New Study Shows Exercise Improves Survival in Colon Cancer Patients

Colorectal cancer rates are rising in the U.S., especially in adults under the age of 50. As a result, there is increasing focus on ways to improve early detection, strengthen treatment strategies, and reduce the risk of recurrence. Unfortunately, 20–40% of patients with stage III colorectal cancer still experience disease recurrence, even after surgery and chemotherapy. A new study published in The New England Journal of Medicine and presented at the American Society of Clinical Oncology (ASCO) annual meeting provides the strongest evidence to date that regular exercise can help prevent colorectal cancer recurrence and improve survival. These findings support the growing body of research showing that lifestyle changes, especially consistent physical exercise, can be a powerful tool for cancer survivors, alongside medical therapies.

At Private Health Management (PHM), our researchers and clinicians stay current on the latest cancer advances and guide patients in choosing the treatments and lifestyle strategies that will best support their recovery.

Study overview

The findings come from a Phase 3, randomized, controlled study called the CHALLENGE trial, which was conducted by researchers at institutions across the U.S. and Canada.¹ Nearly 900 patients with stage III colon cancer who had completed surgery and chemotherapy were randomly assigned into either an exercise group or a control group. The exercise group focused primarily on cardiorespiratory fitness by following a structured, home-based walking program, gradually increasing to 150 minutes per week of moderate to vigorous intensity activity, spread over at least 5 days. Researchers followed the participants for a median of 3.5 years, and outcomes measured included disease-free survival, overall survival, and health-related quality of life.

Key results

• In the exercise group, more patients were alive and cancer free:
– 80.3% of patients remained alive and cancer-free at 5 years follow-up in the exercise group, while in the control group, this value was 73.9%. This difference was statistically significant.
– 90.3% of patients were alive at 8 years follow-up in the exercise group, while in the control group, 83.2% were alive, which was also strongly significant.

• Benefits were observed regardless of age, sex, or baseline physical fitness.

• Participants reported improved quality of life, less fatigue, and better physical functioning.

Importantly, adherence to the exercise program was high, and side effects were minimal, showing that moderate exercise is both feasible and safe for cancer survivors. The control group, who received health education, also improved their physical conditioning and likely benefitted, though less than the exercise group, who had more structured training. This suggests that exercise may have an even stronger effect on cancer outcomes. The authors proposed that exercise may improve outcomes by reducing inflammation, enhancing immune function, improving insulin sensitivity, and boosting circulation, all of which may help prevent tumor regrowth. These findings align with previous observational studies and emerging laboratory evidence on the biological effects of exercise during and after cancer treatment.^2–5

Current guidelines recommend exercise for patients with cancer

ASCO guidelines recommend both aerobic and resistance exercise during cancer treatment, especially for patients receiving curative therapy or living long-term with metastatic disease.⁶ These recommendations are based on earlier studies that observed how exercise seemed to help patients with cancer feel and function better during treatment. Studies have suggested that physical activity can help maintain strength and fitness, improve mood and sleep, and reduce side effects, such as fatigue, pain, muscle loss, and weight changes.^6–8 However, these findings were mostly from studies that noticed patterns but didn’t prove cause and effect. The recent CHALLENGE trial adds powerful new evidence by directly testing whether exercise can improve survival and reduce recurrence in colon cancer, and the results clearly showed that it can.

The American College of Sports Medicine advises most cancer patients to engage in:⁹

• Aerobic activity: 2–3x/week for 30 minutes (e.g., walking, cycling)
• Resistance training: 2–3x/week using body weight or light weights
• These routines should be adjusted based on the individual’s fitness, treatment stage, and health conditions. Patients should consult their care team before starting a new program and begin gradually.

The bottom line

This high-quality study provides strong evidence that regular exercise, such as walking 30 minutes a day, can improve survival outcomes in colon cancer patients. These findings, supported by existing guidelines and biological evidence, reinforce the importance of movement as a low-cost, low-risk, high-benefit strategy and supports the incorporation of exercise as part of the standard of care in cancer survivorship plans.

References

1. Courneya, K. S. et al. Structured Exercise after Adjuvant Chemotherapy for Colon Cancer. N Engl J Med (2025) doi:10.1056/NEJMoa2502760.
2. Mechanisms of Exercise in Cancer Prevention, Treatment, and Survivorship | SpringerLink. https://link.springer.com/chapter/10.1007/978-3-030-42011-6_4.
3. LaVoy, E. C. et al. T‐cell redeployment and intracellular cytokine expression following exercise: effects of exercise intensity and cytomegalovirus infection. Physiological Reports 5, (2017).
4. An Exercise-Induced Metabolic Shield in Distant Organs Blocks Cancer Progression and Metastatic Dissemination | Cancer Research | American Association for Cancer Research. https://aacrjournals.org/cancerres/article/82/22/4164/710131/An-Exercise-Induced-Metabolic-Shield-in-Distant.
5. Schadler, K. L. et al. Tumor vessel normalization after aerobic exercise enhances chemotherapeutic efficacy. Oncotarget 7, 65429–65440 (2016).
6. Ligibel, J. A. et al. Exercise, Diet, and Weight Management During Cancer Treatment: ASCO Guideline. Journal of Clinical Oncology (2022) doi:10.1200/JCO.22.00687.
7. Visovsky, C. & Dvorak, C. Exercise and Cancer Recovery. Online J Issues Nurs 10, (2005).
8. Mok, J., Brown, M.-J., Akam, E. C. & Morris, M. A. The lasting effects of resistance and endurance exercise interventions on breast cancer patient mental wellbeing and physical fitness. Sci Rep 12, 3504 (2022).
9. Campbell, K. L. et al. Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable. Medicine & Science in Sports & Exercise 51, 2375 (2019).