Cancer exercise programmes in the UK: what to expect

A cancer exercise programme is a block of supervised exercise for people before, during or after cancer treatment. In the UK they are run by NHS hospital teams, cancer charities, leisure centres and some gym chains. The programmes we looked at start with an assessment and run for a set number of weeks. Your cancer nurse specialist is the best first person to ask about what runs near you.

What is a cancer exercise programme?

A cancer exercise programme is structured, supervised exercise for people with cancer, pitched at a level that suits your treatment and your fitness. Many begin with an assessment and run for a fixed block of weeks.

Macmillan Cancer Support explains that "some GPs, cancer treatment centres and support groups have exercise referral schemes. These can refer you to a cancer exercise specialist or a clinical exercise physiologist" [1].

Macmillan describes a cancer exercise specialist as "a fitness instructor who is qualified to help people with cancer to exercise safely", who "might work in a gym or local leisure centre", and a clinical exercise physiologist as "a healthcare professional who is an expert in screening, assessing and advising what physical activity is best for you and your situation" [1].

Exercise is one part of wider cancer rehabilitation, alongside nutrition and emotional support.

What kinds of cancer exercise programme are there in the UK?

There are six broad kinds: NHS prehab and rehab programmes, charity centre sessions, leisure-centre classes, gym-chain programmes, online programmes, and private one-to-one sessions with a clinical exercise physiologist. What is open to you depends on where you live and your type of cancer.

• NHS prehab and rehab programmes. Greater Manchester's Prehab4Cancer uses "Level 4 GM Active instructors" in community leisure centres, three times a week for up to 12 weeks before major surgery, then 12 weeks afterwards [3]. North Bristol NHS Trust describes an "exercise cancer prehabilitation to rehabilitation 12 week programme at your local leisure centre" [4]. See our prehabilitation guide.
• Charity centre sessions. Maggie's centres across the UK offer free support with no appointment needed [5]. Maggie's Manchester, for example, runs yoga, Tai Chi and walking groups and prehab sessions [6].
• Leisure-centre classes. Energise in Bristol is a partnership between Macmillan Cancer Support, North Bristol NHS Trust and Everyone Active, with "fitness instructors specially qualified to support people with cancer" [2].
• Gym-chain programmes. PureGym, with The Institute of Cancer Research and The Royal Marsden, offers men with locally advanced or metastatic prostate cancer on hormone therapy a free year's membership and a 26-week programme [7]. Nuffield Health's Cancer Activity Programme is "a free, 24-week exercise programme" for people having hormone therapy for prostate cancer; you need a referral from your cancer care team, and it currently takes referrals from selected NHS trusts only, so availability varies [8]. See our prostate cancer and exercise guide.
• Online programmes. MOVE Against Cancer offers "a free 8-week one-to-one online support programme for 13-30 year olds living with & beyond cancer"[9]. The South East London Cancer Alliance links to an online module, "Being Active When You're Living With Cancer", available in English and 14 other languages [10].
• Private one-to-one sessions with a clinical exercise physiologist, who assesses you and writes a programme around your treatment [1].

What happens on a cancer exercise programme?

You usually start with an assessment, then attend supervised sessions for a set number of weeks before exercising on your own or in community classes. Length and format vary.

The assessment. Energise says: "Before you start, we'll do a health check and give you more information about the programme" [2]. Prehab4Cancer describes "a full holistic assessment", after which "the exercise specialist will devise a suitable programme for the patient" [11].

The sessions. Energise gives each person a "personalised programme with a mixture of aerobic and resistance exercise", in a gym group "with other cancer patients or people who've had cancer" [2]. Length differs: 12 weeks at North Bristol [4], 24 weeks on Nuffield Health's programme [8] and 26 weeks on PureGym's [7].

The end of the programme. UK prehabilitation guidance says everyone with cancer should be "advised on how to self-manage, recognise and respond to any change in physical and/or psychological state" [12], so ask early what support continues once your block ends. Our guide to exercise after cancer treatment covers the longer term.

Who runs cancer exercise programmes, and who are they for?

Community classes are often run by fitness instructors qualified to help people with cancer exercise safely [1]; some, such as Greater Manchester's Prehab4Cancer, use Level 4 qualified instructors [3]. Registered professionals handle complex needs. They are for people with cancer before, during or after treatment, and each sets its own entry rules.

The 2019 UK guidance from Macmillan, the Royal College of Anaesthetists and the NIHR Cancer and Nutrition Collaboration sorts support into three levels [12]:

• Universal: "applicable to anyone with cancer".
• Targeted: for people with or at risk of late effects, or with other long-term conditions, prescribed "by a registered health and care professional according to need".
• Specialist: for people with "complex needs, complex treatment eg major surgery, severe impairment and/or disability", who "will need referral to registered professionals".

