Physical Exercise & Nutrition

Staying active and eating well aren't luxuries when you have lung cancer; they're powerful tools that can improve how you feel, how you respond to treatment, and your overall quality of life.

Why exercise and nutrition matter

A lung cancer diagnosis often makes people feel they should rest and avoid physical activity. The reality is different. Research consistently shows that appropriate exercise and good nutrition can significantly improve outcomes for people with lung cancer at every stage of treatment. These aren't optional extras; they're evidence-based interventions that work alongside medical treatment to help you feel stronger, manage side effects better, and maintain your independence.

Studies show that exercise reduces fatigue, improves physical function, lessens anxiety and depression, and may even extend survival. Similarly, proper nutrition helps maintain strength, supports your immune system, manages treatment side effects, and improves quality of life.

👉 The key message: Physical activity and nutrition are active parts of your treatment plan, not things to think about "later when you feel better."

The Evidence for Exercise

The research is compelling. A systematic review found that exercise significantly reduced cancer-related fatigue in patients with advanced lung cancer and particularly benefited those under 60 (ScienceDirect, December 2024). The analysis of eight randomised controlled trials involving 749 patients showed meaningful improvements in fatigue, quality of life, and breathlessness.

A landmark 2025 study demonstrated that personalised exercise programmes significantly improved physical function and reduced fatigue in lung cancer patients undergoing surgery, with women showing especially strong benefits (Huntsman Cancer Institute, March 2025). Patients who followed structured exercise plans maintained or improved their fitness, whilst those receiving standard care experienced declines.

Research across multiple cancer types shows that men with lung cancer who maintained physical activity after diagnosis reduced their risk of death by 18-23% (Cancer Epidemiology, Biomarkers & Prevention, 2025).

What Exercise Can Do for You

Before treatment (prehabilitation):

  • Improves fitness levels going into surgery or treatment

  • Reduces risk of complications

  • Shortens hospital stays

  • Speeds recovery time

During treatment:

  • Manages fatigue (counterintuitive but true)

  • Reduces anxiety and depression

  • Maintains muscle mass and strength

  • Improves sleep quality

  • Helps manage treatment side effects

After treatment:

  • Supports recovery and rehabilitation

  • Reduces risk of recurrence

  • Improves long-term quality of life

  • Helps rebuild strength and stamina

Types of Exercise to Consider

No single exercise prescription fits everyone. Your programme should match your current fitness level, treatment stage, and any limitations you have. Three main types work together:

  • Aerobic exercise (activities that raise your heart rate): Walking is the most accessible and effective option for most people. Other options include cycling, swimming, or gentle dancing. Start with what you can manage, even if it's just five minutes at a time.

  • Resistance training (activities that build muscle): Using light weights, resistance bands, or your own body weight helps maintain muscle mass that treatment can deplete. This might include chair exercises, wall press-ups, or lifting light tins of food.

  • Flexibility and balance: Gentle stretching, yoga, or tai chi help maintain range of motion and prevent falls. A 2024 study found that tai chi helped people with advanced lung cancer sleep better and feel less fatigued (JAMA Oncology).

Start slowly and build gradually. If you're new to exercise or haven't been active recently, begin with short sessions and increase duration and intensity over time. Five minutes of walking is better than none.

The Evidence for Nutrition

Proper nutrition during lung cancer treatment isn't about following a "cancer diet." It's about maintaining your strength, managing side effects, and supporting your body through treatment. Research shows that dietary counselling helps maintain body weight and enhances treatment responses in lung cancer patients (Journal of Clinical Medicine, September 2024).

A comprehensive 2023 systematic review found that increased energy and protein intake was strongly associated with improved quality of life, functional outcomes, and performance in lung cancer patients. The research also showed that omega-3 fatty acids may reduce inflammation and chemotherapy toxicity (Nutrients, March 2023).

Malnutrition is common in lung cancer patients and harms treatment outcomes, quality of life, and survival. Around 50% of lung cancer patients experience appetite loss and many experience unintentional weight loss. However, good nutrition can counter these effects.

What Good Nutrition Can Do for You

Maintain strength and energy:

  • Adequate calories and protein help preserve muscle mass that cancer and treatment can deplete. This keeps you stronger and more able to carry out daily activities.

