Moving Safely During Immunotherapy and Targeted Treatments

Immunotherapy and targeted therapies have changed cancer care and opened new options for many people. Immunotherapy helps your own immune system recognize and attack cancer cells by using substances made by the body or in the lab to  boost natural defenses. Targeted therapies act on specific molecules that drive cancer growth. These treatments can sometimes cause fewer “classic” chemotherapy-type side effects, but they bring their own challenges. 

Fatigue, joint, and muscle pain, rashes, and inflammation in the heart, lungs, or other organs can make it hard to know how, or even whether, to exercise. The encouraging news is that many people can move safely on these treatments, and appropriate physical activity may support quality of life and symptoms. The key is individualization and close communication with your care team.​

Why move at all during immunotherapy or targeted therapy?

People on these treatments commonly experience:

• Persistent fatigue and decreased stamina.

• Muscle loss and deconditioning.

• Joint or muscle pain (arthralgia, myalgia).

• Mood changes, sleep problems, and anxiety related to tests, scans and symptoms.​

Physical activity during treatment has been associated with:

• Improved fatigue, physical function, mood, and sleep.​

• Better maintenance of strength and endurance, which supports daily tasks and recovery.

• A greater sense of control and connection to one’s body during a demanding treatment phase.​

Emerging research also suggests that exercise may interact with the immune system in ways that could influence responses to immunotherapy, although the optimal “dose” and timing are still being studied.​

Why immunotherapy and targeted therapy need special attention

Unlike chemotherapy, which primarily targets rapidly dividing cells, immunotherapy and targeted treatments work through the immune system and specific molecular pathways. This means side effects can involve organs and systems that matter for exercise safety, such as:

• Lungs (pneumonitis, inflammation causing cough or shortness of breath).

• Heart (myocarditis, arrhythmias, reduced heart function).

• Joints and muscles (arthritis‑like pain, myositis).

• Gut, liver, endocrine glands, and skin.​

Because of this, new or worsening symptoms can be serious, and your exercise plan should always adapt to what your team sees in your labs, scans, and clinical status.

What safe movement can look like

If your oncology team has cleared you to be active, safe movement during immunotherapy or targeted therapy usually means low‑ to moderate‑intensity exercise that respects day‑to‑day changes. Common examples include:

Aerobic activity

• Walking on flat surfaces, inside or outside, using support if needed.

• Light cycling on a stationary bike if balance is an issue.

• Light to moderate effort on cardio equipment, staying within heart-rate or exertion ranges your team recommends.  

• Body weight movements designed to increase heart rate

• Short bouts of gentle movement spread throughout the day rather than one long session on higher fatigue days.​

Strength and mobility

• Body‑weight or resistance‑band exercises for major muscle groups, adjusted to your energy and joint comfort.

• Weighted movements for strength on days when your energy is higher. 

• Gentle yoga or mobility routines focusing on flexibility and posture, not extreme stretching. Or long holds that aggravate joints or skin. 

Helpful guideposts:

• During light activity, you can talk in full sentences. During moderate effort, you can still speak in short phrases. 

• You feel mildly to moderately tired afterward, but not “wiped out” or sick.

• Most sessions are 10–30 minutes, and can be broken into smaller chunks if needed.​

Symptoms and red flags: what to avoid or stop for

Because these treatments can affect the immune system and multiple organs, there are specific situations where you should stop exercise and call your team urgently:

• New or worsening shortness of breath, chest pain, or heart pounding out of proportion to the effort.

• Severe or sudden joint, muscle, or chest wall pain.

• Fainting, near‑fainting, or feeling like the room is spinning.

• Significant diarrhea, abdominal pain, or blood in the stool.

• Dark urine, yellowing of the skin/eyes, or signs of liver strain.

• Widespread, painful rash, or skin lesions that worsen with movement or heat.​

Your team may also ask you to temporarily pause or reduce activity if you are receiving high‑dose steroids for immune‑related side effects, managing serious infections, or being evaluated for organ inflammation.

Adjusting for fatigue, pain, and “off” days

Even when serious side effects are not present, many people on immunotherapy or targeted therapy describe a fluctuating pattern of:

• “Okay” days when light activity feels manageable or even energizing.

• “Low” days when fatigue, stiffness, or aches make movement harder.​

A safe approach to movement respects that rhythm:

• Lean into movement on better days, within the limits your team sets. 

• Scale down to very gentle movement (or rest) on low days, without guilt.

• Break sessions into shorter bouts if sustained exercise feels overwhelming.

The aim is consistency over perfection—doing something most weeks, even if the amount and intensity changes.

The role of wearables and self‑monitoring

If you use a wearable or app to track steps, heart rate, or sleep, it can help you and your care team see patterns over time:

• Changes in activity or sleep around infusion days.

• Gradual improvements or declines in stamina.

• Days where your recovery signals (like unusually poor sleep, higher resting heart rate, or low ‘recovery/body battery” scores) suggest that a lighter session is wiser.​

Curava uses information such as:

• Your daily fatigue and symptom check‑ins (e.g., joint pain, breathlessness, rash, gut changes).

• Connected wearable data like sleep, resting heart rate, and step counts, when available.​

This allows your plan to shift—suggesting lighter movements or rest on days your body is clearly under more stress, and slightly more activity on days when you feel and look more recovered. 

How Curava supports safe movement on these treatments

Curava is designed specifically for people living with and beyond cancer, including those receiving immunotherapy and targeted therapies. Inside Curava, your experience is built to:

• Start from your treatment context: Onboarding captures your diagnosis, treatment type (including specific immunotherapies and targeted agents), known side effects, and any heart/lung or autoimmune history, and encourages you to confirm exercise recommendations with your oncology team.​

• Adapt to real‑time symptoms and fatigue: Short daily check‑ins ask about fatigue, joint or muscle pain, breathing changes, skin issues, and gastrointestinal symptoms so your plan can be dialed up, modified, or dialed down.

• Use data to back up how you feel: When connected to wearables, Curava takes into account changes in sleep and activity patterns, helping ensure the recommended session matches your recovery that day rather than a rigid schedule.​

• Offer human support when questions arise: A 24‑hour response messaging feature lets you send questions to qualified professionals (such as exercise physiologists and nutrition professionals) so you are not left to interpret new symptoms or concerns on your own. 

Staying active during immunotherapy or targeted treatment is not about pushing through at all costs—it is about moving in a way that respects what your body and your labs are telling you. By combining your oncology team’s guidance with tools like Curava that adjust to your fatigue, symptoms, and recovery, you can usually find a level of movement that feels safe, doable, and genuinely supportive of your treatment and everyday life.