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After treatment and remission

Returning to movement after treatment: strength, stamina, balance

When active treatment ends, many people feel that their body is not what it was: muscles have weakened, stairs feel hard and tiredness comes quickly. This is normal and often improves gradually. This topic explains simple principles for safely rebuilding strength, stamina and balance.

Last updated: ~4 min read
On a dark navy background, light dumbbells and a softly glowing resistance band on the floor in warm golden light.
Figure 1.Light dumbbells and a resistance band are simple tools for strength exercise.

01Short answer

Returning to movement after treatment should be gradual. According to international guidance, a useful direction is about 30 minutes of moderate aerobic activity (such as brisk walking) three times a week and strength exercises for the main muscle groups twice a week, plus balance and flexibility. But everyone’s starting point is different: talk to your team first, especially after anthracyclines, radiotherapy, a transplant, steroids or if you have neuropathy. A physiotherapist can design an individual programme. New joint pain, chest pain or unusual breathlessness is a reason to tell your doctor.

02Simple explanation

After long treatment, muscle mass and stamina decline. This is not laziness — it is the result of the illness, the medicines and long bed rest.

Steroids (such as dexamethasone or prednisolone) can weaken muscles, especially around the hips and thighs, and make bones more fragile.

Neuropathy — numbness and tingling in the feet — affects balance. Balance exercises can help reduce the risk of falls.

Strength exercise does not have to mean heavy barbells: standing up from a chair, wall push-ups, light dumbbells and resistance bands all count.

Recovery is gradual. Small, regular steps are safer and more effective than sudden big efforts.

03Scientific explanation

ACSM 2019: for cancer survivors, 30 minutes of moderate aerobic activity three times a week plus strength training twice a week is considered beneficial for fatigue, anxiety, depression, physical function and quality of life.

WHO: adults are advised to do 150–300 minutes of moderate aerobic activity a week and muscle strengthening on at least two days; balance exercises are added for older adults.

Blood cancers: a Cochrane review (2019) shows that aerobic exercise may slightly reduce fatigue and improve quality of life; the evidence is still incomplete.

Follow-up: the NCI considers monitoring for late effects (heart, bones, lungs) an important part of follow-up care; this can also shape an exercise plan.

04What happens in the body?

Before you start

Talk to your team: the treatment you received (anthracyclines, radiotherapy, a transplant, steroids) determines whether you need heart, bone or lung checks. Also ask whether your line has been removed and whether your blood counts are stable. Ask for a referral to a physiotherapist or rehabilitation specialist.

Stamina: aerobic activity

Walking, an exercise bike, swimming (once your team allows it). Start with 10–15 minutes at a pace where you can talk, and build up to 30 minutes over several weeks. Three times a week is a good start.

On a dark navy background, a softly glowing stationary exercise bike in a calm room with a water bottle and towel beside it.
Figure 3.An exercise bike helps rebuild stamina gradually with little strain on the joints.

Strength: muscle exercises

Twice a week, on non-consecutive days. Standing up from a chair and sitting down, wall push-ups, heel raises on a step, light dumbbells or a resistance band. Do each movement slowly, without holding your breath, 8–12 times. You should feel mild tiredness, not pain.

Balance and flexibility

Standing on one leg while holding the back of a chair, heel-to-toe walking along a line, gentle stretches. If you have neuropathy, always do these near support. Tai chi and gentle yoga can also help balance.

On a dark navy background, the soft silhouette of a person seen from behind standing on one leg while lightly holding the back of a chair.
Figure 2.Balance practice beside a chair keeps support within reach.

Managing fatigue

Spread your energy across the day: put exercise at the time you feel strongest, and do not pile heavy tasks into one day. On good days, do not overdo it — you may “pay for it” the next day. If fatigue gets in the way of life, tell your team: anaemia, thyroid problems and sleep can be checked.

Returning to sport and work

Talk to your doctor before returning to contact sports such as football or martial arts. At the gym, wipe equipment down and choose quiet times. If your work is physical, discuss a gradual return plan with your doctor and employer.