Support your immune system:

  • Proper nutrition provides the vitamins, minerals, and nutrients your immune system needs to function well during treatment.

Manage side effects:

  • Strategic food choices can help with nausea, constipation, taste changes, and other treatment side effects. Eating well can make treatment more tolerable.

Improve treatment outcomes:

Well-nourished patients tend to respond better to treatment, experience fewer complications, and recover more quickly.

What to Eat

Lean protein helps tissues repair and provides energy. Good sources include fish (particularly oily fish rich in omega-3s), chicken, turkey, eggs, beans, lentils, tofu, Greek yoghurt, and nuts. Aim to include protein with every meal.

Fruits and vegetables provide vitamins, minerals, and antioxidants that support your body's defences. Aim for a variety of colours. Studies show that vitamin C, vitamin A, vitamin E, selenium, and zinc can strengthen the body's antioxidant defences. Good choices include berries, citrus fruits, leafy greens, carrots, tomatoes, and cruciferous vegetables like broccoli.

Whole grains provide energy through fibre and carbohydrates. Choose wholemeal bread, brown rice, oats, quinoa, and whole grain pasta. These also contain antioxidants that may help fight disease.

Healthy fats reduce inflammation and improve nutrient absorption. Omega-3 fatty acids found in oily fish (salmon, mackerel, sardines), walnuts, flaxseeds, and chia seeds have particular benefits for lung cancer patients. Olive oil and avocados also provide beneficial fats.

Stay hydrated: Drink plenty of water throughout the day, particularly if you're experiencing side effects like diarrhoea or vomiting.

Managing Common Eating Challenges

  • Loss of appetite: Eat small, frequent meals rather than three large ones. Choose nutrient-dense, calorie-rich foods. Don't wait until you feel hungry.

  • Nausea: Eat bland, easy-to-digest foods. Ginger, peppermint, and citrus can help. Avoid fatty, fried, or very sweet foods. Eat slowly and rest after meals with your head elevated.

  • Taste changes: Experiment with different seasonings and marinades. Use plastic utensils if food tastes metallic. Try adding lemon juice or pickles for more flavour.

  • Sore mouth or throat: Choose soft, moist foods. Avoid acidic, spicy, or rough-textured foods. Smoothies, soups, and scrambled eggs may be easier to manage.The research is compelling.

What should I know about physical exercise and nutrition?

  • This is the most common concern, but research consistently shows the opposite. Exercise actually reduces cancer-related fatigue rather than increasing it. Start gently and build gradually. You may feel tired immediately after activity, but overall energy levels typically improve with regular exercise. The key is finding the right balance for you.

  • Breathlessness is common with lung cancer, but appropriate exercise can actually improve it. Start with very gentle activity like slow walking for just a few minutes. Pulmonary rehabilitation programmes teach breathing techniques and exercises specifically designed for people with lung problems. Many find their breathing improves with structured exercise under professional guidance.

  • No. There's no specific "cancer diet" that will cure lung cancer or replace medical treatment. Focus on eating a balanced, varied diet rich in fruits, vegetables, lean protein, and whole grains. Avoid restrictive diets or unproven "cancer-fighting" foods unless recommended by your doctor. Good general nutrition is what your body needs during treatment.

Here we answer some of the most common questions - from feeling too breathless for exercise to losing your appetite!

  • Weight loss is common but concerning. Eat small, frequent meals throughout the day rather than three large meals. Choose calorie-dense, protein-rich foods like nut butters, full-fat dairy, eggs, and smoothies. See a dietitian who can suggest high-calorie supplements if needed. Sometimes appetite-stimulating medication can help, so discuss this with your doctor.

  • This depends on how you feel and what treatment you're receiving. Many people can do gentle activity on treatment days, whilst others need rest. Listen to your body and adjust accordingly. On chemotherapy days, you might manage a short walk. On recovery days, you might feel able to do more. There's no one-size-fits-all answer.

