You want to keep moving, but you also know that the energy available today may not match yesterday. Advice to exercise can feel incomplete when it does not account for pain, the location of cancer, or the effort of getting through treatment. You need a plan that fits your body and your priorities.

The 2024 ASCO–Society for Integrative Oncology fatigue guideline supports exercise during and after treatment, alongside other approaches such as CBT and mindfulness-based programs. These recommendations do not mean every activity is suitable for every patient. The choice and amount need to fit the person’s condition. [1]

Ask what is appropriate for your situation

Tell the team about balance problems, new pain, breathlessness, and any known bone involvement or restrictions. Ask which movements, loads, and positions are suitable, and whether a cancer rehabilitation specialist or physical therapist can help. Bone metastases and weak bones can change what activity is safe. [2]

A useful answer should be specific enough to follow. “Stay active” may leave you wondering about lifting, twisting, walking distance, or an exercise class. Ask for clarification about the activities you actually want to do rather than trying to translate general advice on your own.

Keep something meaningful in the plan

The goal might be walking to the garden, preparing part of a meal, seeing a friend, or continuing a modified exercise routine. Name the activity you want to preserve so the team can help you work toward it. A plan can support participation as well as a number on a fitness tracker.

Once you have suitable guidance, choose an amount you can manage without using every available bit of energy. Include the effort of preparing and recovering, not just the minutes spent moving. You can also ask which everyday activities already count toward the plan.

Use a pause before the next demand

Pacing can mean breaking an activity into parts, accepting help, or pausing before another task. For example, finish the agreed activity, sit comfortably, and reassess before beginning the errands. The pause gives you a chance to notice how you are doing instead of treating the next task as automatic.

I believe staying active during treatment matters: activity is a cornerstone of recovery. What that looks like can change with the stage of treatment and with how you feel from day to day. Some days a short walk is the right amount. Chemotherapy and some radiation can lower blood counts for a while, and in those weeks all-out or strenuous exercise may not be a good choice. Ask your team when those weeks are likely to fall and what limits apply to you. [2,4]

If activity brings new pain, unusual breathlessness, dizziness, or a marked decline, stop and contact the team as appropriate; severe symptoms need urgent care. A difficult reaction can also mean pain or shortness of breath that you need to tell your team about, or taking longer than usual to recover afterward. [2] Treat it as information for adjusting the plan, not as a reason to work harder or as proof that all future movement is impossible. During chemotherapy, a temperature of 100.4°F (38°C) or higher is a medical emergency: call your oncology team immediately, including after hours. [3]

Review the whole fatigue plan

If fatigue remains difficult, ask what else deserves attention: symptom control, nutrition, sleep, distress, or help with daily demands. A movement plan is one part of support. It should not become another obligation used to judge whether you are trying hard enough.

CBT and mindfulness-based fatigue programs are included in the clinical guideline, but their inclusion does not make fatigue imaginary. They offer ways to manage its effects and are considered alongside physical care and appropriate activity. [1]

Next Steps

Use Treatment Day Energy Plan to bring your priorities to a rehabilitation or oncology conversation. Keep the agreed activity instructions with the plan so you can use the version intended for you.

Sources

[1] Bower et al. (2024). Management of Fatigue in Adult Survivors of Cancer: ASCO–Society for Integrative Oncology Guideline Update.
https://doi.org/10.1200/JCO.24.00541 [2] American Cancer Society. Physical Activity When You Have Cancer.
https://www.cancer.org/cancer/supportive-care/nutrition-activity-with-cancer/physical-activity-when-you-have-cancer.html [3] CDC. Watch Out for Fever.
https://www.cdc.gov/cancer-preventing-infections/patients/fever.html [4] UPMC Hillman Cancer Center. Low Platelet Count (Thrombocytopenia).
https://hillman.upmc.com/patients/community-support/education/miscellaneous/low-platelet-count