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After treatment and remission

Getting active again

Getting active again after treatment rebuilds strength, energy and mood. This topic explains when and how to start, how much activity is recommended and how to stay safe.

Last updated: ~3 min read
A path of light towards a sunrise.
Figure 1.First steps back to activity.

01Short answer

During leukaemia treatment people often move very little because of tiredness, hospital stays and infection risk. This leads to loss of muscle and stamina. After treatment, physical activity is one of the best-proven ways to reduce fatigue (topic “Chronic fatigue”), strengthen muscles and bones, protect the heart, maintain weight and improve mood and sleep. The general rule: start slowly and build up gradually. In the first days, 5–10 minutes of walking may be enough (topic “Walking”). Then slowly increase the time and pace. The WHO and ACS recommend that adults do at least 150 minutes of moderate activity a week (such as brisk walking) and strength exercises twice a week (topic “Rebuilding strength”); children should average 60 minutes of active movement a day. This is the end goal — it is normal to reach it over weeks and months. Any activity is better than none. Balancing tiredness and rest matters (topic “Balancing fatigue and activity”). If you have heart, lung or bone problems, neuropathy or balance difficulties, a physiotherapist or rehabilitation specialist can help build a safe programme (topics “Rehabilitation” and “Physiotherapy”).

02Simple explanation

Activity reduces fatigue and improves strength and mood.

The rule: start slowly, build up gradually.

The goal: 150 minutes a week and 2 strength sessions.

Any activity is better than none.

If you have problems: a physiotherapist.

03Scientific explanation

Recommendations: the WHO recommends that adults do 150–300 minutes of moderate or 75–150 minutes of vigorous activity a week, plus strength exercises on at least 2 days; children and teenagers should average 60 minutes a day.

Survivors: the ACS recommends that survivors return to normal activity as soon as possible after treatment and avoid long periods of sitting.

Benefits: the ACS and WCRF note that physical activity reduces fatigue, anxiety and depression and improves quality of life and physical strength.

Safety: the COG recommends that survivors with heart, lung or bone late effects talk to their doctor before starting a new intensive sport.

04What happens in the body?

Why be active?

Activity strengthens muscles, bones and the heart, reduces fatigue, and improves sleep and mood.

Fibres of light growing brighter.
Figure 2.Muscles regain strength.

When can I start?

Often straight after treatment ends, with light activity. Ask your doctor about timing and any limits.

How do I start?

Begin with 5–10 minutes of walking a day. Add a few minutes each week. A pace at which you can talk but not sing is moderate intensity.

A ladder of light with low rungs.
Figure 3.Build activity step by step.

Strength and flexibility

Add gentle strength exercises twice a week (using your body weight or a resistance band) and stretching. A physiotherapist can teach good technique.

Children

Play, cycling, swimming and dancing — the best activity for a child is the one they enjoy. Agree the return to school sport with the doctor.

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.

05The path back to activity

Steps.

Ask — Ask your doctor what is safe.1AskAsk your doctor what is safe.
Start — With about 10 minutes.2StartWith about 10 minutes.
Strength — Gentle strength exercises.3StrengthGentle strength exercises.
Build up — Week by week.4Build upWeek by week.
ActivityDaily movement.
StrengthMuscles get stronger.
MoodMore energy and better mood.

06An example activity plan (simplified)

StageWhat to doHow much
StartLight walking5–10 minutes a day
Build upLonger walksA few minutes more each week
StrengthGentle strength exercisesTwice a week
GoalModerate activity150 minutes a week

* Make your own plan with your doctor or physiotherapist.

07Key terms

Moderate intensity
A pace at which you can talk but not sing.
Strength exercise
Movements that build muscle.
Stamina
The ability to keep moving for a long time.
Stretching
Gentle movements for flexibility.
Physiotherapist
A specialist in movement and strength.
Sedentary lifestyle
Sitting for long periods.

08Key points

  • Start slowly.
  • Build up gradually.
  • Add strength exercises.
  • Avoid long periods of sitting.
  • Stop if warning signs appear.
  • Make a plan with your doctor.

09Frequently asked questions

I feel tired — should I still be active?

Yes, gently; activity often reduces tiredness.

Can I go to the gym?

Often yes; ask your doctor about your immunity and any central line.

Can I swim?

If you have no central line and your doctor agrees, usually yes.

How fast should I reach the goal?

Do not rush; weeks and months is normal.

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. I feel tired — should I still be active?

  2. Can I go to the gym?

  3. Can I swim?

  4. How fast should I reach the goal?

  5. Does this information replace medical advice?

My questions

12Sources

  1. American Cancer Society. Nutrition and Physical Activity During and After Cancer Treatment
  2. World Health Organization. Physical activity
  3. NHS. Exercise
  4. World Cancer Research Fund. Cancer Prevention Recommendations
  5. Children's Oncology Group. Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent and Young Adult Cancers
  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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