Exercise and lymphoma

This information is about exercise before, during and after lymphoma treatment. 

Exercise doesn’t need to mean formal, structured exercise. It includes physical activity built into your day-to-day life, such as walking and household tasks.

We have separate information about getting ready for treatment (prehabilitation), of which exercise can play an important part. You might be interested in our Preparing for Treatment service too.

We also have resources to help with your physical and mental wellbeing, and some top tips for regaining fitness, suggested by our Facebook community.

On this page

What physical activity should I do?

How can physical activity help me?

How can I balance physical activity with rest?

What types of physical activity are there?

What safety precautions should I take when exercising?

Where can I find out more about physical activity?

Frequently asked questions about physical activity and lymphoma

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What physical activity should I do?

The UK physical activity guidelines are the same for people with cancer who are otherwise well as they are for people who do not have cancer. However, it’s important to choose the frequency, type and amount of physical activity that is safe for you and fits with your energy levels. This could mean starting slow and small, and building up gradually. Try to find something you enjoy too. 

Speak to your medical team about the type and intensity of physical activity that is safe for you. They might be able to refer you to a specialist physiotherapist for more guidance.

What are the recommendations?

For adults, the recommendation is to do 150 minutes (2 and a half hours) of moderate intensity physical activity each week. If you prefer, you could instead take 75 minutes (1 and a quarter hours) of high-intensity (quick and energetic) activity.

One way to reach the recommended amount is to do 30 minutes of moderate intensity physical activity 5 days a week. 

Moderate intensity physical activity makes you breathe more quickly but doesn’t make you feel short of breath.  In practical terms, this is performing tasks at a pace where you feel challenged enough but able to respond in full sentences when needed.

Dale Bayquen, Haematology-Oncology Physiotherapist

The recommendations for children depend on the child’s age and physical ability. Guidelines are available on the UK government website.

As part of your physical activity, a couple of times a week, you should include:

• strengthening activities – examples include reaching up towards the ceiling or sky, stretching your arms out in straight in front of you, and standing up from a chair
• coordination, balance and flexibility exercises – particularly for people aged 65 years or over.

It is also important to give your body time to rest. We have tips below to help you get a balance between physical activity and physical rest.

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How can physical activity help me?

Physical activity can have lots of benefits to your general health and wellbeing, including to:

• increase muscle strength and improve balance
• control weight, blood pressure and blood-sugar levels
• build bone strength to help prevent brittle bones (osteoporosis), which is particularly important for women given treatment that affects their ovaries (such as pelvic radiotherapy). Menopause also increases your risk of osteoporosis
• reduce the risk of coronary heart disease
• improve your general emotional wellbeing, for example by managing stress – some people feel an added benefit of being outside and around nature.

For some people, physical activity is part of their social life. For example, you could play tennis or go for a walk with a friend. For others, physical activity gives an emotional outlet and an opportunity for quiet reflection and mental relaxation.

The NHS website has more information about the benefits of exercise. 

How can physical activity help people with lymphoma?

Physical activity can also help to prepare your body for lymphoma treatment (prehabilitation), as well to recover after treatment. 

For example, it could help to lower the:

• side effects and late effects of some lymphoma treatments
• length of time you need to stay in hospital
• risk of infections while you are on treatment
• risk of developing blood clots while you are on treatment.

I have a target of 5,000 steps a day, which I do by walking for about 45 to 50 minutes. I know that some people find pedometers really motivating, as they can give a rough idea of distance walked and calories burnt. I also bought a kettlebell and found online kettlebell workouts to do. These activities have reduced both my weight and blood pressure markedly over the past couple of years.

David, diagnosed with B-cell skin lymphoma

In our frequently asked questions section, you’ll find more information about research findings relevant to people with lymphoma.

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How can I balance physical activity with rest?

Speak to your medical team for advice about how to get a good balance between physical activity and rest, particularly if you experience cancer-related fatigue.

Tips you might like to consider include to:

• Build your level of physical activity up gradually – for example, you could walk for 10 to 15 minutes on three days each week. Over time, you could start to increase this by another 10 or 15 minutes.
• Have regular breaks and give yourself enough time to recover afterwards – this should include a rest day (when you take only more gentle physical activity) between any days that you do higher intensity physical activity.
• Be kind to yourself – you might not be able to do as much physical activity now compared with before you had lymphoma. For some people, it can take a year or two to feel back to the level of physical fitness they had before having lymphoma.

