Cancer Rehabilitation

Support for strength, movement and everyday recovery

Cancer and cancer treatment can affect the body in many different ways. Surgery, chemotherapy, radiotherapy and periods of reduced activity may contribute to fatigue, weakness, stiffness, reduced mobility and loss of physical confidence.

Cancer rehabilitation focuses on helping you maintain or rebuild physical ability during and after treatment. The programme is adapted to your diagnosis, treatment, symptoms and current level of activity.

The aim is to help you remain as active and independent as possible while working within the guidance of your oncology and medical team.

What is cancer rehabilitation?

Cancer rehabilitation uses physiotherapy and appropriate exercise to address physical difficulties associated with cancer and its treatment.

Rehabilitation may take place:

• Before treatment
• During treatment
• After surgery
• During chemotherapy or radiotherapy
• After treatment has finished
• During longer-term recovery
• When living with ongoing or advanced cancer

The approach will be different for every person.

Some people may mainly need help rebuilding strength after surgery, while others may be managing fatigue, reduced mobility or difficulty returning to normal exercise.

When cancer rehabilitation may help

An assessment may be useful if you are experiencing:

• Reduced strength
• Cancer-related fatigue
• Reduced physical fitness
• Difficulty walking
• Reduced balance
• Joint or muscle stiffness
• Reduced movement after surgery
• Difficulty using an arm or leg normally
• Weakness after hospital admission
• Difficulty returning to exercise
• Reduced confidence with physical activity
• Difficulty managing stairs
• Reduced independence with everyday activities
• Physical changes following chemotherapy or radiotherapy
• Difficulty returning to work
• Ongoing physical limitations after treatment

Rehabilitation can also help people who want guidance on maintaining physical activity while going through treatment.

What happens during your first appointment?

Your first appointment begins with a discussion about your cancer treatment, current health and the physical difficulties you are experiencing.

The physiotherapist may ask about:

• Your diagnosis
• Current or previous cancer treatment
• Surgery
• Chemotherapy or radiotherapy
• Current medication
• Fatigue
• Pain
• Walking and mobility
• Strength
• Balance
• Current physical activity
• Other health conditions
• Activities you currently find difficult
• Work and home responsibilities
• What you would like to return to doing

The physical assessment may include:

• Walking
• Strength
• Joint movement
• Balance
• General mobility
• Getting up from a chair
• Stairs
• Physical endurance
• Movements affected by surgery or treatment

The assessment helps establish a safe and realistic starting point for rehabilitation.

What rehabilitation may include

Treatment depends on your current symptoms, treatment stage and physical ability.

Strengthening exercises

Cancer treatment and periods of reduced activity can lead to muscle weakness.

Exercises may focus on:

• Legs and hips
• Arms and shoulders
• Trunk and core muscles
• General whole-body strength

The starting level can be adjusted according to your current energy and physical ability.

Strength can then be built gradually as treatment and recovery allow.

Walking and cardiovascular activity

Walking can be a practical way to maintain or rebuild fitness.

You may begin with short periods of activity before gradually increasing:

• Walking duration
• Distance
• Pace
• Frequency

Other cardiovascular activities may also be introduced where appropriate.

Movement and mobility

Surgery, radiotherapy or long periods of reduced movement can sometimes lead to stiffness.

Exercises may be used to maintain or improve movement in affected areas.

The programme will take account of any surgical restrictions and the tissues involved in treatment.

Balance exercises

Reduced strength, fatigue or some treatments can affect balance.

Rehabilitation may include:

• Standing balance
• Stepping
• Turning
• Walking around obstacles
• Lower-limb strengthening

The exercises can be adapted according to your falls risk and current ability.

Home exercise programme

You may receive a manageable programme to complete between appointments.

The amount of exercise can be adjusted according to treatment, fatigue and how your body responds.

Cancer-related fatigue

Fatigue associated with cancer can feel very different from ordinary tiredness.

It may affect both physical and mental energy and may not completely improve after sleeping or resting.

Fatigue can make it difficult to:

• Exercise
• Work
• Walk longer distances
• Complete household tasks
• Socialise
• Maintain a normal daily routine

It can be tempting to respond by resting for longer periods.

However, too much inactivity can contribute to further loss of strength and fitness.

Rehabilitation aims to find a manageable balance between activity and recovery.

Building activity gradually

If your activity has reduced significantly during treatment, returning immediately to your previous routine may be too demanding.

Rehabilitation may begin with a level of movement you can manage consistently.

Progress might involve gradually increasing:

• Walking
• Exercise duration
• Number of repetitions
• Resistance
• Household activity
• Time spent standing
• General daily movement

The programme can be adjusted around treatment cycles and changes in energy.

Exercise during cancer treatment

Physical activity may still be possible during cancer treatment, although the appropriate amount can change from one person to another.