Fitness instructors can deliver targeted support "under delegated authority", but "assessment and prescription (of targeted and specialist interventions) should be undertaken by registered health and care professionals" [12]. Our guide to the cancer rehabilitation team explains each role.

Energise is for people over 16 with a cancer diagnosis and a stable medical condition, in treatment, finished or on maintenance treatment [2]. Prehab4Cancer asks for people aged 18 or over with certain cancers (its referral page lists primary lung, upper gastrointestinal and bowel cancer), offered curative treatment, registered with a Greater Manchester GP and able to get to sessions, alone or with help from a carer or family member [13]. Its pages do not all list the same cancer types [3][13], so check with your team.

How do you get on a cancer exercise programme, and can you self-refer?

It depends on the programme. Some accept self-referral, many need a referral from your cancer nurse specialist, GP or another health professional, and Maggie's centres need no referral at all [5].

Two London examples listed by RM Partners show the difference. At Lampton Leisure in Hounslow, "people can self-refer". Places Leisure's 'Stronger Together Prehab' and 'Stronger Together Rehab' programmes in Kingston and Wandsworth say "a referral will need to be made by a healthcare professional" [15].

Bristol City Council asks you to get your GP, consultant, nurse, physiotherapist or cancer specialist to refer you to Energise [2], and North Bristol NHS Trust says you can also self-refer to Energise at Horfield Leisure Centre [4]. For Prehab4Cancer, "any healthcare professional involved in the person's care can make this referral", ideally your clinical nurse specialist or key worker [13]. Macmillan says hospital prehab referrals can come from your clinical nurse specialist or someone else in your multidisciplinary team, where a service exists [14].

Many work like a general exercise referral scheme, with instructors trained for cancer.

Are there free exercise classes for cancer patients?

Some are. Maggie's centre support [5], MOVE Against Cancer's online programme [9], Prehab4Cancer [3] and Nuffield Health's Cancer Activity Programme [8] are free, and PureGym's prostate programme includes a free year's membership [7]. Other programmes set their own terms, so ask before you join.

How do you find a cancer exercise programme near you?

Start by asking your cancer nurse specialist or treatment team what runs locally. You can also put your postcode into Macmillan's "in your area" search, or use the Cancer Care Map directory of local cancer support.

Macmillan's local search covers "support groups, exercise classes, information centres, financial and benefits advice" [16]. RM Partners describes the Cancer Care Map as "a simple, online resource that can help you find cancer support services including physical activity opportunities in your local area" [15].

If you are looking for a cancer gym near you, ask your local leisure centre too: Energise, for example, runs at Horfield Leisure Centre in Bristol [4].

If you live in London, our page on cancer rehabilitation in London sets out the NHS, charity and community routes there.

What if a group programme isn't right for you?

Ask your oncology team first. If your cancer or treatment makes exercise more complicated, their advice decides what comes next, which may be hospital or specialist NHS support rather than a community class.

UK guidance urges "caution where cancer has spread to bone and during treatment associated with reduced immunity or reduction in normal blood counts", and says that in these situations "the advice of the oncology team should be sought" [12]. People with complex needs "will need referral to registered professionals", and their exercise may need to take place in hospital with medical oversight, for example with physiotherapists [12].

If you have lymphoedema, start with your NHS lymphoedema service. The NHS says a GP may refer you to "a specialist lymphoedema treatment centre" [19]. Our lymphoedema and exercise guide explains more.

For people with late effects of treatment or other long-term conditions, the guidance describes "group exercise or one-to-one support in local community gym setting run by cancer exercise specialists". It lists physiotherapists, "specialised exercise physiologists" and trained cancer exercise fitness instructors among the people who deliver it [12].

An international roundtable found that "exercise training and testing were generally safe for cancer survivors" [18]. Programmes also have limits on who they can take: Energise, for example, excludes people with conditions such as unstable angina or acute heart failure [2].

If side effects are getting in the way, Cancer Research UK says your healthcare team or GP "can refer you to a physiotherapist or another healthcare professional who specialises in working with people with cancer" [17]. Once your oncology team agrees, a clinical exercise physiologist is another option for one-to-one support, especially if no programme runs near you or you don't meet its entry rules. They can assess you and plan around your treatment [1]. The two professions complement each other.

Request a match with a verified clinical exercise physiologist through The Health Nav.

Talk to your oncology team first

Macmillan says: "Before starting any physical activity plan, it is important to talk to a healthcare professional first" [1]. Cancer Research UK advises you to "always speak to your doctor, specialist nurse or GP before starting any activity, especially if you haven't been active for a long time" [17].

