Exercise may significantly reduce the risk of colon cancer return in patients, a new study found.

The late trial, published Sunday in the New England Journal of Medicine and published at the American Society of Clinical Oncology (ASCO) annual meeting in Chicago, found that people who perform exercise programs after undergoing stage 3 or high-risk stage 2 colon cancer can reduce the risk of cancer, with a new cancer diagnosis or death of 28%.

"We approved the same medications, in some cases fewer than that," said Dr. Julie Gralow, chief medical officer of ASCO.

The third phase randomized controlled trial included nearly 900 patients in six countries. The average age was 61 years old, about 90% of the participants had stage 3 colon cancer, and about 35% of the patients relapsed within five years after treatment. From 2009 to 2024, researchers followed each patient for about eight years.

Half of the participants participated in the exercise program after completing the surgery and chemotherapy. The other half was in the control group and was given a booklet that encouraged them to exercise and eat well after recovery.

The ultimate goal of a workout program is to get people to increase their workouts from anywhere they just started, increasing their workouts by a certain amount each week.

The goal is to add 10 hours per week - a unit that measures the same unit as the metabolism of a task or MET, i.e. whether it is sitting on a table or running at full speed, it is the amount of energy the body uses in a task. How much a metropolis spends on exercise depends on the duration and how long it takes to exercise. For reference, an hour of brisk walking is equivalent to about 4 hours.

During the first six months of the program, participants slowly achieved their goals. In the first year, they meet with a coach every two weeks - a physical therapist, personal trainer or sports doctor to develop a personal exercise plan and conduct supervised exercises. After the first year ended, participants met with their coach once a month for two years.

Everyone’s exercise program is tailored for them. Their coaches built a program around which types of exercise participants liked in the past and how they exercised appropriately to their lifestyle.

"For most people, this is four days a day for most people, four days a week, four days a week," said Dr. Christopher Booth, a medical oncologist and professor of oncology at Queen's University in Ontario, Canada.

Booth and his team, who led the trial, wanted to first understand whether the assigned coach would motivate people to exercise more after completing cancer treatment. If so, they wonder if the exercise will reduce its risk of cancer recovery.

The answer to both questions is yes.

Eight years after recovery, 90% of the exercise planning department of the trial did not have a relapse or a new cancer diagnosis, compared with 83% in the control group. Of the 445 people in the exercise group, 41 died within eight years after cancer treatment, while 66 of the 444 people in the control group died. People who exercise more are also at a lower risk for several other cancers, including breast and other colorectal cancers.

Those who did not participate in the exercise program reduced their exercise time by 5.2 to 7.4 per week, equivalent to 1.5 to 2.25 hours of brisk walking.

“It’s not as simple as telling people to exercise,” Booth said. “We know that for many people, it’s very difficult to develop exercise habits. We really need (insurance companies) to cover it up.”

The study is the first to randomly participate in an exercise program that may not have other exercise after cancer treatment. It is based on observational studies and shows that people with stage 3 colon cancer exercise longer than those who don’t.

"Exercise is hardly exercised. This should be part of standard treatment for colon cancer," said Nancy You, MD, PhD, medical director of the Young Attack Colorectal Cancer Program at the Anderson Cancer Center, University of Texas.

It is not clear why regular exercise seems to have such a big impact on colon cancer recurrence, but a growing number of studies have shown that exercise can reduce the risk of recurrence in breast, colon and rectal cancer, sometimes by as much as 45%.

"Potential assumptions related to the effects of exercise on insulin, body composition and basal metabolic rate, all of which can have anti-tumor effects," said Jeffrey Meyerhardt, Ph.D., co-director of the Center for Colon and Rectal Care at the Dana-Farber Cancer Institute in Boston.

Nevertheless, helping patients integrate more consistent exercise into their lives after cancer, especially when they are unable to enter the coach or are not very active before the cancer diagnosis, which can be a challenge. It is not clear what the benefits will be for extending the lifespan of people with late stage colon cancer, which is incurable.

“It’s exciting that it does confirm the evidence that people who exercise after a colon cancer diagnosis can reduce the risk of recurrence and increase the risk of survival,” Meyerhardt said. He added that people should understand that this exercise is an additional therapy rather than an alternative to standard care.

Everyone in the trial underwent surgery and chemotherapy before the exercise trial began. Booth said that for oncologists, being able to provide a research-supported way for recent cancer survivors to continue treatment will be an important part of patient care.

“One of the common questions that oncologists are asked when patients complete chemotherapy is, ‘What else can I do, DOC?’ This is indeed certain.