The first large-scale clinical trial results have shown that exercise lowers the risk of cancer recurrence and mortality. Until now, exercise has been recommended as an adjunct to treatment, but it has been demonstrated that it is more effective in disease prevention than medication.
Christopher Booth, a professor of oncology at Queen's University in Kingston, Canada, noted on the 1st (local time) during the American Society of Clinical Oncology (ASCO) meeting in Chicago that "the results of a three-year exercise program for patients with stage 3 colorectal cancer confirmed that exercise reduces the mortality risk for cancer patients by one-third and is more effective than various medications in preventing cancer recurrence and death." The findings of this study were published in the international journal The New England Journal of Medicine (NEJM) on the same day.
The clinical trial involved 889 patients with stage 3 colorectal cancer across six countries, including the U.S., the U.K., Australia, France, Canada, and Israel, from 2009 to 2023. The patients were divided into two groups: half, or 445 patients, participated in a structured exercise program with a personal trainer 1 to 2 times a month for three years, while the remaining 444 patients were only given a brochure containing general health care methods.
The exercise program included activities such as walking for 1 hour, 3 to 4 times a week. After conducting the three-year exercise program and following up for five years, it was found that the exercise group had a 28% lower risk of cancer recurrence or the occurrence of new cancers compared to the other group. By the end of eight years, the mortality risk had decreased by 37%.
Professor Booth said, "Among 10 patients with stage 2 or 3 colorectal cancer who have completed surgery and chemotherapy, 3 typically experience recurrence," adding that "there is now strong clinical evidence that exercise can practically improve the prognosis of patients with a high likelihood of recurrence."
Healthcare professionals worldwide have long recommended exercise for cancer patients, but there has been a lack of solid evidence. This study is significant as it fills that gap. Julie Gralow, chief medical officer (CMO) of ASCO, stated, "The findings of this study provide top-level evidence of how important exercise is in the cancer treatment process," and noted that "encouraging physical activity right after cancer treatment will significantly change clinical practice in the future."
He said, "Exercise has no side effects, unlike medications, and has less expense while being even more effective." Gralow also mentioned that since this clinical trial focused solely on patients with colorectal cancer, similar studies are needed for other types of cancer, such as breast and prostate cancer.
Stephen Powis, national medical director of the National Health Service (NHS) England, stated, "Exercise provides various benefits such as maintaining a healthy weight, boosting immunity, reducing inflammation, and improving mood," adding that "this study clearly demonstrates that exercise significantly helps improve cancer survival rates."
Of course, cancer patients should first consult with healthcare professionals about exercise. This study was conducted with the support of Cancer Research UK. Charles Swanton, a chief clinician at the institute, remarked, "It is clear that exercise positively impacts cancer patients, but it should not be applied uniformly to all patients," emphasizing that "consultation with healthcare providers is essential before starting an exercise program."
References
The New England Journal of Medicine (2025), DOI: https://doi.org/10.1056/NEJMoa2502760