  • Not necessarily, and some may actually interfere with treatment. High-dose antioxidant supplements can potentially reduce the effectiveness of chemotherapy and radiotherapy, which work partly by creating oxidative stress in cancer cells. Always tell your doctor about any supplements you're taking. Get nutrients from food when possible, and only take supplements if recommended by your healthcare team.

Exercise Guidance

Talk to your healthcare team first

Get clearance before starting any exercise programme, particularly if you have bone metastases, low blood counts, breathlessness, or recent surgery.

Start where you are

If you've been inactive, begin with short sessions of gentle activity. Even five minutes of walking counts. Gradually increase duration and intensity as you're able.

Listen to your body

Some fatigue after exercise is normal, but you shouldn't feel exhausted. If you experience chest pain, severe breathlessness, dizziness, or unusual symptoms, stop and contact your doctor.

Be consistent rather than intense

Regular moderate activity is better than occasional vigorous exercise. Aim for movement most days, even if it's gentle.

Consider supervised programmes

Many cancer centres offer exercise programmes specifically designed for people with cancer. Physiotherapists can create personalised plans.

Nutrition Guidance

Work with a dietitian

Ask your healthcare team for a referral to a registered dietitian who specialises in cancer care. They can create a personalised plan based on your specific needs, treatment, and side effects.

Don't restrict unnecessarily

Unless advised by your doctor, you don't need to follow restrictive diets or eliminate entire food groups. Focus on eating well, not eating less.

Avoid unproven supplements

Always check with your doctor before taking any supplements, as some can interfere with cancer treatment. Get nutrients from food when possible.

Practice food safety

During treatment, your immune system may be weakened. Wash hands and produce thoroughly, cook meat properly, avoid unpasteurised dairy, and skip foods from salad bars.

Why Your Gut Microbiome Matters

The Gut-Lung Connection

Scientists have discovered something remarkable: the trillions of bacteria living in your digestive system can significantly influence your lung health and how well you respond to lung cancer treatment. This relationship, known as the gut-lung axis, represents a two-way communication system between your intestinal and respiratory systems.

The research is compelling. Studies have found that beneficial gut bacteria including Bifidobacterium, Akkermansia, and Faecalibacterium can enhance immunotherapy effectiveness by producing beneficial metabolites that support immune responses. Clinical trials have shown improvements in treatment response rates of around 10-15% when probiotic supplements were used alongside immunotherapy. Remarkably, research from MD Anderson Cancer Center showed that lung cancer patients on high-fibre diets achieved immunotherapy response rates of 77% compared to just 29% in control groups.

Large-scale studies of over 1.4 million adults found that high dietary fibre and yogurt consumption were associated with reduced lung cancer risk, with yogurt consumption linked to up to 30% risk reduction.

What a Healthy Gut Microbiome Can Do

Your gut houses approximately 70% of your immune system. A healthy, diverse gut microbiome can improve treatment effectiveness, reduce side effects like chemotherapy-induced diarrhoea, and support immune function. Gut bacteria produce short-chain fatty acids through fibre fermentation, which influence immune responses and inflammation throughout your entire body, including your lungs.

Supporting Your Gut Health

Foods that help:

  • High-fibre foods: Whole grains (oats, brown rice, quinoa), legumes (beans, lentils), vegetables (leafy greens, broccoli), fruits (berries, apples), and nuts and seeds

  • Fermented foods: Natural yogurt with live cultures, kefir, sauerkraut, kimchi, and kombucha increase gut microbiome diversity and decrease inflammation

  • Prebiotic foods: Onions, garlic, leeks, asparagus, and bananas feed your beneficial gut bacteria

What can harm your gut:

Research shows that unnecessary antibiotic use can negatively impact treatment outcomes by disrupting the gut microbiome. This doesn't mean avoiding antibiotics when medically necessary, but it's worth discussing with your doctor whether they're truly needed. Diets high in processed foods, saturated fats, and added sugars should be consumed in moderation.

Practical steps:

Start small—add one or two servings of high-fibre foods daily or include natural yogurt each day. Aim for variety: eating 30 different types of plants per week helps build a diverse gut microbiome. Always discuss probiotic supplements with your healthcare team before starting them, as certain strains like Bifidobacterium and Clostridium butyricum have shown promise when used alongside cancer treatment.