Also known by these names
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.
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.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
Finding an activity that is fun will increase both your motivation and your enjoyment.
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."3
Both types of movement provide benefits.
Movement and Cancer Treatment
American Cancer Society’s Nutrition and Physical Activity Guidelines for Cancer Survivors
Achieve and maintain a healthy weight.
Engage in regular physical activity.
Achieve a dietary pattern that is high in vegetables, fruits, and whole grains.
ACS Guidelines on Nutrition and Physical Activity for Cancer Prevention
Achieve and maintain a healthy weight throughout life.
Be physically active.
Eat a healthy diet, with an emphasis on plant foods.
If you drink alcohol, limit your intake.
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.”
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.”10
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:14
- 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:15
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.16
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."30
- “Cancer survivors who exercise can potentially benefit from reduced levels of fatigue, and improved quality of life, physical function, and body composition.”31
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:36
- A large effect on upper and lower body strength post 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.
Clinical Practice Guidelines
Clinicians should assess individual and community-level barriers to meeting the healthy lifestyle recommendations and support patients in developing strategies to overcome challenges.
The 2017 National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology (NCCN Guidelines®) on Survivorship include these recommendations:41
- Develop a plan for regular physical activity and healthy nutrition as part of management and treatment of anxiety, depression and distress.
- Recommend routine physical activity as part of cancer-associated cognitive dysfunction interventions.
- Exercise/physical activity is one of the nonpharmacologic treatments recommended for vasomotor symptoms (such as hot flashes/night sweats) disruptive to quality of life and for pain/myalgias.
- Regular physical activity in the morning and/or afternoon (but not within three hours of bedtime) is recommended for sleep disorders.
- For general healthy lifestyles, engage daily in general physical activity to include exercise, daily routine activities, and recreational activities. Avoid sitting for long periods.
- Clinicians should assess individual and community-level barriers to meeting the healthy lifestyle recommendations and support patients in developing strategies to overcome challenges.
- A risk assessment for physical activity-induced adverse events is recommended.
- Resistance training of all major muscle groups is recommended for 20 minutes two or three times a week each session.
Reducing the risk of developing cancer or the risk of recurrence
Research has found that getting at least 30 minutes of moderate physical activity every day lowers risks for endometrial, postmenopausal breast and colorectal cancers.
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.
Clinical Practice Guidelines
The 2018 American Institute for Cancer Research guidelines for physical activity found strong evidence that being physically active decreases these risks:46
- Colon cancer
- Breast cancer (postmenopause)
- Endometrial cancer
In addition, vigorous physical activity decreases the risk of both pre- and postmenopausal breast cancer.
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.47
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.48
A 2017 review of evidence noted a few cautions:49
- 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.|
- Programs and protocols
- Alschuler & Gazella complementary approaches:50
- Breast cancer
- Cancer prevention
- Cancer treatment
- Colon cancer
- Hormone balance
- Immune system function
- Leukemia, lymphoma and myeloma
- Lowering risk of cancer recurrence/secondary cancers
- Ovarian cancer
- Prostate cancer
- Reversing insulin resistance
- Testicular cancer
- Treatment recovery and survivorship
- Block program51
- Cohen & Jefferies Mix of Six anticancer practices52 Anticancer Living. New York: Viking. 2018.
- Geffen Seven Levels of Healing53
- Lemole, Mehta & McKee top 5 lifestyle interventions for all their protocols54
- McKinney protocols55
- Ornish Lifestyle Medicine for Prostate Cancer
- Traditional systems
Non-cancer Uses of Moving More
Physical activity is used for these conditions and purposes:56
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 April 8, 2019. Note: BCCT has not conducted an independent review of research of moving more. 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.
Brian Bouch discusses integrative oncology, part 1
- American Institute for Cancer Research:
- Stevinson C, Campbell A, Cavill N, Foster J. Physical activity and cancer: a concise evidence review. Macmillan Cancer Support. 2017.
- Meneses-Echávez JF, González-Jiménez E, Ramírez-Vélez R. Effects of supervised exercise on cancer-related fatigue in breast cancer survivors: a systematic review and meta-analysis. BMC Cancer. 2015 Feb 21;15:77.
