New Study: Structured Exercise Improves Colon Cancer Survival Rates

A recent study may have finally provided a definitive answer to a critical piece of the colon cancer puzzle: whether exercise improves survival after treatment. In a first-of-its-kind study, patients who had undergone a colon resection with chemotherapy were assigned to two distinct study groups.

The first group received exercise and nutrition information but no direct guidance from a lifestyle coach. The second group received active consultation and training, with two to three visits per month in the first year, followed by monthly visits thereafter. Patients received this treatment for three years and were followed for a total of five years.

After five years, a clinically significant difference in survival rates was observed between the two patient groups:

• Active Coaching Group: ~80% survival rate.
• Self-Directed Group: ~74% survival rate.

The study clearly showed that a structured exercise program was more effective than self-directed guidance. While the exact biological mechanisms explaining why exercise and diet make such a difference in new or recurring cancer are still being researched, the correlation has been observed for a long time.

This data is timely, as the incidence of colon cancer has increased shockingly, especially in younger cohorts. We are seeing an alarming rise in cancer diagnoses and colon cancer deaths in demographics we wouldn’t have commonly seen just a few decades ago. The incidence and severity of colon cancer seem to follow the increased prevalence of obesity and sedentary lifestyles in modern society. This study confirms that returning to healthy lifestyle habits can significantly improve post-cancer treatment outcomes [1, 2].

Important notes regarding the study:

• Participants who worked with a coach were significantly more likely to follow the nutritional guidelines set for them.
• Interestingly, there was no significant difference between the two cohorts in the amount of weight loss over the duration of the study.
• The primary differentiator was the survival rate: 80% in the counseling group versus 74% in the control group.

Dr. Crean’s Take on This Research

When I started practicing in colorectal health, colon cancer was primarily considered a disease of older age. We certainly did have anomalies where younger patients would present with cancer, sometimes severe. However, in part because of the increase in obesity over the past generation, this earlier onset of cancer is becoming the norm rather than the exception. Indeed, many other forms of cancer are becoming more prevalent in the United States following this same trend.

A significant part of our metabolic health depends on improving our diet and exercise habits. This helps with insulin sensitivity and reduces systemic inflammation. While not directly referenced in the study, I would argue that the increase in cancers and obesity in the U.S. is also partly attributed to a societal shift in stress levels. We have never been as stressed as we are today as a country, and stress can cause systemic inflammation. Of course, a proper diet and exercise are key components of stress management, lending further credence to the results of this study [3].

References & Further Reading

1. Brown, J. C., et al. (2018). “Physical Activity in Stage III Colon Cancer: IMPACT Results.” Journal of Clinical Oncology. (Demonstrates the association between physical activity and improved disease-free survival in stage III colon cancer patients).
2. Meyerhardt, J. A., et al. (2006). “Impact of Physical Activity on Cancer Recurrence and Survival in Patients With Stage III Colon Cancer: Findings From CALGB 89803.” Journal of Clinical Oncology. (Foundational study establishing the link between exercise and reduced recurrence).
3. National Cancer Institute (NCI). “Obesity and Cancer.” (Explains the biological mechanisms linking inflammation, insulin sensitivity, and cancer progression).