Swimming During and After Cancer

This fact sheet explains how you can take part in swimming and other aquatic activities, during and after treatment for cancer.

Introduction

Regular swimming can be an excellent form of exercise for individuals during and after treatment for cancer. It can be helpful to understand more about the precautions you should take depending on the stage of cancer and type of treatment you may have been receiving, to help you manage your symptoms and recovery.

How swimming and other aquatic activities can help

We used to think that resting during and after cancer treatment was best. We now know that remaining active can help manage symptoms like pain and fatigue. Like other forms of exercise, swimming can be great for our physical and mental health. Regular swimming can help improve mood, self-esteem, and sleep, and it can help reduce stress and anxiety.

Some treatments for cancer can cause symptoms such as fatigue, muscle loss or joint pain. When we exercise in water we use both upper and lower body muscles – this is a great way of improving body composition, muscle strength and fitness. For those with joint pain, the buoyancy effect of water can reduce discomfort during exercise. Water based exercise can also help reduce any swelling from surgery or other treatments.

Having cancer doesn’t mean you can’t swim or exercise in water, but there are a few things you might need to consider.

What you need to know when considering swimming during or after cancer treatment

Getting started

• It is important to discuss your desire to swim with your healthcare team.
• If they say it is safe to do so, it is best to start slow and gradually build up how much swimming you do. This will also ensure that you don’t feel too exhausted.

Swimming during and after chemotherapy

• Chemotherapy can affect your immune system. This means that your body won’t be able to fight off infections as well, as it should.
• So, exercising in water during chemotherapy is not advised as you could become unwell from any germs in the pool.
• If you want to go swimming soon after chemotherapy, discuss this with your consultant who can tell you when your immune system has recovered sufficiently to do so.
• Be aware that you may also have a loss of feeling in your fingers/toes and may be unable to grip equipment effectively e.g. floats or noodles.

Swimming during and after radiotherapy

• Swimming in chlorinated pools is not recommended during or shortly after radiotherapy. This is because radiotherapy can cause skin changes and irritation. These changes can be further irritated by pool chemicals.
• It is advisable to shower thoroughly after being in a swimming pool, to remove excess chlorine. Stop immediately if your skin becomes painful.
• For those who don’t suffer skin changes, swimming may be possible but it is advisable to check with your consultant first. Ask them how to best look after your skin.

Swimming during hormone (endocrine) therapy

• Hormone therapy lowers hormone levels to help stop cancer growth. Lowering hormone levels in both men and women increases the risk of health conditions such as osteoporosis. This is where bones become weak making them more susceptible to fractures.
• Since swimming is a non-weight bearing activity, it is recommended that you also engage in weight bearing activities in or out of the pool, which can help maintain bone strength.

Swimming with a peripherally inserted central catheter (PICC), Hickman central line or implantable chest port

• Swimming with a PICC or Hickman central line is not recommended due to the risk of infection and potential of dislodging the line.
• You may be able to swim with your implantable chest port once the incision has healed and as long as no needle is in place.

Swimming after cancer surgery

• The wound must have settled before swimming. This is likely to be at least three weeks after surgery, but you should check this with a healthcare professional. You may still be advised to apply a water proof dressing.
• After surgery, some people find that they feel less fit, and joints may feel stiff. Swimming can help as the water can offer a gentle stretch to increase range of movement, and resistance to build strength.
• For certain surgeries, short term modifications may be required. For example, after surgery for breast cancer you may wish to use fins (flippers) to reduce the strain on chest and arms, use a float to support the arm on the affected side, and avoid swim paddles until muscle strength and joint range is back to normal.

Swimming with a stoma/colostomy bag

Swimming with a stoma/colostomy bag may be a worry for you; but having this should not restrict your swimming.

• Discuss any concerns and bag management with your stoma nurse.
• Test your bag out in the bath beforehand if you are nervous about it leaking or becoming detached in water.
• Empty your stoma bag shortly before entering the pool can give you peace of mind that you have plenty of time before you need to empty your bag again.
• Don’t be conscious of people seeing your bag and let that stop you from swimming and having fun, different clothing can help as follows:
  • Women: can wear full length swimsuits, or high waisted bikini bottoms.
  • Men: can wear swim shorts with higher waist bands can cover the bag. Specially designed swimwear for stoma bag wearers are also available.
  • Generally: most pools will allow other coverings to be worn in the pool, such as t-shirts or rash vests

Tips for swimming during and after cancer treatment

Many people have body anxieties during and following cancer treatment, so you are not alone and there will be ways to overcome this:

Do:

1. look for male or female only swimming sessions.
2. look at the wide range of swimming clothing now available and choose a design that helps you feel most comfortable.

Hair loss during chemotherapy can be upsetting and stressful. Staying active is a great way to help deal with these emotions. Therefore you may consider the following:

Do:

1. wear a swimming cap if you wear a wig and feel uncomfortable taking it off in public.
2. look for swimming sessions with other individuals with cancer or other long term health conditions.
3. take care of your skin with moisturising shampoos and conditioners. Some individuals may experience a tender and itchy scalp that might worsen with the chemicals used to improve pool water quality.

Starting any exercise after cancer treatment can be daunting as you may feel tired and unfit. Some people worry and feel that they may get in the way of other faster swimmers. However, many pools have different lanes for swimming ability.

Do:

1. begin in the slow lane and progress into the faster lanes as your fitness improves.
2. ask your local pool about special sessions which cater for individuals of similar swimming ability.

Don’t:

1. overdo it on good days. Remember that your swim is only a small part of your day.

Specific tips for other disciplines

Open water swimming:

• Be aware that the outdoor environment is less controlled than a swimming pool. After surgery or treatment, you may not be as strong as you were beforehand, so take care to adjust gradually and build back up to previous levels.
• There can be infection risks with untreated water, so check with your healthcare team who will be able to advise when your immune system has recovered sufficiently.
• Ensure any wounds from surgery are well healed.

If you are swimming abroad:

• Do: ensure you take a copy of your prescription and take extra medication and supplies than you would normally need, in case any get lost or stolen.
• Consider: local pool hygiene standards as these may be variable.

Additional advice

For further information:

Moving Medicine patient resources on cancer: movingmedicine.ac.uk/consultation-guides/patient-infofinder/?p=adult&c=cancer

Health Fact Sheets

Swim England’s Health Commission group have developed a range of fact sheets on swimming with particular health conditions, written for competitive swimmers, the general public and to also assist those who support or advise swimmers.

Listed below is the current fact sheet library for people with health conditions.

To view and download fact sheets written specifically for people who support or advise swimmers, head to our Health and Wellbeing pages.