Physical exercise is playing an increasingly important role in comprehensive cancer care. We now know that, when adapted to each patient’s circumstances, it can help maintain strength and functional capacity, reduce fatigue related to cancer and its treatments, and improve emotional well-being and quality of life.
However, simply advising someone with cancer to exercise is not enough. The type of activity, intensity and goals must be adapted to their diagnosis, the treatment they are receiving and, above all, the stage of their cancer journey.
At IVOQA, we have developed an oncology exercise training programme to support patients at every stage: before surgery, during their hospital stay and recovery, while receiving treatments such as chemotherapy, and after treatment has finished.
Exercise and cancer: What does the evidence tell us?
There is growing scientific evidence supporting the inclusion of physical exercise in cancer care.
In its 2022 clinical guideline, the American Society of Clinical Oncology (ASCO) recommends aerobic and resistance exercise during active treatment with curative intent, provided there are no contraindications. The available evidence shows that exercise can help reduce fatigue and preserve cardiorespiratory fitness, physical function and strength during treatment. The guideline also recommends preoperative exercise (prehabilitation) for people undergoing lung cancer surgery, as it may reduce postoperative complications and length of hospital stay.
Similarly, the 2019 international consensus from the American College of Sports Medicine (ACSM) concluded that exercise is safe during and after cancer treatment and proposed a general guideline: approximately 30 minutes of moderate-intensity aerobic exercise three times a week, combined with resistance exercise twice a week, for at least 8–12 weeks. This is a general starting point that must be tailored to each patient in practice.
Particularly significant results are also emerging for certain types of cancer. In 2025, the CHALLENGE clinical trial, published in The New England Journal of Medicine, included 889 patients with stage III or high-risk stage II colon cancer who had completed adjuvant chemotherapy. Compared with those who received health education materials alone, participants who followed a structured exercise programme for three years had a 28% lower risk of recurrence, a new cancer or death, and a 37% lower risk of death. At five years, 80.3% of patients in the exercise group remained disease-free, compared with 73.9% in the control group. This was the first phase III randomised clinical trial to demonstrate that an exercise programme can improve survival in patients with cancer. Participants in the exercise group experienced slightly more musculoskeletal problems, highlighting the importance of having exercise prescribed and supervised by professionals.
More information: Exercise After Chemotherapy Improves Survival in Colon Cancer.
In another article, we explain in greater detail the benefits of exercise during the cancer journey and how to adapt physical activity to each patient.
Read also: Physical Exercise During and After Cancer Treatment.
Below, we explain how we put these recommendations into practice at IVOQA.
Training before surgery is not the same as training during chemotherapy
A person’s physical condition can change considerably throughout treatment. That is why, at IVOQA, we do not offer a fixed exercise programme that remains unchanged for months.
Before surgery, during what is known as prehabilitation, the goal is to improve strength, functional capacity and respiratory fitness so that the patient is in the best possible condition for the procedure.
After surgery, priorities change. In the first few days, patients may need to begin with breathing exercises, gentle mobilisation, getting out of bed or gradually starting to walk. Later, training focuses on restoring mobility, strength and independence.
Every session also needs to be adapted during chemotherapy. Fatigue, general health and side effects can mean that two sessions just a few days apart are completely different.
Once treatment has finished, exercise remains important for regaining and maintaining physical fitness and establishing an active lifestyle over the long term.
That is why our programme always begins with an individual assessment.
A training programme tailored to every patient
Before starting, we carry out a medical and physical fitness assessment to establish the patient’s baseline functional status.
For our in-person programmes, we also use Technogym Check-up, a tool that provides objective information on different aspects of physical fitness and establishes a starting point.
We use this assessment to design an exercise plan and review it regularly according to the patient’s progress, treatment stage and needs.
The aim is not to set a generic amount of exercise for someone with cancer, but to determine what each patient can do at any given time and how we can help them progress in a personalised way.
Exercise during a hospital stay
Exercise can begin during a hospital stay. Early mobilisation after surgery forms part of Enhanced Recovery After Surgery (ERAS) protocols and is associated with fewer complications and faster recovery.
After surgery, our team adapts activity to the patient’s clinical condition and functional ability. In the early stages, this may involve breathing exercises, mobilisation in their room, standing up or beginning to walk.
As recovery progresses, further exercises can be introduced and activity can be increased gradually.
When the patient’s condition allows, some of this work can also take place on IVOQA’s therapeutic terrace, an outdoor space at Viamed Santa Elena University Hospital.
Learn more about our inpatient oncology exercise training programme
Discharge from hospital does not mean the end of the programme. Once patients return home, we can continue supporting them and adapt their training to the next stage of recovery.
In-person training at our gym
For patients who are able to exercise outside the hospital, we have a dedicated training space at ViaCare – Menéndez Pidal Medical Centre in Madrid.
Our in-person programmes are designed for different stages of the cancer journey: preparation before surgery, postoperative recovery, training during chemotherapy and maintenance after treatment has finished.
Sessions are one-to-one or take place with a maximum of two people, allowing us to supervise training and adjust exercises and loads as each patient progresses.
These programmes are also open to people receiving cancer treatment at other centres.
Learn more about our in-person exercise training programmes for cancer patients
Continuing to train from home
Not all patients can travel to Madrid regularly or make the journey several times a week.
That is why we also offer an online training programme that allows patients to follow a personalised plan from home.
Patients receive exercises adapted to their circumstances, videos showing them how to perform each movement correctly, and ongoing follow-up so that the programme can be updated as they progress.
This option can make it easier to keep exercising when distance, treatment or personal circumstances make in-person training difficult.
Learn more about our online exercise training programme for cancer patients
From hospital to everyday life
Our aim is for exercise to support patients throughout their cancer journey whenever it is appropriate.
In some cases, it begins before surgery. It may continue in the hospital room after the procedure, progress throughout recovery and then be maintained at our gym or from home.
The goal is not to train in the same way throughout the process. Quite the opposite: it is to adapt movement and exercise to what each person needs at every stage.
Discover our oncology exercise training programme
In this video, you can learn more about how we work and how we integrate exercise into comprehensive cancer care at IVOQA.
If you would like to explore the different options available, you can find out more about our oncology exercise training programme and our inpatient, in-person and online training options.
Request information
If you would like to find out which programme may be most suitable for you, please contact our team. We will carry out an initial assessment to understand your medical and functional circumstances and advise you on the available options.
Sources
- Ligibel JA et al. American Society of Clinical Oncology (ASCO). Exercise, Diet, and Weight Management During Cancer Treatment: ASCO Guideline. Journal of Clinical Oncology, 2022;40(22):2491–2507.
- Courneya KS et al. Structured Exercise after Adjuvant Chemotherapy for Colon Cancer. The New England Journal of Medicine, 2025;393:13–25.
- Campbell KL et al. Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable. Medicine & Science in Sports & Exercise, 2019;51(11):2375–2390.
