• Fatigue
  
• Physical deconditioning
  
• Lymphedema
  
• Body weight changes
  
• Bladder incontinence
  
• Balance and stability
  
• Mental health
  
• Bone health
  
• Muscular strength and size
  
• Cognitive functioning & memory
  
• Quality of life 
  

• Recent surgery. While most surgeons recommend that you return to normal activities of daily living as soon as possible after a cancer surgery, restrictions can apply for up to 12 weeks for returning to exercise or weight training. Check with your surgeon or health care provider to understand your activity restrictions and how long these apply for.
  
• Multiple or uncontrolled health conditions (heart disease, diabetes, lung conditions, high blood pressure, neurological issues)
  
• Anemia (low red blood cell count / hemoglobin)
  
• Unrelieved pain, nausea/vomiting, diarrhea or any symptoms that cause you concern
  

• Low white blood cells / compromised immune system: Public exercise facilities, like gyms and swimming pools, may not be appropriate at this time due to an increased chance of infection. Ensure you wipe down the equipment that you are using before touching it and where possible exercise at home or in facilities designed specifically for cancer survivors. 
  
• Moderate or high fatigue levels: Exercise is recommended and beneficial, however, you should start slowly and progress slowly. 
  
• Bone metastasis: When bone metastasis are present correctly prescribed exercise can be safe and beneficial. The type of exercise that is recommended will depend on the location, type and severity of your bone metastasis. An exercise specialist with cancer specific training can recommend appropriate and safe exercises for you. More information on how to find an exercise specialist can be found in the "How to Find an Oncology Trained Exercise Professional" section of the "More Resources" tab above.
  
• Advanced cancer: An advanced cancer diagnosis can present multiple complications for becoming more physically active. Correctly prescribed exercise has been shown to be very beneficial for advanced cancer patients. An exercise specialist with cancer specific training can recommend appropriate and safe exercises for you. More information on how to find an exercise specialist can be found in the "How to Find an Oncology Trained Exercise Professional" section of the "More Resources" tab above.
  
• Lymphedema: It is safe to exercise with lymphedema, however, you may need to wear a compression garment and modify the types of exercise that you perform. A physiotherapist or your health care provider can help provide you with more information.  More information on how to find a physiotherapist can be found in the "How to Find an Oncology Trained Exercise Professional" section of the "More Resources" tab above.
  
• Poor shoulder movement: It is common after breast cancer treatments to have reduced range of motion in your shoulders. Exercise can help with this, however, it is important to speak to an exercise professional or physiotherapist if you cannot move your arm as well as you did prior to treatment as they will be able to advise on safe exercises to perform.  More information on how to find an appropriate professional can be found in the "How to Find an Oncology Trained Exercise Professional" section of the "More Resources" tab above.
  
• Ostomy: It is advised that you avoid exercises that increase intra-abdominal pressure when being active with an ostomy. Check with your surgeon or health care provider to understand your activity restrictions. An exercise specialist with cancer specific training can recommend appropriate and safe exercises for you. More information on how to find an exercise specialist can be found in the "How to Find an Oncology Trained Exercise Professional" section of the "More Resources" tab above.
  
• Severe peripheral neuropathy: If your feet or hands are numb, precautions may need to be taken to ensure that you can exercise safely. Walking poles can be a great way to increase your balance when you are outside and adaptations can be made to your strength training to ensure you are safe.
  
• Osteoporosis: Exercise is safe and recommended with osteoporosis. You may need to modify your activity, depending on your specific physical condition. A physiotherapist or exercise physiologist can help provide you with more information.  More information on how to find appropriate professional can be found in the "How to Find an Oncology Trained Exercise Professional" section of the "More Resources" tab above.
  

• Pace yourself. Start with a small amount of walking that you can currently tolerate and build up slowly over time. By adding a small amount each week, you will allow your body to adapt to the change and tolerate a larger amount. 
  
• Consistency is key. The most important thing when starting is to initially only do what you can tolerate well (both at the time and afterwards) and then add small amounts to this each day.
  
• Your response to exercise is very important.  If exercise causes you to have a large increase in fatigue (or an ‘energy crash’) it is likely that you worked too hard.  Try reducing the time, distance and/or intensity the next time you are active. Similarly, exercise should not lead to pain, nausea or dizziness.
  
• Have a daily routine and exercise at the time of day when you feel your best. 
  
• Record your exercise and your fatigue levels. By keeping a diary you will be able to see how much exercise you are doing and how your fatigue levels are responding.  If you are exercising correctly, you should see your total amount of weekly exercise increase and your levels of fatigue reduce. 
  
• You can track fatigue with a 0-10 scale, with 0 being “no fatigue” and 10 being “extreme fatigue”.  Your fatigue will vary throughout the day, so try tracking your average fatigue level each day.
• If you are unsure what you should be doing, seek help from an exercise professional. More information on how to find an exercise specialist can be found in the "How to Find an Oncology Trained Exercise Professional" section of the "More Resources" tab above.
  

• Body weight: You can use the weight of your body to provide resistance and to build up strength. Some examples include basic movements like standing up from a chair and sitting back down (chair squats) and standing a little less than arms length away from a wall, lowering your chest  down towards the wall and then pushing away (wall pushups). Body weight exercises can be performed anywhere (at home, work, a park, the gym).
  
• Weights, resistance bands, dumbbells: Weights and bands are low cost and portable and can be a great way to build up muscle mass and strength. Some examples include holding weights while you perform a chair squat to strengthen your lower body, pulling a resistance band in a rowing motion to strengthen your back muscles or curling weights up and down to strengthen your arm muscles. These types of exercises can be performed anywhere and a balanced program can work all muscles in your body.
  
• Gym machines, cables: Most gym facilities have resistance machines and cable pulleys that are designed to strengthen your muscles. Many of these machines are easy to use and can work all muscles in your body. If you are new to the gym environment, ensure you seek proper instruction from an exercise professional prior to starting.  If you currently have low white blood cell counts, it is not recommended to expose yourself to this environment until this is back to normal levels.

If you have not been regularly active, or are experiencing symptoms that limit your ability to be active, it is recommended that you start with 30 minutes of moderate-to-vigorous aerobic exercise (e.g. walking, cycling, swimming), three times per week (for a total of 90 minutes per week of moderate-to-vigorous aerobic exercise), plus 2 muscle strengthening exercise sessions per week. This has been shown to help reduce symptoms related to cancer and its treatment,  such as fatigue, anxiety, and depression, and to improve sleep.

Once you are regularly active, it is recommended to build up to 150+ minutes of moderate-to-vigorous aerobic exercise (e.g. walking, cycling, swimming), and two muscle strengthening exercise sessions per week to improve and maintain general health and well-being.

1. Exercise intensity. Walking can be moderate-to-vigorous intensity, however this depends on your currently physical condition and the type of walking that you do. For some people, moderate intensity might only be achieved if you walk briskly and include some hills.  This will vary between individuals. You can use many different methods to measure the intensity of your walking, such as heart rate, rate of perceived exertion (RPE) and the talk test. An exercise professional can guide you on these areas. A quick and easy way to check your intensity is the talk test:
• Low intensity activity – You can talk and sing easily and your breathing will not interrupt this. 
• Moderate intensity activity - you can to talk, but not sing.  
• Vigorous intensity activity – you can say a few words but then need to pause for a breath. You cannot sing.
2. Strength training. Walking is not strength training and while you will feel yourself becoming stronger by walking, specific strength training exercises are still recommended at least two times per week.