Moving More

Also known by these names

  • Exercise
  • Fitness
  • Movement
  • Physical Activity

Moving your body reduces the risk of cancer and in promotes health after a diagnosis, as noted by the American Cancer Society and several medical groups in their clinical practice guidelines.

Moving More as one of the 7 Healing Practices

Key Points

  • Movement can take many forms.
  • Finding an activity that is fun will increase both motivation and enjoyment.
  • At least 30 minutes of moderate physical activity every day lowers risks for endometrial, postmenopausal breast and colorectal cancers. More activity may be associated with even more benefits.
  • Vigorous exercise in short bursts several times a day is also beneficial.
  • BCCT is interested in moving more because it may reduce the level of physical function decline, increase survival, enhance tolerance to cancer treatments, and reduce sleep disruption and depression associated with cancer and treatments.
  • Moving more is generally beneficial, but some health conditions warrant caution.
  • Moving more is beneficial across all cancer types.
  • Practices to reduce risk of injury are advised.

Movement includes many activities, such as these:

  • Walking or hiking
  • Participation in active sports such as tennis, soccer or basketball
  • A workout at a gym
  • Recreational activities such as dancing, bicycling, swimming, skiing or martial arts
  • Group aerobic activities such as Zumba
  • Active gardening, yard work or housework
  • Movement therapies such as yoga, qigong and tai chi.

Finding an activity that is fun will increase both your motivation and your enjoyment.

Finding an activity that is fun will increase both your motivation and your enjoyment.1 Movement can also be combined with social activities, increasing the potential for fun and also strengthening your connections to family and friends.

Frequent movement can help counteract the health risks of prolonged sitting. The American Institute for Cancer Research encourages people to break up long periods of sitting with frequent activity breaks.2 A large analysis of data from the Cancer Prevention Study-II Nutrition Cohort found that, among low to moderately active adults, replacing sitting with light physical activity was associated with a reduction in cancer mortality, all-cause mortality and cardiovascular disease mortality.3

Anticancer Lifestyle Program

Using expert videos, animation, text and interactives, the Fitness Module of the Anticancer Lifestyle Program explains the connection between fitness and health, providing some tools you need to develop a regular fitness routine.

Anticancer Lifestyle Program link

This course is offered on a “pay-what-you-can” basis for 90-day access to all course modules.

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Movement and Cancer Treatment

American Cancer Society’s Nutrition and Physical Activity Guidelines for Cancer Survivors7

Achieve and maintain a healthy weight.

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Engage in regular physical activity.

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American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention8

Achieve and maintain a healthy weight throughout life.

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Be physically active.

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Cancer patients may need to adjust movement types and levels during or after treatments such as surgery, chemotherapy or radiation. Following your doctor’s advice is important, but even within restrictions most patients can increase their level of activity and receive benefit. The American Cancer Society’s (ACS) Nutrition and Physical Activity Guidelines for Cancer Survivors that “the goal should be to be active as much as possible.”

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Clinical Practice Guidelines

2009 evidence-based clinical practice guidelines for integrative oncology recommend referral to a qualified exercise specialist for guidelines on physical activity to promote basic health.”14

Clinicians should assess individual and community-level barriers to meeting the healthy lifestyle recommendations and support patients in developing strategies to overcome challenges.

The 2018 American Institute for Cancer Research guidelines for physical activity found strong evidence that being physically active decreases these risks:15

In addition, vigorous physical activity decreases the risk of both pre- and postmenopausal breast cancer.

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Treating the Cancer

At least a moderate-intensity activity such as brisk walking or climbing stairs is needed for benefit.

Working against cancer growth or spread, improving survival, or working with other treatments or therapies to improve their anticancer action

A 2017 review of evidence came to these conclusions:23

  • A growing evidence base indicate that physical activity has potential value at all stages of cancer care.
  • Preliminary evidence associates regular physical activity after a cancer diagnosis with longer survival and lower risk of recurrence or disease progression.
  • Preliminary evidence suggests that following an exercise program before treatment (prehabilitation) leads to increased cardiorespiratory fitness, fewer post-operative complications and shorter hospital admissions.

A 2018 review looked at data from more than 5800 patients with one of eight specific tumors: breast, colon, prostate, ovarian, bladder, endometrial, esophageal, and skin cancer (mostly melanoma). The results:24

In comparison to patients who were habitually inactive, habitually active patients experienced a 39% decreased hazard of all-cause mortality and a 36% decreased hazard of cancer-specific mortality. Previously inactive patients who began exercising after diagnosis experienced a 28% decreased hazard of all-cause and cancer-specific mortality in comparison to patients who remained inactive. Patients engaging in 3–4 sessions/week experienced the greatest survival advantages, but 1–2 sessions/week also yielded significant survival advantages in comparison to inactivity.

A large prospective cohort study found that maintaining higher leisure-time physical activity levels (at least two to seven hours per week) and increasing such activity in later adulthood were associated with comparable low risks of cancer mortality. The authors conclude that midlife is not too late to start physical activity.25

Improving Muscle Mass and Density

26 Muscle density improves when fat embedded in muscle fibers is reduced.27 Aerobic activity, such as moderate to vigorous walking, dancing, swimming or cycling, can improve muscle density.28

More muscle mass and greater muscle density are highly associated with improved survival in hospitalized patients with advanced cancer.29

Breast Cancer

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Colorectal Cancer

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Prostate Cancer

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Managing Side Effects and Promoting Wellness

Managing or relieving side effects or symptoms, reducing treatment toxicity, supporting quality of life or promoting general well-being

Physical activity interventions improve quality of life and other patient-reported outcomes during and after cancer therapy.

