substantial scientific progress across cancer control categories, from prevention through treatment coping to survivorship, and confirmed that evidence-based physical activity guidelines have been developed for the majority of these areas (British Journal of Cancer, 2024).

At Vitruvian EP, cancer care is one of our established clinical focus areas. We work with patients referred by oncologists, surgeons, GPs, and physiotherapists across West London. What we consistently find is that patients arrive with far less information about the role of exercise than the evidence would support.

What does exercise do for people with cancer?

Exercise produces measurable benefits in several areas that are particularly important for people affected by cancer.

Does exercise reduce cancer-related fatigue?

Cancer-related fatigue (CRF) is one of the most debilitating and commonly reported side effects of cancer treatment. Unlike ordinary tiredness, it does not reliably resolve with rest, which is one reason why rest-based management has limited effect over time.

The evidence suggests that structured exercise is among the most effective interventions for CRF. A 2023 meta-analysis published in BMC Nursing found significant reductions in fatigue scores across cancer types following exercise interventions (BMC Nursing, 2023). A separate systematic review and meta-analysis examining over 16,000 patients across diverse cancer diagnoses reported improvements in fatigue outcomes, with stronger effects observed in breast cancer patients (PMC, 2024).

That structured physical activity can reduce fatigue, rather than worsen it, is one of the most consistently counterintuitive findings in exercise oncology. It is also one of the most reliably replicated.

Citation note: A 2024 systematic review and meta-analysis (PMC11413772) examining over 16,000 cancer patients found a standardised mean difference of -0.33 for cancer-related fatigue in response to exercise, with breast cancer patients showing particularly strong effects. The review classified exercise therapy as safe and effective, with adverse events described as “extremely rare” in supervised settings.

Does exercise improve quality of life?

Yes. The same large-scale review reported meaningful improvements in health-related quality of life among breast cancer patients. Similar effects have been observed across other cancer types and treatment contexts.

Quality of life in the context of cancer encompasses physical functioning, psychological well-being, social participation, and daily independence. The evidence suggests exercise supports multiple domains simultaneously - not just physical capacity.

Can exercise affect cancer outcomes directly?

This is an area where the science is developing, and it is important to be precise about what the evidence does and does not show. What the research currently indicates:

• Regular physical activity is associated with a reduced risk of developing several cancers, including breast, colon, and prostate cancer, operating through effects on inflammation, metabolism, immune function, and hormone regulation

• Preclinical studies have consistently demonstrated anti-tumour effects of exercise across various cancer models, though evidence in humans is an active and evolving area of research

• A 2025 meta-analysis published in GeroScience reported that post-diagnosis physical activity was associated with significantly lower cancer-specific mortality across multiple cancer types, including breast cancer, prostate cancer, lung cancer, and colorectal cancer (GeroScience, 2025)

These findings do not mean that exercise is a cancer treatment. They suggest that physical activity has a broader relationship with cancer biology than was previously understood, and that this relationship warrants proper clinical consideration in cancer care.

How does cancer treatment affect the capacity to exercise?

Cancer treatment affects physical capacity in ways that vary considerably by diagnosis, treatment type, and individual response. This is why a standardised approach to exercise is not appropriate.

Chemotherapy is associated with fatigue, nausea, peripheral neuropathy (numbness or tingling in the hands and feet), and changes in cardiovascular function. Radiotherapy can cause localised tissue effects and fatigue. Surgery affects mobility and functional capacity, particularly in the early recovery period. Some hormone therapies are associated with changes in bone density and muscle mass over time.

Each of these factors affects what kind of physical activity is appropriate, at what intensity, and at which point in the treatment journey. A clinical exercise physiologist is trained to account for these variables and adapt exercise accordingly - not simply to provide a standard fitness programme.

The evidence on safety during active treatment is reassuring. A 2024 systematic review published in PMC found that structured exercise can be safely and effectively delivered during chemotherapy, with no exercise-related adverse events reported across the 19 included studies (PMC, 2024). Cancer Research UK also states that exercise is “safe, possible and helpful for many people with cancer or who have finished cancer treatment,” noting that individuals should discuss exercise with their clinical team (Cancer Research UK).

The key phrase in both sources is supervised. The safety profile of exercise in cancer care is associated with clinically informed programmes, not unsupervised gym attendance or generic fitness content.

Why does clinical supervision matter in exercise oncology?

Exercise for people affected by cancer requires clinical expertise. The physiological effects of cancer treatment are specific, variable, and sometimes unpredictable - and the appropriate exercise response needs to reflect that.

A clinical exercise physiologist can assess functional capacity, identify contraindications or precautions related to the specific treatment received, adapt intensity and exercise type in response to the patient's response, and monitor for signs that activity needs to be modified or paused.

