Keeping Active Saves Lives: Exercise Improves Survival in Colon Cancer Patients

A large-scale international study published in the New England Journal of Medicine has confirmed that supervised physical exercise not only lowers the risk of cancer recurrence but also enhances overall survival in colon cancer patients. This is the first strong evidence supporting physical activity as an effective complementary treatment following chemotherapy. 

Strong results after 8 years of follow-up 

The clinical trial, carried out between 2009 and 2024, included 889 participants diagnosed with high-risk stage II or III colon cancer. All had undergone surgery and completed chemotherapy between 2-6 months prior to inclusion. Patients were randomly assigned to two groups: one group (445 people) followed a supervised physical exercise programme, while the other (444 people) received only general information on healthy lifestyles, with no specific programme or follow-up. 

With an average follow-up period of 7.9 years, the results showed a clear difference between the groups: 

Five-year disease-free survival was 80.3% in the exercise group, compared with 73.9% in the control group. This represents a 28% reduction in the risk of relapse or death. 

Eight-year overall survival was also higher in the physically active group: 90.3%, compared with 83.2% in the group that received only health education.

A structured exercise programme 

The physical activity programme lasted 3 years and aimed for a weekly target of 150 minutes of moderate- to high-intensity exercise. Activities included face-to-face and virtual sessions led by accredited physiotherapists. 

Beyond its impact on survival, the active group showed significant gains in physical capacity, including improved oxygen uptake and better performance in the six-minute walk test. There was also an improvement in physical quality of life, with an increase of 7 points on the SF-36 scale, a self-assessment questionnaire completed by the patient. 

Adverse effects were generally mild, mostly involving musculoskeletal issues, and only 10% were directly linked to exercise. 

Experts such as Dr Joan Maurel, coordinator of the colorectal cancer committee at the Clínic, remarked: “The impact of exercise on survival is comparable to that of some adjuvant drugs, but without the added toxicity.” 

Moreover, Dr Francesc Balaguer, Head of the Gastroenterology Department at the Clínic, states that “colon cancer is strongly influenced by environmental factors. That’s why it’s essential to follow a Mediterranean diet rich in fibre, maintain regular physical activity, and avoid harmful habits such as smoking and alcohol consumption.” 

The challenge of bringing it into clinical practice 

These findings highlight the need for a change in the management of cancer patients. The importance of incorporating supervised exercise into post-chemotherapy recovery plans has now been confirmed, along with the need for more physiotherapists and exercise specialists. 

This study reinforces the idea that "movement is medicine". Structured exercise not only improves physical and emotional health; it can save lives. The evidence leaves little doubt: keeping active after cancer is not just a recommendation, it is part of the prescription.

Information documented by:  

Dr Joan Maurel, Coordinator of the Colorectal Cancer committee, Clínic Barcelona 

Dr Francesc Balaguer, Head of the Gastroenterology Department, Clínic Barcelona.  

Reference article:

Courneya et al., New England Journal of Medicine, 1 de juny de 2025.