A structured exercise regime after cancer treatment can dramatically reduce the risk of dying, the disease returning or a new cancer developing, according to a landmark trial.
As reported in British newspaper The Guardian, the trial found that patients who underwent regulated fitness routines with a personal trainer or health coach after they completed treatment had a 37 per cent lower risk of death and a 28 per cent lower risk of recurrent or new cancers developing, compared with patients who received only health advice.
Results of the trial, which involved patients from the United States, United Kingdom, Australia, France, Canada and Israel, were presented in Chicago at the American Society of Clinical Oncology 2025 annual meeting and published in the New England Journal of Medicine. The Asco event is the world’s largest cancer conference.
Julie Gralow, who was not involved in the study, is the chief medical officer of Asco.
She told The Guardian that the study’s findings would lead to “a major shift in understanding the importance of encouraging physical activity during and after treatment”.
The 90-minute Asco session was titled “Adjunctive Therapies in Colon Cancer: As Good as a Drug?”.
Dr Gralow said: “I would have retitled it ‘Better than a Drug’, because you don’t have all the side-effects.
“It’s the same magnitude of benefit of many drugs that get approved for this kind of magnitude of benefit – 28 per cent decreased risk of occurrence, 37 per cent decreased risk of death. Drugs get approved for less than that, and they’re expensive and they’re toxic.
“When I started three decades ago it was still the era where we’d be gentle and say, don’t overdo yourself when you’re on chemo. We’ve reversed that. I would say [exercise is] better than a drug.”
Exercise is key
The results of the trial have been endorsed by Chris Fosker, chief executive officer and medical director at Bermuda Cancer and Health Centre.
He said: “BCHC is excited to continue to see strong evidence supporting the benefits of exercise for people living with and beyond cancer.
“At BCHC, we have long encouraged physical activity as part of healthy survivorship, and this study adds important evidence showing the benefits of a structured exercise programme with coaching and support.”
Dr Fosker added: “This approach is central to BCHC’s Integrated Wellness Programme, which will help patients incorporate exercise safely and effectively into their lives.
“As the evidence grows, so too does the importance of ensuring these evidence-based support services are accessible to all who can benefit from them.”
In the trial, The Guardian reported, researchers enrolled 889 colon cancer patients between 2009 and 2023, 90 per cent of whom had stage 3 disease. Patients were randomly assigned to take part in a structured exercise programme or to just receive a healthy lifestyle booklet.
Exercise group patients worked with a personal trainer twice a month for coaching sessions and supervised exercise sessions, and later did so once a month, for a total of three years.
The Guardian reported that the exercise group were coached and supported to help them achieve set exercise goals. Their weekly target was the equivalent of three to four walks of between 45 and 60 minutes, but patients could choose how they got more active.
After five years, patients in the exercise group had a 28 per cent lower risk of recurrent or new cancers than those in the other group. After eight years, the same patients also had a 37 per cent lower risk of dying than those who were only handed the healthy lifestyle booklet.
Value of personal trainers
Christopher Booth, the study’s lead author, is a medical oncologist and health services researcher at Queen’s University in Kingston, Ontario. He is a professor of Oncology and Public Health Sciences, holds the Canada Research Chair in Population Cancer Care, and has published 300 peer-reviewed manuscripts in major journals.
Dr Booth said: “After completing surgery and chemotherapy, about 30 per cent of patients with high-risk stage 2 and stage 3 colon cancer will eventually experience recurrence of their disease. As oncologists, one of the most common questions we get asked by patients is ‘what else can I do to improve my outcome?’
“These results now provide us with a clear answer: an exercise programme that includes a personal trainer will reduce the risk of recurrent or new cancer, make you feel better and help you live longer.”
Charles Swanton, a professor and cancer researcher, is the former chief clinician of Cancer Research UK, the charity that funded the UK arm of the study.
A specialist in oncology and cancer research, he is a senior group leader at London’s Francis Crick Institute, Royal Society Napier Professor in Cancer and thoracic medical oncologist at University College London Hospitals.
Professor Swanton told The Guardian: “This fascinating study captures the power of exercise to transform people’s health and boost their chances of surviving cancer after treatment. For an intervention that isn’t a drug, exercise offers remarkable benefits for patients.”