Some days may feel relatively normal, while others may involve much greater fatigue or treatment-related symptoms.

Your exercise programme may therefore include different levels of activity.

For example:

• A normal programme for better days
• A shorter programme when energy is reduced
• Gentle movement during more difficult periods

The aim is to remain appropriately active without feeling that every session needs to be completed at the same intensity.

Rehabilitation after cancer surgery

Surgery can temporarily affect strength, movement and general mobility.

The type of rehabilitation required depends on the operation.

Early rehabilitation may focus on:

• Getting out of bed
• Walking
• Breathing and movement
• Maintaining circulation
• Restoring basic mobility
• Becoming independent with everyday movement

As healing progresses, treatment may become more focused on strength, joint movement and returning to normal activity.

All rehabilitation should follow the restrictions and guidance provided by the surgical team.

Movement after breast cancer surgery

Breast and chest surgery may temporarily affect shoulder and arm movement.

You may notice:

• Shoulder stiffness
• Difficulty reaching overhead
• Tightness around the chest
• Reduced arm movement
• Weakness
• Difficulty dressing or completing household activities

Rehabilitation may include gradual shoulder and arm exercises, posture and strengthening as healing progresses.

The programme should reflect the type of surgery and any ongoing treatment.

Rehabilitation after abdominal or pelvic surgery

Abdominal or pelvic surgery can temporarily affect mobility, trunk strength and confidence with activities such as lifting and bending.

Early rehabilitation may focus on:

• Walking
• Getting in and out of bed
• Standing from a chair
• General mobility
• Gradually increasing activity

As recovery progresses, exercises may include strengthening and controlled return to lifting, work or exercise where medically appropriate.

Rehabilitation after bone or soft-tissue cancer treatment

Treatment involving bones, joints or soft tissues can have a significant effect on movement and strength.

Depending on the area treated, rehabilitation may focus on:

• Joint movement
• Muscle strength
• Walking
• Balance
• Use of walking aids
• Upper-limb function
• Returning to normal activities

Where surgery has affected bone or soft tissue, specific restrictions around weight-bearing or exercise may need to be followed.

Weakness after hospital admission

A hospital stay can result in a noticeable loss of physical strength, particularly when someone has spent longer periods in bed.

After discharge, you may find that:

• Walking feels harder
• Stairs are more tiring
• Standing from a chair requires more effort
• You need more frequent rest
• Normal household activities feel physically demanding

Rehabilitation can begin with basic strength and mobility before gradually building towards your previous level of activity.

Managing reduced physical fitness

Cancer treatment can interrupt exercise for weeks or months.

Even if you were physically active before treatment, your previous exercise level may not initially feel manageable.

This does not mean you cannot return to it.

Your programme may progress from:

• Gentle movement
• Short walks
• Basic strengthening
• Longer cardiovascular activity
• More demanding strength work
• Normal recreational exercise

Progress should reflect your current ability rather than where you were before treatment.

Pacing your activities

Some people experience a pattern of doing much more when they have energy and then needing a long recovery period afterwards.

Pacing can help make activity more consistent.

This might involve:

• Breaking larger tasks into smaller sections
• Alternating physically demanding and easier activities
• Planning more demanding tasks for times when energy is usually better
• Taking short planned breaks
• Increasing activity gradually

The aim is not to rest more and more. It is to use available energy in a way that allows you to remain active.

Better and more difficult days

Symptoms during cancer treatment can change from day to day.

It may be useful to have different versions of your exercise programme depending on how you feel.

On a more difficult day, rehabilitation might involve:

• A shorter walk
• Reduced resistance
• Fewer exercises
• Gentle mobility
• Additional recovery

When energy improves, you can return towards your usual programme.

Having some flexibility can make activity easier to maintain over time.

Balance and falls

Weakness, fatigue, reduced activity or certain treatment effects can make some people feel less steady.

You may notice difficulty:

• Walking outdoors
• Using stairs
• Turning
• Walking when tired
• Moving over uneven surfaces

An assessment can identify whether balance, strength or another physical factor is contributing.

Treatment may include strengthening, balance exercises and walking practice.

A walking aid may also be considered where appropriate.

Managing pain during rehabilitation

Pain can affect how comfortable you feel moving or exercising.

The approach depends on the reason for the pain and the area affected.

Physiotherapy may involve modifying:

• Exercise intensity
• Range of movement
• Walking distance
• Resistance
• Positioning
• Everyday activity

New, unexplained or significantly changing pain should be discussed with your oncology or medical team rather than automatically treated as a normal exercise response.

Returning to everyday activities

Cancer rehabilitation is not only about formal exercise.

The goal may simply be to regain enough physical ability for normal life.

This may include:

• Walking around the home
• Shopping
• Cooking
• Using stairs
• Driving
• Household activities
• Caring for children
• Gardening
• Going out socially
• Travelling
• Returning to hobbies

The rehabilitation programme can gradually become more specific to the activities that matter to you.