I think it’s good to focus on progress over perfection: celebrate small milestones and focus on what your body can do today.

Jana, diagnosed with diffuse large B-cell lymphoma

You might be interested in top tips for moving and regaining fitness after lymphoma treatment offered by members of our Facebook Support Group.

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What types of physical activity are there?

Physical activity can be split into different groups. The general recommendations are to include moderate activity, strengthening activities and coordination, balance and flexibility activities in your weekly activity. 

I’ve been in remission since 2008 and have kept active by walking, cycling, playing badminton and working on my allotment.

Malcolm, diagnosed with follicular lymphoma

Examples of moderate activity include:

• walking
• mowing the lawn
• vacuum cleaning
• gentle cycling
• dancing
• aqua aerobics
• golf.

Examples of strengthening activities include:

• digging in the garden
• getting in and out of a chair
• squatting
• walking up steps
• carrying shopping bags
• push-ups
• sit-ups
• resistance-band training
• yoga.

Examples of coordination, balance and flexibility activities include:

• standing on one leg
• yoga
• Tai Chi
• Pilates
• stretches.

The NHS website has more examples of different types of physical activities, including suggestions that you can do at home. 

I am in my 40s and found gentle tai-chi sessions during and after my treatment to be incredibly helpful to support strength, balance and flexibility in a calming way. Gardening was great too.

Jana, diagnosed with diffuse large B-cell lymphoma

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What safety precautions should I take when exercising?

Ask your medical team about the type and intensity of physical activity that is suitable for you. Your clinical nurse specialist, a physiotherapist or cancer exercise specialist can be good people to ask. They can help come up with a plan that considers your treatment stage, energy levels, and any side effects. Find out from your medical team which professionals are available to support you.

During, or soon after your lymphoma treatment, you might be advised to avoid some activities. For example, if you have certain side effects, including those that affect your blood cell counts. 

Your medical team can also advise on any precautions you should take based on your individual circumstances. For example, you might be advised against high-impact activity (like running) if lymphoma affects your bones and you have a higher risk of bone fracture. 

Low blood counts

You will be given advice by your medical team about physical activity that is safe for you if you have low counts of some types of blood cell.

Shortage of platelets (thrombocytopenia)

If you have a shortage of platelets (thrombocytopenia), you are at a greater risk of bruising and bleeding. Doctors therefore ask you to avoid high-impact sports such as football and rugby.

Shortage of neutrophils (neutropenia)

If you have a shortage of a type of neutrophils (neutropenia), you are more vulnerable to infection – your risk is further increased if you have HIV or have had a stem cell transplant (particularly an allogeneic (donor) stem cell transplant) within the last 6 to 12 months.

Check with your medical team how to limit your risk of infection when exercising. For example, they might recommend that you avoid public gyms, swimming pools and spas. There is more about when you might need to avoid swimming in our frequently asked questions section.

Low red blood cells (anaemia)

If you have a shortage of red blood cells (anaemia), you are likely to feel tired and to become short of breath easily with physical activity. This might affect which types and intensity of physical activity is suitable for you.

Other factors you might need to consider when planning your physical activity include:

• Effects of chemotherapy drugs on your heart or lungs – you might feel short of breath and uncomfortable when doing high-intensity exercise. Ask your clinical nurse specialist for advice about what’s safe for you.
• Nerve damage to your peripheral nervous system (peripheral neuropathy) – this can cause symptoms like numbness or a tingling sensation (‘pins and needles’) in your hands and feet. Peripheral neuropathy can also affect your muscle strength and your grip and balance. It might therefore be safer to a use a stationary (‘exercise’) bike indoors rather than cycling outside.
• Diarrhoea or vomiting – this can happen for lots of reasons, including as a side effect of lymphoma treatments and pain relief medication. It can also be a symptom of heightened stress and anxiety. Diarrhoea and vomiting change the levels of certain minerals (such as sodium and potassium) in your body. This means that you should not exercise while you have diarrhoea or vomiting as this could further affect such levels and make you more unwell.
• Bone health – if your bone health is affected by lymphoma or its treatment, your medical team can give you advice about the types of exercise that are safe for you, to help reduce the risk of fracture and increase muscle strength and joint stability. 