Reviews of research support the role of moving more in quality of life:

  • "Physical activity interventions improve quality of life and other patient-reported outcomes during and after cancer therapy."44
  • “Cancer survivors who exercise can potentially benefit from reduced levels of fatigue, and improved quality of life, physical function, and body composition.”45
  • A large prospective study of breast cancer patients enrolled in the Women's Health Initiative found that increasing levels of exercise before diagnosis was associated with a significant graded reduction in subsequent cardiovascular events in long-term survivors of primary breast cancer.46  
  • Greater muscle density is associated with lower patient symptoms (including anxiety and depression) and reduced health care use.47 49

Movement has also been shown to reduce these symptoms and side effects of cancer and treatment:

A 2010 review and meta-analysis found these effects of physical activity interventions with cancer survivors:54

  • A large effect on upper and lower body strength after treatment
  • Moderate effects on fatigue
  • A small to moderate positive effect for physical activity level, aerobic fitness, muscular strength, functional quality of life, anxiety and self-esteem
  • With few exceptions, exercise was well tolerated during and post treatment without adverse events.

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Reducing Risk

Reducing the risk of developing cancer or the risk of recurrence

ACS Recommendations

The American Cancer Society makes these recommendations to reduce cancer risk:62  

  1. Be physically active.
  2. Adults should engage in 150‐300 minutes of moderate‐intensity physical activity per week, or 75‐150 minutes of vigorous‐intensity physical activity, or an equivalent combination; achieving or exceeding the upper limit of 300 minutes is optimal. Children and adolescents should engage in at least 1 hour of moderate‐ or vigorous‐intensity activity each day.
  3. Limit sedentary behavior such as sitting, lying down, watching television and other forms of screen‐based entertainment.

A large 2019 analysis found that engaging in 7.5 to 15 MET-hours per week (see above) was associated with a lower risk of seven of the 15 cancer types studied, including colon (in men), breast, endometrial, kidney, myeloma, liver and non-Hodgkin lymphoma (in women).63 Other research has found that getting more than 30 minutes of moderate physical activity every day lowers risks for endometrial, postmenopausal breast and colorectal cancers. Vigorous physical activity is associated with reduced risk of premenopausal breast cancer..64 Greater cardiorespiratory fitness reduces risk of lung cancer in male former smokers and risk of cancer mortality in current smokers.65

Physical activity helps to lower cancer risk in several ways:

  • Regular activity helps keep hormone levels healthy and reduce the contribution of high hormone levels to cancer risk.
  • Being active may strengthen the immune system.
  • Activity helps speed potentially harmful substances through the intestinal tract.
  • Staying physically active can help manage body weight and the contribution of body fat to increased risk for many types of cancer.

Physical activity after a diagnosis of cancer is associated with a lower risk of cancer recurrence in survivors of several common cancers.

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Optimizing Your Terrain

Inactive women with newly diagnosed breast cancer were enrolled in an exercise intervention for about a month after diagnosis and until undergoing surgery. Compared to women participating in a mind-body intervention control group, those exercising demonstrated significant upregulation of 18 unique pathways, including several implicated in immunity and inflammation.70

A study with mice found that voluntary exercise accelerated muscle repair in old mice and improved old muscle stem cells function related to rejuvenation.71


What's the Difference between Exercise and Physical Activity?

According to Ted Schettler in The Ecology of Breast Cancer: "Exercise is a form of physical activity that is usually planned, structured, and done to improve some aspect of fitness such as strength, flexibility, or aerobic endurance. Exercise also improves general health, well-being, and overall quality of life. Physical activity includes activity that is part of daily life. Household, workplace, and lifestyle physical activity are most common."72

Both types of movement provide benefits.

Moving more is generally well tolerated by patients. However, some health conditions such as heart conditions or deep vein thrombosis may cause exercise to be a problem. Avoid exercise during bouts of vomiting, nausea and diarrhea. Patients may be advised not to exercise on days of chemotherapy treatments or for 24 hours afterward. All patients are encouraged to seek the advice of their healthcare provider before undertaking a new or increased exercise routine.73

Physical activity involves the risk of injury. Building strength and balance as exercise is gradually increased, paying attention to proper technique, and other precautions are recommended.74

A 2017 review of evidence noted a few cautions:75

  • Avoid high-intensity activities when immunosuppressed, or when experiencing pain, severe fatigue, or compromised bone health.
  • Avoid activities requiring balance when frail or experiencing dizziness or peripheral sensory neuropathy.
  • Anyone with a stoma should start with low resistance exercise and progress slowly to avoid herniation.

Integrative Programs, Protocols and Medical Systems

For more information about programs and protocols, see our Integrative Programs and Protocols page.

Highlighted Video

Brian Bouch discusses integrative oncology, part 1

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Non-cancer Uses of Moving More

Physical activity is used for these conditions and purposes:83

  • Obesity and overweight
  • Heart disease
  • Type 2 diabetes and metabolic syndrome
  • Mental health and mood improvement
  • Increase strength and prevent falls
  • Increased longevity and quality of life

See also:

BCCT has not reviewed the effectiveness of moving more for non-cancer uses.

Written by Nancy Hepp, MS, and Laura Pole, RN, MSN, OCNS; most recent update on September 14, 2020. Note: This summary draws from the American Institute for Cancer Research and other sources as noted. BCCT is grateful to Ted Schettler, MD, MPH, for his review and comments on this page.

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