Study: Exercise may delay the return of colon cancer and help people live longer

RELEVANCE

Most relevant for: People diagnosed with early colon cancer.

It may also be relevant for:

• people with colorectal cancer
• people newly diagnosed with cancer
• people in treatment for cancer

Relevance: High

Strength of Science: High

More rating details

What is this study about?

This study explores whether exercise can improve outcomes for colorectal cancer patients who have already completed cancer treatment. The study included 889 participants who:

• were diagnosed with stage 3 and high-risk stage 2 colon cancer
• had completed surgery and chemotherapy at least 6 months before, and no more than two years before, study enrollment
• reported that they exercised less than 150 minutes each week

The participants were randomly assigned to two groups:

• Health education group participants were given information about exercise and nutrition but not a specific exercise plan.
• Exercise group participants received the same educational information as the health education group, as well as an exercise guidebook for colorectal cancer survivors, access to support meetings for behavior modification and supervised exercise sessions.
  • The exercise program included moderate intensity activities, such as brisk walking.
  • Participants were allowed to choose their own exercise routines and schedules, as long as they met the activity goals of the program.

Researchers followed participants for nearly eight years and tracked if cancer came back, if a new cancer appeared, and how long participants lived overall.

Why is this study important?

Prior research suggested that exercise can help people with cancer feel better, both physically and mentally. In particular, exercise can reduce fatigue from cancer treatment and improve quality of life (read our prior XRAY on this topic, here). However, a direct test of whether exercise can improve colorectal cancer outcomes had not been done before this 2025 study.

This study suggests that exercise, done regularly and at moderate intensity, can slow down or prevent the return of colorectal cancer and help people live longer. These findings will likely lead to similar studies of other cancers and may change colorectal cancer care guidelines to include stronger and more specific guidance about exercise.

Study findings

Overall, the study found that those who completed the structured exercise program lived longer without cancer growth than people who received only health education over the same three-year period.

Key findings after 8 years of follow-up include:

• People in the exercise group were 28% less likely to experience a return of colorectal cancer or to develop a new cancer.
  • Eight years after completing the study, 90% of people in the exercise group were still living, compared to 83% in the health education group.
• People in the exercise group showed a greater increase in physical activity than those in the health education group (although physical activity increased for both groups).
  • The exercise group’s increased activity was similar to adding 45-60 minutes of brisk walking or 25-30 minutes of jogging, three to four times/week according to the researchers.
• People in the exercise group showed improved fitness, measured in several ways, including:
  • the distance participants could walk in 6 minutes
  • the measurement of participants’ lung function (called VO2 max)
• People in the exercise group did not lose weight or change waist size. This suggests that the improved outcomes were not due to weight loss.
• People in the exercise group were more likely than the health education group (18.5% versus 11.5%) to experience muscle- or bone-related side effects (for example muscle pain).

Limitations

While this study shows promising results, here are a few details to consider.

• Some participants assigned to the health education group also increased their physical activity levels. The researchers point out that the benefits of exercise as demonstrated in this study might have been even stronger if the exercise group had been compared to people who did not exercise at all.
• This study did not explain how exercise may affect cancer outcomes. Health improvements may be related to better immune function, lower inflammation or changes in insulin levels, but more detailed research is needed to know for sure.
• The study did not report information about participants’ race, ethnicity or genetic status, so it is unknown how these findings apply to all groups.
• Patients with stage 1 or metastatic colorectal cancer were not included in this study, so the impact of exercise for these groups is unclear.
• People whose cancer returned within a year of their surgery were excluded from the study. This may have excluded people with more aggressive forms of cancer.
• The study enrolled patients for 15 years. The authors state that there was no substantial changes in the intervention other than change in chemotherapy from 6 month to 3 month (that would affect both exercise and health education groups similarly).
• The exercise group had more social interaction in the form of mandatory behavioral support groups and supervised exercise activities. The researchers cannot rule out some benefit from this contact such as stress reduction or coping strategies rather than exercise directly.

If you have been treated for colorectal cancer, this study suggests that regular, moderate-intensity exercise can make a positive difference in your long-term health. Prior research has shown that exercise can improve overall well-being for people with cancer, but this study is the first to show that exercise may also help improve survival and reduce the chance of cancer coming back.

The participants of this study who benefited from exercise completed a structured exercise program that included behavioral changes and consistent moderate to vigorous exercise, such as brisk walking or jogging.  Participants also had support to help them stay on track. If you are considering this type of routine, start by talking with your doctor, a physical therapist or other exercise professional who can help you set appropriate goals for your health and fitness levels.

This study focused on people with stage 2 or 3 colorectal cancer. If you have a different stage or type of cancer, talk with your doctor about what exercise plan may be beneficial to you.

Reference

Courneya KS, Vardy JL, O’Callaghan CJ, et al. Structured exercise after adjuvant chemotherapy for colon cancer. New England Journal of Medicine. 2025; 393(1): 13-25.

Disclosure: FORCE receives funding from industry sponsors, including companies that manufacture cancer drugs, tests and devices. All XRAYS articles are written independently of any sponsor and are reviewed by members of our Scientific Advisory Board prior to publication to assure scientific integrity.

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posted 11/05/25