Q. I am undergoing treatment for breast cancer at the moment, I am really keen to keep fit during this difficult time as a way of being focused and positive and coming out of this a new me. I am a little unsure as to what exercise plan I should use.

A. It is amazing how many lives and conditions can be positively affected by exercise and activity. Cancer is no exception and although a serious illness, which is often aggressively treated, the careful introduction of exercise can be a powerful aid to a full and healthy recovery. Of course, exercise is something all women should try to include in their life as although several risk factors for breast cancer cannot be altered, research from the national cancer institute in America has shown that a lack of physical activity is a strong predictor of risk for breast cancer in young women. For those in remission from cancer, exercise can help return them to their former level of physical and psychological function. However, exercise can also help those who are undergoing treatment by maintaining endurance levels and the ability to carry out everyday tasks.

It is not just physical benefits that can be gained from exercise. Cancer treatment can be emotionally exhausting and draining, and exercise has been shown to have profound psychological benefits for people in cancer therapy. There is strong evidence that has shown reduced levels of depression and anxiety in female cancer patients. Interestingly, much of this research has been carried out with women suffering from breast cancer.

Making an exact recommendation on what exercise you should do is very difficult. There is very little research to tell us if there is an optimal level of intensity or frequency to train at. Of course, everybody is affected differently and at different stages of treatment so each person’s capacity for exercise is different. Developing a safe and effective programme of exercise should be done in careful consultation with your doctor and a skilled personal trainer. There are also many different side effects from the various drugs used to treat cancer, these can include anaemia, and damage to muscle and nerves. Some of these side effects can happen months and even years after treatment and need to be given consideration before starting a programme of exercise.

What we can be pretty sure of is that your exercise programme should try to incorporate several different activities, and given that most cancer patients tend to suffer from reduced strength and endurance, these would seem like good places to start. Aerobic training such as swimming and walking can help improve fitness and endurance, strength exercises can improve daily function and help maintain muscle, while activities such as yoga or pilates can help to improve balance, strength and flexibility. Remember, as cancer treatment can be a complicated area, you should always consult with your doctor before beginning anything. If possible seek out a trainer who can work with you to help get things started.