- Harvard Women's Health Watch: 10 tips to prevent injuries when you exercise
- Alschuler LN, Gazella KA. The Definitive Guide to Thriving after Cancer. Berkeley, California: Ten Speed Press. 2013.
- Moss Reports (purchase required): Select from the list of cancers down the left side of the page for a report describing uses of conventional, complementary, alternative and integrative therapies related to that cancer. Ralph Moss is among the most knowledgeable and balanced researchers of integrative cancer therapies. The cost of his Moss Reports is not negligible, but many patients find them of considerable value. Moss is also available for consultations.
- Ornish Lifestyle Medicine for prostate cancer
- National Comprehensive Cancer Network Professional Guidelines on Survivorship, including Exercise (subscription required)
- National Comprehensive Cancer Network, Patient and Caregiver Resources:
- Finding fitness programs tailored to people with cancer:
- Livestrong at the YMCA
- Livestrong Ask the Expert: Cancer and Exercise
- Livestrong: Exercise and Workouts
- Incorporating non-exercise movement into daily life:
- American Heart Association: No Time for Exercise? Here Are 7 Easy Ways to Move More!
- Nutritious Movement: A Day in a Movement-Rich Life
- Reader's Digest: Rise Up Against Sitting Disease
- Mark's Daily Apple: 13 Ways to Move More Throughout the Day (Even While at Work)
- The New School at Commonweal: Ted Schettler: The Ecology of Breast Cancer
- Morgan Freeman and Lori McCreary: The C-Word
- Lorenzo Cohen and Alison Jefferies: Anticancer Living: Transform Your Life and Health with the Mix of Six
- Gary Deng, MD, PhD: Complementary Therapies for Pain Management
- Jeremy R. Geffen, MD, FACP: The Seven Levels of Healing®: Celebrating Life and Spirit on the Journey through Cancer
- Michael Lerner: Choices In Healing: Integrating the Best of Conventional and Complementary Approaches to Cancer
- Keith I. Block, MD: Life over Cancer: The Block Center Program for Integrative Cancer Treatment
- Lise Alschuler, ND, FABNO, and Karolyn Gazella: The Definitive Guide to Cancer, 3rd Edition
- Donna Wilson: Exercise and Recovery
- World Cancer Research Fund and the American Institute for Cancer Research: Food, Nutrition, Physical Activity and the Prevention of Cancer: a Global Perspective
- American Academy of Anti-Aging Medicine and Metabolic Medical Institute: Integrative Cancer Therapy Fellowship Modules
- Glenn Sabin with Dawn Lemanne, MD, MPH: N of 1
- National Cancer Institute: Office of Cancer Complementary and Alternative Medicine
- Ting Bao, MD: The Role of Integrative Therapy in Cancer Care
- American Institute for Cancer Research: Cancer Health Check
- Ted Schettler, MD, MPH: The Ecology of Breast Cancer: The Promise of Prevention and the Hope for Healing
- Donald I. Abrams, MD, and Andrew T. Weil, MD: Integrative Oncology, 2nd Edition
- Gerald Lemole, MD; Pallav Mehta, MD; and Dwight McKee, MD: After Cancer Care: The Definitive Self-Care Guide to Getting and Staying Well for Patients with Cancer
- EmpowHER: Keith Block: My Activity
- The New School at Commonweal: Dwight McKee, MD: 40 Years Practicing Integrative Cancer Medicine, Part 1
- The New School at Commonweal: Dwight McKee, MD: 40 Years Practicing Integrative Cancer Medicine, Part 2
- Wayne Jonas, MD: Your Healing Journey: A Patient’s Guide to Integrative Breast Cancer Care
- Karen Basen-Engquist and others: Moving Research Into Practice: Physical Activity, Nutrition, and Weight Management for Cancer Patients and Survivors
- September 2018 Issue of the Journal of Alternative and Complementary Medicine
- Dwight McKee, MD, editor: Clinical Pearls
- US Department of Health and Human Services: Physical Activity Guidelines for Americans
- Lise Alschuler and Karolyn A. Gazella: iThrive Plan