05Returning to movement in four steps

Check, stamina, strength, balance.

Ask your team — Heart, bone and lung checks.1Ask your teamHeart, bone and lung checks.
Stamina — Walking three times a week.2StaminaWalking three times a week.
Strength — Muscle exercises twice a week.3StrengthMuscle exercises twice a week.
Balance — Near support, a little every day.4BalanceNear support, a little every day.
Stronger musclesStairs and daily tasks may get easier.
Less fatigueMood and sleep may improve.
Fewer fallsBalance improves.

06A weekly direction (simplified)

Type of activityHow muchExample
Aerobic3 times a week, up to 30 minutesBrisk walking, exercise bike
Strength2 times a week, not on consecutive daysChair stands, resistance band
BalanceA few minutes every dayStanding on one leg with support
FlexibilityAfter exerciseGentle stretching
Sitting timeAs little as possibleGet up and walk every hour
Contact sportWith your doctor’s approvalFootball, martial arts

* This is a long-term direction, not a starting target. Begin at your own level and agree it with your team.

07Key terms

Aerobic activity
Sustained movement that works the heart and lungs.
Strength exercise
Exercise in which muscles work against resistance.
Resistance band
An elastic band for strength exercises.
Steroid myopathy
Muscle weakness caused by steroids.
Avascular necrosis
Loss of blood supply to bone; causes joint pain.
Neuropathy
Numbness in hands and feet; affects balance.
Anthracyclines
Chemotherapy drugs that can affect the heart.
Rehabilitation
Planned help to restore function.

08Key points

  • Recovery is gradual — that is normal.
  • Talk to your team before you start.
  • Aerobic activity three times a week.
  • Strength exercises twice a week.
  • Do balance exercises near support.
  • Spread your energy across the day.
  • Tell your doctor about new joint pain.
  • A physiotherapist can design an individual programme.

09Frequently asked questions

When can I go back to the gym?

When your blood counts are stable, your line has been removed and your team agrees. Choose quiet times, wipe equipment down and start with light weights.

Will I get back to my old level?

Many people recover a great deal, but the timeline is individual — months, sometimes longer. Compare yourself not with your former self but with last month.

My hip hurts. Should I keep exercising?

In people who have had steroids, new persistent hip or knee pain can be a sign of avascular necrosis. Stop exercising and tell your doctor.

Can I lift heavy weights?

Gradually, with good technique and your team’s agreement. Low bone density or heart problems need a special plan.

My child wants to return to sport after leukaemia. What should we do?

Children returning to activity is usually encouraged. Ask the oncologist for written advice about contact sports and school PE.

Does movement prevent relapse?

It has not been proven that physical activity prevents leukaemia from coming back. But it helps strength, heart health, mood and everyday life.

10Questions for your doctor

Take these questions to your appointment. The ones you save are collected on the “My questions” page and stay on this device only.

  1. When can I go back to the gym?

  2. Will I get back to my old level?

  3. My hip hurts. Should I keep exercising?

  4. Can I lift heavy weights?

  5. My child wants to return to sport after leukaemia. What should we do?

  6. Does movement prevent relapse?

My questions

12Sources

  1. Medicine & Science in Sports & Exercise, 2019. Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable
  2. Journal of Clinical Oncology, 2022. Exercise, Diet, and Weight Management During Cancer Treatment: ASCO Guideline
  3. Cochrane Database of Systematic Reviews, 2019. Aerobic physical exercise for adult patients with haematological malignancies
  4. World Health Organization (WHO). WHO guidelines on physical activity and sedentary behaviour
  5. Cancer Research UK. Exercise guidelines for people with cancer
  6. American Cancer Society. Physical Activity and the Person with Cancer
  7. NHS. Strength exercises
  8. NHS. Balance exercises
  9. NHS. Physical activity guidelines for adults aged 19 to 64
  10. NHS. Physiotherapy
  11. National Cancer Institute (NCI). Follow-Up Medical Care
  12. National Cancer Institute (NCI). Fatigue and Cancer Treatment
Medical disclaimerThis information is for educational purposes only and does not replace medical advice.
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