Many cancer patients needn’t wait until their illness is in remission to engage in strength and cardio training, as long as exercise is custom-fit to their unique situation, and they have their physician’s clearance.

Sami Mansfield of Overland Park, KS, is a certified personal trainer and cancer exercise specialist and owner of Life in Focus.

Her trainees have had breast, prostate, lung, ovarian, colon and skin cancer. The response that cancer patients have to exercise is wide-ranging.

Cancer Patients Already Experienced With Lifting Weights

A program of bodybuilding and other forms of intense weightlifting will be more difficult to sustain for a person undergoing cancer treatment than other types of exercise, such as cardio classes, Pilates, swimming and jogging.

Mansfield explains, “Since bodybuilding is a more intensive and predominately anaerobic activity, it is much more difficult to sustain when someone is going through treatment, both chemo and/or radiation.”

It’s important that a cancer patient not cut back on complex carbohydrates; he or she needs this valuable form of fuel.

Cancer and its treatment strains the body, and if exercise is added to that, then a higher intake of healthy carbs is in order.

If your trainee is interested in bodybuilding—even with a history of such—be aware that cancer treatment “causes the depletion of energy-yielding substances (phosphagens), glycogen and blood glucose,” says Mansfield.

“Second, there is the accumulation of metabolites.” Fatigue may come quickly for the bodybuilder or strength-trainer with cancer, since such a workout is primarily anaerobic.

It’s perfectly okay to keep your trainee—who’s already experienced with weights—on lighter resistance and high reps, and add some completely new routines.

This way, the body will get a surprising training stimulus without the threat of too much intensity.

Cancer Survivors with Little Strength-Work Background

Mansfield explains, “I don’t recommend anything too anaerobic during treatment unless they were very fit to begin with. For the average client, they will just get too tired.

“We want to keep them out of the glycolytic energy system (which weight-training relies upon), because it produces lactic acid which contributes to their fatigue.

“However, this is up to the trainer to determine safe levels for their clients. I will lower the weight, increase the reps and allow extra recovery and many clients will do just fine. It’s not an absolutely can-do, but it is essential to monitor their fatigue.”

If your personal training client with cancer can get through a weight workout, then this will help reverse the muscle shrinkage that results from the cancer treatment.

“For someone to continue to do strength training will keep them physically stronger for day-to-day activity, and tolerate treatments much better,” says Mansfield.

“I know that there is starting to be a lot more research, but personally, I have definitely found this very true both on a physical and psychological level.”

Guidelines for Cancer Patients Finished with Treatment Who Have Not Been Exercising

Mansfield says that when to resume working out is highly individual, contingent upon the trainee’s exercise history, as well as how their body has responded to treatment.

“The main thing is to not add to the fatigue level. I usually have them start with recumbent bike or slow treadmill (trainers should encourage a hands-free walk to involve the core and promote correct posture); whatever they prefer, and start to build their strength back up.

“If they are doing well with that, we add light strength training, usually with bands, (stability ball) core and stretching.” Mansfield also includes range of motion and functional training.

For these personal training clients, more demanding weight workouts shouldn’t be added until at least another four to six weeks—depending on what kind of surgery they’ve had.

It’s important to keep communication open between all three parties: trainer, trainee and trainee’s physician.

Breast Cancer Survivors and Gym Workouts

“The way that muscle is affected in breast (surgery) is from the cutting of the nerves,” says Mansfield. “A common issue that is a side effect of the mastectomy is the cutting of nerves under the armpit known as the brachial plexus.

“Side effects include winging out of the scapula, weak muscles in the posterior shoulder region — including but not limited to the teres major and minor, limited range of motion, and weakness.”

Thus, weight routines that target the chest, shoulder and midback are very important for breast cancer trainees.

Final Thoughts on Training Cancer Patients in the Gym

If you’re a personal trainer who does not specialize in this population of clients, sooner or later you’ll have an opportunity to train such a client. Embrace it. Gym workouts, particularly strength training, are very empowering to the current cancer patient as well as cancer survivor.

Mansfield has diverse experience in both community and hospital based cancer centers, and non-profit organizations to help patients live better, healthier lives.