Staying active with a low immune system

The short version

  • Chemotherapy can lower your white blood cells, which makes you more likely to get infections.1
  • Infection during chemotherapy can be life-threatening. Call your 24-hour treatment helpline straight away if your temperature is over 37.5°C or below 36°C, or you feel unwell.1
  • You can usually stay active, with some sensible precautions, such as avoiding public swimming pools when your counts are low.1, 2

Call your 24-hour treatment helpline immediately if you

  • have a temperature above 37.5°C or below 36°C
  • feel unwell, shivery, or have flu-like symptoms, even with a normal temperature
  • have signs of infection: sore throat, cough, breathlessness, pain when passing urine, a rash, or redness and swelling1

Call 999 if you’re confused, very breathless, haven’t passed urine for a day, or feel the worst you’ve ever felt. These can be signs of sepsis.1

Staying active safely

Being active during chemotherapy is safe for most people and helps with fatigue and mood.3 When your blood counts are low:

  • exercise at home or outdoors rather than at busy gyms2
  • avoid public swimming pools and spas1
  • wipe down equipment if you use shared machines, and wash your hands afterwards
  • don’t exercise if you have a temperature or feel unwell. Call your helpline instead.

If your platelets are low, avoid high-impact or contact activities, as you may bruise or bleed more easily. If you’re anaemic, expect to be more breathless and rest as you need to.2

See exercise during chemotherapy and when to rest.

Everyday precautions

Hygiene1

  • Wash your hands before eating, after using the toilet, and after contact with animals.
  • Brush your teeth with a soft toothbrush at least twice a day.
  • Wear gloves for gardening and when dealing with animal waste.

Food safety1

  • Cook food thoroughly, especially meat and eggs.
  • Wash fruit and vegetables.
  • Use separate chopping boards for raw meat and other foods.
  • Don’t eat food past its use-by date.

People1, 4

  • You don’t need to stop seeing family and friends, but avoid people who are unwell.
  • Tell your team if you’ve been in contact with someone with chickenpox or shingles.
  • Ask your team about vaccines, for you and the people you live with.

Related pages

Everyone’s treatment is different, so talk to your cancer team about what is right for you.

References

  1. Gloucestershire Hospitals NHS Foundation Trust. SACT side effects: an increased risk of infection, neutropenia and neutropenic sepsis. www.gloshospitals.nhs.uk/our-services/services-we-offer/cancer/systemic-anti-cancer-therapies-home/sact-treatment/sact-side-effects-symptom-support/sact-side-effects-an-increased-risk-of-infection-neutropenia-and-neutropenic-sepsis/
  2. Macmillan Cancer Support. Physical activity and cancer (MAC12515, 6th edition). November 2023. www.macmillan.org.uk/dfsmedia/1a6f23537f7f4519bb0cf14c45b2a629/18459-10061/mac12515_physical-activity_E06_intpdf_02
  3. Campbell KL, Winters-Stone KM, Wiskemann J, et al. Exercise guidelines for cancer survivors: consensus statement from international multidisciplinary roundtable. Medicine & Science in Sports & Exercise. 2019;51(11):2375–2390. doi.org/10.1249/MSS.0000000000002116
  4. Cancer Research UK. Living with chemotherapy: social life and activities. www.cancerresearchuk.org/about-cancer/cancer-in-general/treatment/chemotherapy/living-with/social-life-activities