Tell your instructor about any change in treatment or new symptoms, and stop if something feels wrong during a session.

Getting matched with a specialist

Your cancer nurse specialist can tell you which programmes are open to you. If there is nothing local, a clinical exercise physiologist can work alongside your NHS team.

Request a match with a verified clinical exercise physiologist through The Health Nav. For the bigger picture, read our overview of cancer rehabilitation in the UK.

This article is general information and does not replace advice from your own healthcare team.

References

1. Macmillan Cancer Support. Physical activity and cancer. Reviewed 1 November 2023. https://www.macmillan.org.uk/cancer-information-and-support/treatment/preparing-for-treatment/physical-activity-and-cancer (accessed 12 Oct 2026)
2. Bristol City Council. Energise cancer rehabilitation exercise classes. https://www.bristol.gov.uk/residents/social-care-and-health/health-and-wellbeing/physical-activity-referral-programmes-for-people-with-health-conditions/energise-cancer-rehabilitation-exercise-classes (accessed 12 Oct 2026)
3. Greater Manchester Moving. Greater Manchester programme using local leisure facilities prepares cancer patients for surgery and helps them recover. https://www.gmmoving.co.uk/outcome-and-result/greater-manchester-programme-using-local-leisure-facilities-prepares-cancer-patients-for-surgery-and-helps-them-recover/ (accessed 12 Oct 2026)
4. North Bristol NHS Trust. Prehabilitation and rehabilitation: exercise programmes. https://www.nbt.nhs.uk/our-services/a-z-services/cancer-care/cancer-prehabilitation-rehabilitation/exercise-programmes (accessed 12 Oct 2026)
5. Maggie's. Our centres. https://www.maggies.org/our-centres/ (accessed 12 Oct 2026)
6. Maggie's. Maggie's Manchester. https://www.maggies.org/our-centres/maggies-manchester/ (accessed 12 Oct 2026)
7. PureGym. Prostate cancer exercise programme. https://www.puregym.com/prostate-cancer/ (accessed 12 Oct 2026)
8. Nuffield Health. Cancer Activity Programme. https://www.nuffieldhealth.com/about-us/our-impact/healthy-life/cancer-activity-programme (accessed 12 Oct 2026)
9. MOVE Against Cancer. https://www.moveagainstcancer.org/ (accessed 12 Oct 2026)
10. South East London Cancer Alliance. Physical activity. https://www.selca.nhs.uk/patients-and-carers/diagnosis-and-treatment/personalising-your-care/health-and-wellbeing-information-and-support/physical-activity (accessed 12 Oct 2026)
11. Prehab4Cancer. Exercise. https://www.prehab4cancer.co.uk/exercise-2/ (accessed 12 Oct 2026)
12. Macmillan Cancer Support, Royal College of Anaesthetists, NIHR Cancer and Nutrition Collaboration. Principles and guidance for prehabilitation within the management and support of people with cancer. 2019. https://cdn.macmillan.org.uk/dfsmedia/1a6f23537f7f4519bb0cf14c45b2a629/1532-10061/prehabilitation-for-people-with-cancer-tcm9-353994 (accessed 12 Oct 2026)
13. Prehab4Cancer. How to refer. https://www.prehab4cancer.co.uk/how-to-refer/ (accessed 12 Oct 2026)
14. Macmillan Cancer Support. Cancer prehabilitation. Reviewed 1 September 2024. https://www.macmillan.org.uk/cancer-information-and-support/treatment/preparing-for-treatment/cancer-prehabilitation (accessed 12 Oct 2026)
15. RM Partners. Physical activity resources for people affected by cancer. https://rmpartners.nhs.uk/our-work/personalised-cancer-care/physical-activity-resources-for-people-affected-by-cancer/ (accessed 12 Oct 2026)
16. Macmillan Cancer Support. Find cancer support services in your area. https://www.macmillan.org.uk/in-your-area (accessed 12 Oct 2026)
17. Cancer Research UK. Exercise guidelines for people with cancer. Reviewed 27 May 2025. https://www.cancerresearchuk.org/about-cancer/coping/physically/exercise-guidelines (accessed 12 Oct 2026)
18. Campbell KL, Winters-Stone KM, Wiskemann J, et al. Exercise guidelines for cancer survivors: consensus statement from international multidisciplinary roundtable. Medicine and Science in Sports and Exercise. 2019;51(11):2375-2390. https://doi.org/10.1249/MSS.0000000000002116
19. NHS. Lymphoedema. https://www.nhs.uk/conditions/lymphoedema/ (accessed 12 Oct 2026)