Exercise and Physical Activity Recommendations

Exercise and Physical Activity Recommendations for Early-Onset Bowel Cancer

Staying physically active after a bowel cancer diagnosis can feel overwhelming, especially during or after treatment. But the benefits are well worth it. Whether you’re recovering from surgery, managing fatigue from chemotherapy, or adjusting to long-term side effects, tailored movement can play a key role in your recovery and overall wellbeing.

This blog breaks down safe and evidence-based physical activity recommendations for Australians living with early-onset bowel cancer, and how to adapt movement to your needs across different stages of treatment and recovery.

Why Exercise Matters After a Bowel Cancer Diagnosis

Exercise isn’t just about fitness. It’s a tool to help you feel better, function better, and live longer. Research continues to show that regular physical activity can:

• Reduce cancer-related fatigue
• Improve sleep quality and mood
• Enhance muscle strength and physical function
• Support immune system health
• Improve gut function and reduce constipation
• Aid in the management of treatment side effects like neuropathy and joint stiffness
• Potentially reduce the risk of cancer recurrence

According to Exercise & Sports Science Australia (ESSA), exercise is now considered a standard part of cancer care. It’s no longer just a complementary option. Cancer Australia and the Clinical Oncology Society of Australia (COSA) also endorse tailored physical activity as a vital part of treatment plans.

Getting Started: General Guidelines for Cancer Patients

Before starting or changing your physical activity routine, always speak with your healthcare team. Ideally, ask for a referral to an Accredited Exercise Physiologist (AEP), especially one with experience in oncology.

Recommended baseline guidelines for adults living with cancer include:

• 150 minutes of moderate-intensity aerobic exercise per week
• 2 to 3 sessions of resistance (strength) training per week
• Daily movement, even if it’s light activity like walking, stretching, or yoga

Moderate-intensity exercise means you’re working hard enough to raise your heart rate and breathe a bit faster, but you can still hold a conversation. Examples include:

• Brisk walking
• Cycling at a comfortable pace
• Swimming
• Dancing
• Gardening

Strength-based training is just as important and might include:

• Bodyweight exercises such as squats, push-ups, or lunges
• Resistance bands or light weights
• Pilates or structured strength workouts

The most important rule? Start where you are, not where you think you should be. If you’re only able to move for five minutes today, that’s still progress. Consistency matters more than intensity.

Exercise Across the Bowel Cancer Journey

Before and During Treatment (Prehab and Active Treatment Phase)

Prehabilitation, or “prehab,” means preparing your body before treatment begins. This is especially important before surgery. The goal is to build strength, stamina, and mental resilience to better cope with treatment side effects.

During chemotherapy or radiation therapy, many people experience fatigue, nausea, pain, or neuropathy. Adjusting expectations is essential.

Tips for exercising during treatment:

• Prioritise gentle movement on difficult days, such as short walks or breathing exercises
• Take advantage of good days for longer sessions if you can
• Avoid long periods of sitting by getting up for a few minutes every hour
• Focus on function rather than fitness goals
• Work with an AEP who can safely monitor fatigue levels, heart rate, and any surgical limitations

Even short bursts of movement can support circulation, mood, and energy levels. Gentle yoga, tai chi, or guided online classes for cancer recovery can be especially helpful.

After Surgery

Recovering from bowel surgery takes patience. Movement is still important, but safety and pacing are key. Most hospitals will encourage short walks within 24 hours of surgery to reduce the risk of blood clots or pneumonia.

Post-surgical exercise tips:

• Start with slow, frequent walking around the house or garden
• Avoid heavy lifting or exercises that strain your core, especially with stomas or abdominal incisions
• Include breathing and posture exercises to support lung function and manage pain
• Reintroduce strength training gradually, particularly for abdominal muscles
• Ask your care team about stoma-safe core exercises, if that applies to you

Every recovery is different. What works for someone else might not work for you. Listen to your body and rest when you need to.

During Long-Term Recovery or Maintenance

As your energy returns and side effects ease, you might be able to resume more structured physical activity. This is a great time to rebuild your fitness base and explore movement that feels good again.

Benefits of regular exercise during this phase include:

• Managing scar tissue and stiffness
• Improving bone density and muscle mass
• Supporting bowel regularity
• Enhancing mental health and easing fear of recurrence

Consider joining local programs such as Life Now by Cancer Council WA or other rehab-based classes designed for cancer survivors. Some are available online if attending in person is difficult.

If chemotherapy or surgery affected your nerves or lymph nodes, focus on balance, joint mobility, and awareness of movement. Be mindful of any swelling, pain, or dizziness and stop if anything feels off.

Special Considerations for Australians with Early-Onset Bowel Cancer

Younger patients often face unique challenges. Balancing work, family life, finances, and emotional stress makes consistent exercise feel harder to prioritise. But movement can help manage all of that, physically and mentally.

If you’re trying to stay active during a hectic phase of life, try:

• Short movement “snacks” such as a 10-minute stretch, walk, or light stair session
• Using active transport, like walking to appointments or parking further away
• Doing family-friendly activities such as park games, swimming, or bike rides
• Joining virtual classes or using on-demand programs from home

Be aware of fertility changes or pelvic floor issues that may impact comfort with certain types of movement. A pelvic health physiotherapist can guide you through recovery if needed.

One of the most powerful reminders came from my late friend Anthony Ellison: “Do it because you can, not because you have to.”

When Not to Exercise

Movement is usually helpful, but there are times when rest is safer. Avoid exercise if you’re experiencing:

• Fever or infection
• Dizziness or fainting spells
• Low white blood cell or platelet counts (check with your oncologist)
• Severe pain or unusual new symptoms
• Ongoing stoma issues or wounds that aren’t healing properly

Let your medical team know if any activity makes you feel worse afterward.

Free and Low-Cost Resources in Australia

• Bowel Cancer Australia – Offers nurse support, stoma information, and movement advice
• Exercise Right (ESSA) – Helps you find an Accredited Exercise Physiologist nearby
• CanWell program – Localised wellness and exercise support in some regions
• Cancer Council Australia – Find exercise support programs by state

Ask your GP or oncologist about Medicare-subsidised referrals to an AEP through a Chronic Disease Management Plan.

Final Thoughts: Your Body, Your Pace

There’s no one-size-fits-all approach to moving your body during or after cancer. The key is finding movement that feels achievable, safe, and worth doing. Some days it’s a gym workout, other days it’s walking to the letterbox. All movement counts.

Set realistic goals. Celebrate small wins. Be gentle with yourself. Your body has been through a lot, and every step forward is part of your healing.