Muscle loss is a particular concern for some patients - both as a consequence of cancer itself and as a side effect of prolonged treatment. This overlaps with sarcopenia, an area we address separately for patients where muscle preservation is a primary clinical focus.

What we aim to provide at Vitruvian Exercise Physiology is exercise support grounded in the clinical context of each individual patient, accounting for their diagnosis, treatment history, current symptoms, and personal goals. In practice, that typically means beginning conservatively and adjusting over time as capacity and confidence develop.

What does clinical exercise physiology for cancer look like?

Our cancer exercise service at Vitruvian EP works with patients across different stages - during active treatment, in the immediate post-treatment period, and in longer-term survivorship. The approach is adapted to each individual based on clinical assessment.

Referrals come from oncologists, GPs and physiotherapists. We also work with clients internationally. In our experience, exercise physiology for cancer remains underutilised across many primary care pathways.

If you would like to find out whether clinical exercise physiology may be appropriate for your situation, the starting point is to visit our cancer service page or contact us directly.

Frequently Asked Questions

Is it safe to exercise during chemotherapy?

Research indicates that exercise is generally safe during chemotherapy when properly supervised. A 2024 systematic review published in PMC found that structured exercise can be safely and effectively delivered during active chemotherapy, with no exercise-related adverse events reported across the 19 included studies. Safety depends on the specific treatment received, current health status, and how exercise is programmed. Discussing exercise with your oncology team and working with a qualified clinical exercise physiologist is the appropriate starting point.

What is cancer-related fatigue and does exercise help?

Cancer-related fatigue (CRF) is a persistent sense of physical and mental tiredness related to cancer or its treatment that does not reliably resolve with rest. Research from multiple systematic reviews and meta-analyses suggests that structured exercise is among the most effective interventions for CRF, with measurable reductions in fatigue scores observed across different cancer types and treatment stages, including during active treatment.

Does the type of cancer affect what exercise is appropriate?

Yes. The appropriate type, intensity, and timing of exercise depends on the specific diagnosis, the treatments received and their side effects, current physical capacity, and individual goals. For example, patients who have had treatment affecting cardiovascular function may require careful monitoring of exertion. Those with peripheral neuropathy may need adaptations to balance and coordination activities. A clinical exercise physiologist will account for all of these factors before designing any programme.

Can exercise reduce the risk of cancer coming back?

This is an active area of research and it is important not to overstate what is currently known. A 2025 meta-analysis in GeroScience reported that post-diagnosis physical activity was associated with significantly lower cancer-specific mortality across multiple cancer types, including breast, prostate, lung, and colorectal cancer. Associations have also been observed between regular physical activity and reduced risk of developing certain cancers. What these findings mean for individual patients depends on cancer type and a range of clinical factors - and is a question best discussed with an oncologist alongside a clinical exercise physiologist.

Key Takeaways

• Exercise is safe for most people during and after cancer treatment when appropriately supervised

• Research demonstrates that exercise can reduce cancer-related fatigue, improve quality of life, and may influence cancer outcomes

• Regular physical activity is associated with reduced risk of developing certain cancers, operating through effects on inflammation, metabolism, immune function, and hormone regulation

• The appropriate exercise response to cancer depends on the specific diagnosis, treatment history, and individual physical capacity

• Clinical exercise physiology offers a supervised, clinically-informed approach to exercise for people affected by cancer

• Vitruvian Exercise Physiology provides cancer exercise services in London - visit our cancer page or contact us

Matt Butterworth is an ESSA-accredited Accredited Exercise Physiologist and Director of Vitruvian Exercise Physiology in London. He holds RCCP registration and AHCS accreditation in the UK. Trained at Queensland University of Technology, Matt has worked with patients managing chronic conditions, musculoskeletal injuries, and age-related decline, as well as high-performance athletes, including Olympic swimmers and national-level cyclists.

References

1. Physical Activity and Cancer Control (PACC) Framework - British Journal of Cancer (2024): https://www.nature.com/articles/s41416-024-02748-x

2. Exercise Therapy in Oncology: Impact on Quality of Life and Side Effects - PMC (2024): https://pmc.ncbi.nlm.nih.gov/articles/PMC11413772/

3. Exercise During Chemotherapy for Cancer: A Systematic Review - PMC (2024): https://pmc.ncbi.nlm.nih.gov/articles/PMC11849706/

4. Exercise and Survival Benefit in Cancer Patients - GeroScience (2025): https://link.springer.com/article/10.1007/s11357-025-01647-0

5. Effects of Exercise Interventions on Cancer-Related Fatigue and Quality of Life - BMC Nursing (2023): https://link.springer.com/article/10.1186/s12912-023-01363-0

6. Exercise and Cancer - Cancer Research UK: https://www.cancerresearchuk.org/about-cancer/coping/physically/exercise-guidelines