On Friday 25 May we hosted a live webchat on physical activity and cancer. Our experts were Macmillan Nurse Louise Bolton, and Matt Corder from the Active Luton Project, who works with cancer patients to help them become more active. They answered questions on the benefits of physical activity, and on the types and levels of activity that are suitable for people living with cancer or after treatment.

Many thanks to Louise and Matt, and to everyone who came along and asked a question. If you’d like to know more, read our website section on physical activity and cancer.

Louise: That was the old advice. We now encourage people to be as active as they can manage to help reduce fatigue tiredness, stress and anxiety. This also helps look after your bones and heart, and reduces the risk of getting a blood clot, as well as help with maintaining a healthy weight.

And if someone is worried about what levels of physical activity are safe for them, what should they do?

Louise: Levels of physical activity depend on your age and how active you normally are, as well as your cancer diagnosis and the treatment you have had or are having. You could discuss this with your doctor or clinical nurse specialist and see if there is an exercise referral scheme in your area to advise you further.

Are there are any specific exercises that you would recommend for someone with lymphoedema in the upper arm following surgery for breast cancer?

Matt: We currently have a number of patients on our programme who require the same sort of exercise. We recommend that you always wear your support. You can focus exercise on the specific muscle groups of the upper arm to build up strength and flexibility for your upper arm. Gym-based exercise is ideal for this, using the equipment such as the bicep curl and tricep curl machines. You can start with a low weight resistance and just do sets of 5 reps with a minute of rest in between, and slowly build up from there.

You can also use small hand weights at home and bring your arms out in front of you, then to the side, and then slowly try and raise them to a height that you are comfortable with. Hand bikes are very good in a gym, as is a rowing machine. When strength and flexibility increase, swimming is also good as it takes away joint pressure.

What are the benefits of swimming after having finished treatment for breast cancer?

Matt: Swimming is a fantastic physical activity for weight management and cardio fitness. It is also relatively accessible to all and a fairly inexpensive activity. There is also the option of group activity in the pool, such as aqua fit, which is also great for a total body workout with the added bonus of no pressure on the joints.

I am quite aerobically fit and am just getting back into weight training. But I am struggling with stomach exercises following the major surgery I had last March and, because I have not been much inclined to do anything about this until recently, I would appreciate your thoughts on good stomach exercise that does not involve swimming!

Matt: Depending on your surgery limitations there would be fitness classes, for example the classic, Thighs, Bums and Tums, which would benefit the abdominal muscle groups. There are specific machines in a gym that work the abs, but without knowing what effect your surgery has had, it’s difficult for me to advise. Sit ups are great, and you can do them anywhere, but, again, this depends on your individual limitations.

Pilates or Yoga would also be great to help build up strength and toning of the stomach, and are low impact.

Pilates has proved problematic as my lack of muscle means my back takes more of the strain (have had a prolapsed disc for over 30 years which flares up now and again) so I think I will have to avoid that for now. Can do sit ups but the discomfort afterwards is not motivating me to make a huge effort. So my next question would be - what do you suggest for motivation?

Louise: Have you got a gym buddy who can help support you? It is important to set yourself an achievable goal that is realistic to your current level of fitness. Maybe look at a new activity you have not tried before?

I used to be very active and am struggling to do things that will help maintain my weight/ lose it as I have been fairly inactive since the diagnosis. I have tried brisk walking with a compression stocking but my arm aches for approx 3 days after. Is this normal? Also I have tried swimming and I am good at that but I am struggling to take it easy as I used to swim 60 to 100 lengths.

Matt: Again swimming would be good as its low impact on joints as you are weightless in a pool.

But I am allergic to something in communal pools so I don't like to go - I sneeze and have to blow my nose constantly for hours after.

Another community member: You can use nose plugs.

Matt: Have you tried any fitness classes or gym-based activity? Perhaps some gym-based work focusing on the lower body will still allow you to exercise but limit the strain on your arm. The other option is to use upper body-specific gym machines to help build up the muscle group and mobility of that joint in order to stop the ache in the long term.

The recumbent bike will be good in the gym. This is the one where you are leaning back - as you are in a more relaxed position, this machine will enable you to burn calories whilst not moving your arms.

My arms have started to be not as toned as they were previously. I have to be in a wedding dress in August. Am I allowed to use small weights for my arms? I kind of got scared and stopped everything.

Matt: I think light weights would be ok for your arms, just not dynamic explosive movements. Bicep and tricep curls with small weights will be great - you can even use tins of beans while you’re at home!

I have a problem finding the time to train now I’m back to work full time. I have to squeeze it in when I can, that's usually evenings and then I'm tired out the next day. So any suggestions for exercises I can do in the office (without frightening my colleagues!)?

Matt: There are a few chair-based activities you can do. They are very low intensity, though, like spelling words out with your legs/feet etc. The other option is maybe using a swiss ball as your chair at work. This is something i have seen introduced to some offices as you are always doing small movements to balance yourself and is great for toning and core strength I would practice at home, though, first so you don’t fall off in the office!

I’ve had lymphoedema for about 5 years now and the summer also makes it fatter so how can I keep it cool?

Louise: Do you wear a support that could be cooled before you put it on or spray it periodically with water to dampen it?

Matt: There is a product called Magicool that is in an aerosol you can spray it and gives you an instant cool hit. Boots was the last place I found it in March this year. You don’t need to put it in the fridge, it just stays anywhere and sprays from the can.

Any suggestions for someone who is dealing with neuropathy?

Louise: Neuropathy is nerve damage. There is more information on neuropathy on the Macmillan website.

Matt: Is it localised to a specific body part?

Pins and needles in my fingertips, but my whole hands are stiff and sore so gripping is a bit of an issue.

Matt: Perhaps some gym or cycling gloves would help with grip. Have you tried using hand grips or a stress ball type device? Even a foam tennis ball would be good to use at the start and build up.

When I swim can I do front crawl, butterfly and backstroke too? Backstroke will be especially hard for me as I don't have full motion yet.

Matt: Perhaps breast stoke would be good for you, or use a float to hold onto and swim that way.

I have been thinking about going swimming to help my muscles, but I need a swimming costume for mastectomy. I also have neuropathy in my hands and feet which make me scared of stubbing my toes.

Louise: Your breast care nurse should have up to date advice about swimming costumes post-surgery. In the back of health and fitness magazines you often see adverts for specific costumes.

I think Bravissimo also has a service to help you if you have a shop near you. Or a specific lingerie shop who will sometimes know someone clever with needle work who could adapt bras of your choice.

Matt: Perhaps you could look into whether your local swimming pool has 'Ladies Only' sessions to help you ease back into swimming. There are swim socks, swim slippers made from wetsuit material that may help grip on your feet and ease any impact

What is the best exercise for weight loss for someone like me who is menopausal or weight gain for someone who has lost weight during treatment?

Matt: Macmillan has produced a booklet called ‘Weight Management After Treatment’ – that helps with the diet and nutrition side of things. All Macmillan booklets can be ordered online.

Exercise-wise, the best for weight loss is going to be a cardio workout combined with a balanced diet. Exercise bike, cycling, treadmill, running, rowing machine and cross trainer are all good. It’s the intensity of exercise that burns calories.

Moderate to high intensity means you are able to talk, but your breathing is quicker, body is warm, face might be red, and heart rate increased. High intensity means you can't talk, and are breathing very hard. The longer you can maintain that intensity the more calories you will burn.

A combination will work over time. You will notice a change in body shape before a loss on scales, though.