July 2025
Structured exercise may significantly reduce colon cancer recurrence
By Melanie Hinze
Exercise after surgery and chemotherapy for colon cancer can significantly improve survival, enhance quality of life, boost fitness and reduce the risk of both cancer recurrence and the development of new primary cancers, an Australian expert has told Medicine Today.
Dr Janette Vardy, Professor of Cancer Medicine at The University of Sydney, and Medical Oncologist and Director of the Sydney Cancer Survivorship Centre at Concord Repatriation & General Hospital, Sydney, was commenting on her and colleagues’ study that investigated the effect of structured exercise on colon cancer mortality and disease-free survival.
‘Patients often ask what they can do after completing chemotherapy to help prevent the cancer from returning,’ she said, noting that ‘for the first time, we have robust evidence indicating that exercise is extremely beneficial.’
The phase 3, randomised CHALLENGE trial, conducted across 55 centres in six countries, included 889 patients with resected colon cancer and who had completed chemotherapy. Participants were randomised to either a three-year structured exercise program or usual care with health education.
At a median follow up of 7.9 years, disease-free survival was significantly longer in the exercise group. The five-year disease-free survival was 80.3% in the exercise group compared with 73.9% in the health education group. The eight-year overall survival was 90.3% in the exercise group and 83.2% in the health education group.
‘This should prompt a change in our standard care for patients with colon cancer,’ Dr Vardy told Medicine Today. ‘However, the study clearly shows that simply advising people to exercise is not enough – we need to help integrate exercise into their daily routines with a structured exercise program that incorporates a behavioural change component.’
Dr Vardy said these results were also likely to be applicable to individuals with other types of cancer.
‘The study population consisted of patients with stage 3 (and high-risk stage 2) colon cancer, but the findings are likely applicable to individuals with other types of cancer, as the CHALLENGE results suggested lower rates of primary breast and prostate cancer in the exercise group.’
For GPs, Dr Vardy said helping patients with cancer incorporate exercise into their daily lives was therefore crucial.
‘Having a care plan for patients with cancer and referring them to exercise specialists with experience working with patients with cancer is a great place to start, particularly for those who were relatively sedentary prior to their cancer diagnosis,’ she said.
‘The benefits of exercise are extensive, offering minimal risk of side effects. Importantly, it also empowers cancer survivors to direct some of their treatment after completing chemotherapy,’ Dr Vardy added.