Exercise program improved colon cancer survival in trial

A supported exercise program for colon cancer survivors improved the time participants lived without recurrent or new cancer and their overall survival in a randomized trial reported by the American Society of Clinical Oncology. The findings apply to people with high-risk stage II or stage III colon cancer who had already completed surgery and chemotherapy, rather than to all cancers or stages.

The international CHALLENGE trial enrolled 889 people in six countries between 2009 and 2023. Most had stage III disease, and all had undergone surgery intended to cure their cancer followed by adjuvant chemotherapy, ASCO said.

Does exercise improve colon cancer survival?

In this trial, the answer was yes for the defined group studied. At five years, 80% of participants assigned to the exercise program were alive without recurrent or new cancer, compared with 74% of those given health education materials; ASCO reported a 28% lower risk of recurrence or a new cancer in the exercise group.

At eight years, overall survival was 90% among people assigned to the program and 83% in the education group. There were 41 deaths in the exercise group and 66 in the comparison group, corresponding to a reported 37% lower risk of death with the program.

What the program involved

Participants were randomly assigned either to three years of individualized, supported physical activity or to materials encouraging physical activity and healthy nutrition. Both groups continued to receive standard cancer surveillance and follow-up care, according to ASCO.

The activity plans were tailored to participants and could include moderate-intensity activity such as brisk walking, with behavioral support and supervised exercise sessions, according to Facing Our Risk of Cancer Empowered. The trial tested a structured program with ongoing support, not one universal workout plan or exercise dose.

Risks and limits of the findings

Musculoskeletal adverse events, including injuries such as strains or fractures, occurred in 19% of people in the structured-exercise group and 12% of those receiving health education materials, ASCO reported. It said 10% of adverse events in the exercise group were related to taking part in the program.

The evidence does not show the same benefit for stage I colon cancer, metastatic disease or cancers other than colon cancer. Facing Our Risk of Cancer Empowered also noted that some people in the education group became more active, while the added contact and support received by the exercise group could have affected results.

Exercise was used after standard treatment, not in place of it. People considering a new activity plan during or after cancer care should discuss an individualized approach with their clinical team.

This story draws on original reporting from Medical Xpress.