Returning to work

Returning to work after cancer treatment can involve both physical and mental adjustment.

Physical difficulties may include:

• Fatigue
• Reduced strength
• Walking
• Prolonged standing
• Sitting for longer periods
• Lifting
• Travelling to work

Rehabilitation may help build physical capacity for these demands.

A gradual return or temporary changes to working hours or duties may also be useful depending on your role and recovery.

Returning to exercise

If you exercised before your diagnosis, you may want to return to activities such as:

• Walking
• Running
• Cycling
• Swimming
• Gym training
• Yoga or Pilates
• Exercise classes
• Recreational sport

Returning can usually be gradual.

You may initially need to reduce exercise duration, resistance or intensity before building towards your previous routine.

The appropriate progression depends on treatment, symptoms and general health.

Returning to the gym

Strength training can form part of rehabilitation for some people during or after cancer treatment.

A gym programme may begin with:

• Light resistance
• Controlled movements
• Fewer exercises
• Longer recovery between sets

As strength and energy improve, resistance and exercise volume can gradually increase.

The goal is not to immediately return to the weights used before treatment.

Consistency and gradual progression are more important during recovery.

Maintaining independence

For some people, the main goal of cancer rehabilitation is maintaining independence rather than returning to high-level exercise.

Treatment may focus on:

• Walking safely
• Standing from a chair
• Getting in and out of bed
• Using stairs
• Managing personal care
• Moving around the home
• Maintaining enough strength for daily activities

These goals can be particularly important when treatment is ongoing or when someone is living with advanced cancer.

Living with ongoing cancer

Rehabilitation can also be useful when cancer is being managed as a long-term or advanced condition.

The goal may be to maintain:

• Mobility
• Strength
• Independence
• Comfort with movement
• Ability to participate in daily life

The programme can change according to symptoms, treatment and energy.

In these situations, rehabilitation does not need to be about continually increasing exercise.

Maintaining a useful level of physical ability can itself be an important goal.

Working with your oncology team

Cancer rehabilitation should take place alongside your wider medical care.

Depending on your needs, this may involve:

• Oncologists
• Surgeons
• Physiotherapists
• Occupational therapists
• Specialist nurses
• Dietitians
• GPs
• Psychologists or counselling services
• Other relevant healthcare professionals

Physiotherapy mainly focuses on movement, exercise and physical function.

Other professionals may provide support with nutrition, fatigue, daily activities, emotional wellbeing and other treatment-related needs.

Exercise may need to change during treatment

There may be times when exercise needs to be reduced, paused or reviewed.

Factors may include:

• Recent surgery
• Infection
• Significant treatment-related illness
• Changes in blood counts
• Significant dizziness
• New balance problems
• Bone involvement
• Cardiovascular complications
• Severe fatigue
• New or changing pain

Your oncology team may provide specific restrictions based on your treatment.

If your health changes significantly, your exercise programme should be reviewed rather than automatically continuing at the same level.

When further medical assessment may be needed

New or changing symptoms should not simply be assumed to be a normal part of cancer treatment.

Contact the appropriate medical team if you experience symptoms such as:

• New or significantly increasing pain
• Sudden weakness
• New numbness
• Significant unexplained swelling
• New severe balance problems
• Fever or signs of infection
• New chest pain
• Unexplained shortness of breath
• Sudden deterioration in mobility
• Symptoms that are clearly different from your usual treatment effects

If concerns are identified during your rehabilitation assessment, further medical review may be recommended before continuing or progressing exercise.

Treatment based on your goals

Cancer affects everyone differently.

Your rehabilitation goals may include:

• Walking further
• Becoming stronger
• Managing fatigue
• Returning to work
• Exercising again
• Recovering after surgery
• Managing stairs
• Maintaining independence
• Returning to hobbies
• Feeling more confident with physical activity
• Rebuilding fitness after treatment

Your programme can be developed around these practical goals and adjusted as your treatment and recovery progress.

Progress may look different for everyone

Recovery is not always measured by returning immediately to how you felt before cancer treatment.

Progress may include:

• Walking further
• Completing more daily activities
• Becoming stronger
• Needing less assistance
• Recovering more easily after activity
• Exercising more regularly
• Returning to work
• Managing fatigue more effectively

For someone undergoing ongoing treatment, simply maintaining physical ability may also represent meaningful progress.

How long does cancer rehabilitation take?

There is no fixed timeline.

The length of rehabilitation depends on:

• The type of cancer
• Treatment received
• Surgery
• Current symptoms
• Physical ability before treatment
• Fatigue
• Other medical conditions
• The activities you want to return to

Some people may need rehabilitation for a relatively short period following surgery.

Others may benefit from support throughout treatment and during longer-term recovery.

The programme can be reviewed as your health, treatment and physical ability change.