Exercise During and After Chemotherapy or Targeted Therapies

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Chemotherapy treatment uses medicine to weaken and destroy cancer cells in the body. Because chemotherapy medicines target rapidly dividing cells, they can affect other healthy cells that divide quickly, including cells in hair follicles, nails, the mouth, digestive tract, and bone marrow (bone marrow makes red blood cells).

Targeted therapies target specific characteristics of cancer cells, such as a protein that allows the cancer cells to grow or divide rapidly. Targeted therapies are generally less likely than chemotherapy medicines to harm healthy cells.

When can you exercise?

During: Yes, but with some cautions:

  • If you’re experiencing extreme fatigue, anemia (low red blood cell count), or a lack of muscle coordination (ataxia), don’t exercise.
  • If your immune system is compromised and your white blood cell count is low (lower than 3,500 white blood cells per microliter of blood), avoid public gyms, yoga studios, and other public places until your white blood cell count is at a safe level.
  • If you have neuropathy (pain or numbness from peripheral nerve damage) or tingling in your hands or feet from chemotherapy, make sure you take care to reduce your risk of falling or injuring yourself. You may want to have a spotter with you when you exercise.
  • If you’re getting chemotherapy to treat breast cancer that has spread to the bone, you may have a higher risk of breaking a bone. You may have to lower the intensity and duration of your workout. Talk to your doctor about the exercises you plan to do. You also may want to talk to a physical therapist or a certified trainer who has experience working with breast cancer survivors.
  • If you’re on a chemotherapy or targeted therapy that may cause heart damage, make sure you ask your doctor or your cardiologist what type of exercise modifications, if any, are right for you. It’s a good idea also to ask what the intensity level should be for your workouts. You may have to stick with a low intensity.
  • If Adriamycin (chemical name: doxorubicin) is part of your chemotherapy regimen, you shouldn’t exercise on the day you get chemotherapy and do only very low intensity exercise (your heart rate is no greater than 15 to 20 beats above your resting heart rate) for 24 to 48 hours after you get chemotherapy. This is because Adriamycin can make your heart beat irregularly for about 24 hours after you receive it.

Make sure you have your doctor’s OK to start. Explain the exercises you plan to do and ask about any possible limitations. It’s also a good idea to visit a physical therapist trained in lymphedema diagnosis and management for a structural evaluation before you start exercising (if you didn’t do this after surgery). Besides looking for lymphedema, a physical therapist can check for any other issues unrelated to breast cancer that may limit your ability to exercise. Learn how to find a lymphedema therapist.

If you were a regular exerciser before treatment, you probably won’t be able to work out at your usual intensity level, but that’s OK. You need to make sure your body stays strong during treatment. Walking is a great way to start -– it’s an easy cardio exercise that gets your body moving.

Some research suggests that some women getting chemotherapy may be more likely to fall than other women their age. Take precautions to make sure you don’t hurt yourself, such as wearing sturdy athletic shoes and working out on a cushioned mat. Exercise can help improve your balance by strengthening your muscles.

If you have any shortness of breath, pain, or tightness in your chest, stop exercising immediately. Tell your doctor what happened and work with him or her to develop a plan of movements that are right for you.

Exercising during chemotherapy can help ease side effects, such as fatigue and nausea, and can help boost your immune system. Chemotherapy side effects can sometimes make exercising tough, but try to be as active as you’re able to be. Again, walking is a good way to start.

After: Yes. Make sure you have your doctor’s OK to start. Explain the exercises you plan to do and ask about any possible limitations. Some of chemotherapy’s side effects can linger after treatment ends. So as with exercising during chemotherapy, keep these precautions in mind:

  • If you’re extremely tired, have anemia (low red blood cell count), or lack muscle coordination (ataxia), don’t exercise.
  • If you have a low white blood cell count (lower than 3,500 white blood cells per microliter of blood), don’t go to public gyms, yoga studios, and other places with a lot of people until your white blood cell count is at a safe level.
  • If you have neuropathy in your hands or feet (pain or numbness from peripheral nerve damage) from chemotherapy, make sure you’re careful to lower your risk of falling or injuring yourself. You may want to have someone exercise with you just to be safe.
  • You may have to exercise at a lower intensity or for a shorter time if your risk of breaking a bone is higher than average. Ask your doctor about the exercises you want to do. A physical therapist or a certified trainer who has experience working with breast cancer survivors also may have suggestions.
  • If you were on a chemotherapy or targeted therapy that may cause heart damage, make sure you ask your doctor or your cardiologist how long any side effects may last and what type of exercise modifications, if any, are right for you. It’s a good idea also to ask your doctor about a good intensity level for your workouts and when you can increase it.

Other Precautions: If you have any shortness of breath, pain, or tightness in your chest, stop exercising immediately. Tell your doctor what happened and work with him or her to develop a plan of movements that are right for you.

If you have any changes in your arm, hand, trunk, breast, or shoulder, including swelling, stop doing upper body exercises and see your doctor or lymphedema specialist. If you’ve been diagnosed with lymphedema after breast cancer treatment, there are precautions you should take before you exercise. These precautions include wearing a well-fitted compression garment or possibly wearing protective gloves. Learn more about exercise and lymphedema in the Lymphedema section.

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