Spinal cord compression

If lymphoma grows in or around the spine, it can put pressure on the spine and stop the nerves from working properly. This is rare, but serious, and is known as spinal cord compression. 

Spinal cord compression needs urgent medical attention. For most people, the first sign is pain in the spine, back or neck. However, the symptoms depend on where the pressure on the spinal cord is – ask your medical team what symptoms you should be aware of. 

There is more detailed information about the possible signs and symptoms of spinal cord compression on Macmillan Cancer Support’s website.

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Where can I find out more about physical activity?

Speak to your medical team or GP or clinical nurse specialist for advice about the type and intensity of physical activity that is suitable for you. 

Your GP or clinical nurse specialist

Depending on where you live, some GP surgeries offer a referral scheme where you can see a cancer exercise specialist.

Some gyms have programmes for people who are recovering after cancer treatment where you are supported by a relevant professional such as a physiotherapist or exercise specialist. Speak to your clinical nurse specialist for guidance on where to find one, what it might involve and if there is a cost.

Lymphoma Action resources

You might find our physical wellbeing resources helpful. These include videos on seated rejuvenating stretches you can do at home, and a practical toolkit on fatigue and physical exercise.

On our useful organisations webpage, you’ll find a list of resources and websites you might find helpful in relation to exercise and physical activity.

If you have recently finished lymphoma treatment or you are on active monitoring (watch and wait), you might be interested in our Live your Life peer-led self-management programme. This aims to help you find your ‘new normal’ and adapt to life with and beyond lymphoma, practically, physically and emotionally.

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Frequently asked questions about physical activity and lymphoma

We answer some common questions people have about physical activity and lymphoma. Speak to your medical team for advice specific to your situation.

What does the research say about the benefits of physical activity for people affected by lymphoma?

Physical activity can have benefits before, during and after lymphoma treatment. For example:

• A review of 12 studies with a total of 812 people diagnosed with leukaemia or lymphoma found that doing aerobic and resistance exercise 3 to 5 times a week significantly improved overall physical functioning, fitness and quality of life.
• A study looking at people treated with chemotherapy for lymphoma found that doing an exercise or relaxation programme significantly improved quality of life.
• A study looking into the benefits of physical activity in 122 people with Hodgkin and non-Hodgkin lymphoma found that aerobic (cardiovascular or ‘cardio’) activity improved physical abilities and quality of life, including in those people having chemotherapy.
• A review of 44 studies (with a total of over 3,000 participants who were living with various types of cancer, including lymphoma) found significantly reduced cancer-related fatigue in people who did moderate physical activity, including some strengthening activity.
• A review of 10 studies of people with lymphoma or another blood cancer in hospital before having a stem cell transplant found improved heart and lung (cardiorespiratory) functioning in those who took physical activity.

Isn’t rest more important than exercise?

Rest is essential in helping you to recover from lymphoma. However, doctors generally advise that it is both safe and beneficial to do physical activity during and after treatment for cancer. It can also help to manage cancer-related fatigue.

Too little physical activity can lead to muscle weakness and fatigue. Some people get into a cycle of doing less activity, feeling more tired, doing less activity and so on. Try to keep up your physical activity levels so that you can continue with your normal activities. This can also help with your emotional wellbeing. 

Is it safe for me to use public swimming pools?

Swimming has a lot of benefits – for example, it can help to increase your general fitness, strengthen muscles, and manage stress. However, there might be times when you should avoid public swimming pools. This includes if you:

• are neutropenic, in order to avoid infection from public pools and changing rooms
• are having radiotherapy, because chlorine could irritate the skin in the area being treated
• have a central line or PICC line (a tube inserted into a vein deep inside you to give treatments and take blood), due to a risk of it becoming dislodged or infected. 

Can physical activity prevent a relapse (return) of lymphoma?

There is growing support for the potential role of physical activity in lowering the risk of cancer returning (relapsing). Staying active can also increase the likelihood of you being well enough for the best treatment for you, if your lymphoma returns.