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After treatment and remission

Physical strength

Leukaemia treatment reduces muscle strength: long bed rest, steroids and the illness itself all play a part. This topic explains why strength falls and how to rebuild it safely.

Last updated: ~2 min read
A clear hand gently gripping a glowing rope.
Figure 1.Everyday strength returns gradually.

01Short answer

After treatment many people feel weaker than before: climbing stairs, carrying a bag or getting up from a chair becomes harder. The reasons are long inactivity, the effect of steroids on muscle, poor appetite and weight loss, anaemia and the effect of some medicines on nerves. International exercise guidelines (ACSM 2019) recommend strength exercises twice a week after cancer, together with moderate aerobic activity. What matters most is starting light, increasing gradually and agreeing it with your doctor based on your blood counts. Strength usually improves over weeks and months.

02Simple explanation

Losing strength is expected.

The causes are inactivity, steroids and weight loss.

Strength exercises help.

Start light and build up gradually.

Agree the start with your doctor.

03Scientific explanation

Recommendation: under the ACSM 2019 consensus, strength training of the major muscle groups at least twice a week improves physical function after cancer.

Steroid myopathy: long-term corticosteroids can weaken especially the thigh and shoulder muscles; strength recovers gradually after they stop.

WHO: adults are advised 150–300 minutes of moderate activity a week plus 2 days of strength training; after treatment this target is reached gradually.

Safety: the ACS notes that low platelets, anaemia and infection risk affect the type and intensity of exercise.

04What happens in the body?

Why does strength fall?

A few weeks of bed rest noticeably reduce muscle mass. Steroids, weight loss and anaemia add to this.

How to check your strength

Simple questions: can I stand up from a chair without using my hands? Can I climb one flight of stairs without stopping? This shows your starting point.

A glowing staircase of low, even steps.
Figure 2.Stairs are a simple measure of strength.

Which exercises?

Body-weight exercises (sit-to-stand, wall push-ups), elastic bands and light weights. Each movement 8–12 times at a comfortable pace.

A gold elastic band stretched in an arc between two points.
Figure 3.Light resistance training builds muscle.

How often?

2–3 times a week with a rest day in between. Combining this with daily walking is helpful.

Specialist help

A physiotherapist or rehabilitation specialist can design a suitable programme, especially after a transplant or if you have neuropathy.

When to call your doctor

Worrying signs — fever, bleeding, new pain, breathlessness — should be reported to your doctor between visits too. Getting in touch early is always better than waiting.

05From weakness to strength

The steps of rebuilding strength.

Assess — Check strength with simple tasks.1AssessCheck strength with simple tasks.
Approval — Agree the start with your doctor.2ApprovalAgree the start with your doctor.
Start — Begin with light effort.3StartBegin with light effort.
Progress — Increase effort over weeks.4ProgressIncrease effort over weeks.
StrengthMuscles recover.
SafetyEffort matched to your counts.
IndependenceDaily tasks get easier.

06Example starter exercises (simplified)

ExerciseWhat forNote
Sit-to-standThigh musclesStart using your hands for support
Wall push-upArms, chestAgainst a wall, not the floor
Heel raiseCalves, balanceHold a chair
Elastic bandBack, shouldersLight resistance
WalkingStaminaSee “Muscles and stamina”

* Adapt the programme with your doctor or physiotherapist.

07Key terms

Strength exercise
Exercise that works muscles against resistance.
Steroid myopathy
Muscle weakness caused by steroids.
Physiotherapist
A specialist in movement and rehabilitation.
Repetition
One performance of a movement.
Neuropathy
Nerve damage causing numbness and weakness.
Rehabilitation
A programme to restore function.

08Key points

  • Losing strength is expected.
  • Strength exercises help.
  • Start light.
  • Build up gradually.
  • Consider your blood counts.
  • Ask a specialist for help.

09Frequently asked questions

When can I start?

Often soon after treatment, gently — with your doctor’s agreement.

What if it hurts?

Stop if pain is sharp or getting worse and tell your doctor; mild muscle soreness can be normal.

Can I go to a gym?

Once your immunity has recovered, with good hygiene; agree it with your doctor.

How long until strength returns?

Usually weeks to months; regularity matters most.

Does this information replace medical advice?

No. This is general education; only your treating doctor can assess your situation.

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 start?

  2. What if it hurts?

  3. Can I go to a gym?

  4. How long until strength returns?

  5. Does this information replace medical advice?

My questions

12Sources

  1. Medicine & Science in Sports & Exercise, 2019. Campbell KL et al. Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable
  2. American Cancer Society. Physical Activity and the Person with Cancer
  3. World Health Organization (WHO). Physical activity — fact sheet
  4. NHS. Strength exercises
  5. National Cancer Institute (NCI). Fatigue and Cancer Treatment
  6. National Cancer Institute (NCI). Follow-Up Medical Care
  7. National Cancer Institute (NCI). Cancer Survivorship
  8. Cancer.Net (ASCO). Follow-Up Care After Cancer Treatment
  9. Leukemia & Lymphoma Society (LLS). Long-Term and Late Effects of Treatment
  10. National Cancer Institute. Facing Forward: Life After Cancer Treatment
Medical disclaimerThis information is for educational purposes only and does not replace medical advice.
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