On June 10, 2025, a groundbreaking study was published online in The New England Journal of Medicine, pointing out a new direction for the post-operative rehabilitation of colon cancer patients. This study was released at the American Society of Clinical Oncology Annual Meeting held in Chicago, confirming that patients who underwent colon cancer resection and completed adjuvant chemotherapy, if adhering to a three-year structured exercise program, could significantly prolong the disease-free survival period. Dr. Kerry S. Courneya from the University of Alberta led an international team that used nearly eight years of follow-up data to prove that exercise is not only a healthy lifestyle but also a “prescription” against cancer recurrence.
How does exercise rewrite survival data?
This 3-phase randomized trial covering 55 medical centers divided 889 patients who had undergone colon cancer resection and completed adjuvant chemotherapy into two groups: 445 patients entered the structured exercise group, receiving a customized plan including 150 minutes of moderate-intensity aerobic exercise (such as walking, swimming) and two strength training sessions per week; 444 patients were in the control group, only receiving health education materials. After a median follow-up of 7.9 years, the exercise group delivered an astonishing result: the disease-free survival period was significantly prolonged, the risk of disease recurrence, new cancer or death was reduced to 0.72, the 5-year disease-free survival rate reached 80.3%, which was 6.4 percentage points higher than that of the control group (73.9%). More encouraging is the overall survival data: the 8-year survival rate of the exercise group was 90.3%, a 37% lower mortality risk (risk ratio 0.63) compared to the control group (83.2%). “This means that for every 100 patients who persist in exercising, 7 more lives can be saved within 8 years.” The survival curve presented by Courneya at the press conference elicited applause from the audience. Although the incidence of musculoskeletal adverse events in the exercise group (18.5%) was slightly higher than that in the control group (11.5%), the research team found that exercise could exert protective effects through multiple mechanisms. Imaging analysis showed that the rate of skeletal muscle mass loss in the exercise group slowed down by 41% after surgery, and muscles, as “immune regulators”, secrete myokines that can enhance the activity of natural killer cells.
“We detected elevated levels of anti-inflammatory factors such as IL-15 in the blood of patients in the exercise group, which may inhibit the pro-inflammatory response in the tumor microenvironment.” explained co-author Dr. Sarah Dodd. It is worth noting that the study specifically designed an “exercise dose-effect” analysis: patients who completed ≥120 minutes of aerobic exercise per week had a 52% lower risk of recurrence compared to those with less than 60 minutes, showing a clear dose-dependent relationship. This provides a quantitative basis for clinical formulation of personalized exercise prescriptions. “The trial proved that the benefit-risk ratio of structured exercise was significant, but getting patients to move requires systematic support.” The authors in the paper called for the health system to break away from the “knowledge dissemination” model and shift to behavior intervention. Currently, 17 cancer centers in Canada have incorporated this exercise program into the post-operative rehabilitation pathway, including equipping exercise physiologists and developing mobile app-based tracking systems. Lisa Newton, the director of the Oncology Rehabilitation Department at the University of Chicago Medical Center, demonstrated the “chemotherapy period exercise connection plan” designed by her team: “We initiated the exercise intervention 2 weeks before the last chemotherapy session, increasing the compliance rate to 78%.” However, promotion still faces challenges: low-income groups, due to factors such as lack of access to gyms and inconvenient transportation, have a lower exercise persistence rate than affluent groups by 35%. Courneya’s team is developing low-cost community-based exercise models, such as group classes in parks and at-home resistance band training.
As the ASCO annual conference designated this study as the “Breakthrough of the Year”, the National Comprehensive Cancer Network (NCCN) has initiated a guideline revision process. “This might be the first non-drug intervention measure to be proven through a Phase III trial to have an impact on survival outcomes,” commented Dr. Mark Kris, a member of the NCCN guideline committee. In the future, it may be required that all patients after colon cancer surgery receive “an exercise assessment and plan upon discharge”.At the conference in Chicago, a participant in the trial shared her story: “The doctor said my 5-year survival rate after surgery was only 60%, but now it’s the 8th year and I’m still running a half marathon.” The exercise log she showed was densely filled with the training tracks over the past three years – this survival answer written by data and sweat might be redefining the possibility of cancer recovery.
Related Topics:
