New Delhi: Results from a first-of-its-kind global trial, which are likely to influence cancer management guidelines worldwide, have shown that exercise can reduce the risk of colon cancer patients dying from the disease, prevent tumor recurrence and can even prove to be “practically better than many drugs”.
The findings from the trial, named CHALLENGE which went on for years and involved patients from six countries, were presented at the ongoing American Society of Clinical Oncology (ASCO) annual meeting—the world’s largest conference on cancer care—at Chicago.
The latest evidence, also published in the New England Journal of Medicine 1 June, was based on assessing the impact of a three-year structured exercise programme for patients initiated soon after they underwent adjuvant chemotherapy for colon cancers, one of most common malignancies worldwide.
Experts say the findings have a potential to transform the way cancer is managed across countries.
“While we have been encouraging exercise (in cancer patients), until now there has been little evidence of the impact it could have after diagnosis, with little support for incorporating exercise into patients’ routines,” said Dr Ravi Mehrotra, a cancer researcher who is also associated with the World Health Organization’s International Agency for Research on Cancer (WHO-IARC).
“This new evidence on how exercise greatly aids cancer outcomes could soon make it to cancer management guidelines,” Mehrotra, who has previously headed the Indian Council of Medical Research (ICMR)-National Institute of Cancer Prevention and Research, told ThePrint.
In India, over 14.5 lakh new cancer cases are diagnosed every year and the cases are increasing at a rate of nearly 13 percent every year, according to Globocan report 2022.
As of now, standard cancer care for the majority of the patients includes chemotherapy, radiotherapy and surgery—either alone or in combination with each other after individual assessment of each case.
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Concretises what many oncologists observed
As part of the observational study, researchers from 25 leading cancer research institutes enrolled 889 colon cancer patients in the CHALLENGE trial between 2009 and 2023 in the US, the UK, Australia, France, Canada and Israel. Nearly 90 percent of them had advanced stage 3 colon cancer.
Of the total participants, 445 were randomly assigned to take part in a structured exercise programme while the rest 445 received a healthy lifestyle booklet. All of these patients were also receiving standard care for cancer management.
Those in the exercise group initially worked with a personal trainer twice a month for coaching sessions and supervised exercise sessions, and later once a month, for a total of three years.
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. Some chose kayaking or skiing on a regular basis, for example.
After five years, patients in the exercise group had a 28 percent lower risk of recurrent or new cancers than those in the other group. After eight years, the same patients also had a 37 percent lower risk of dying than those just handed the healthy lifestyle booklet, according to the findings.
“A 3-year structured exercise program initiated soon after adjuvant chemotherapy for colon cancer resulted in significantly longer disease-free survival and findings consistent with longer overall survival,” noted the researchers.
Mehrotra added, “The impact of the exercise for the patients following exercise is practically better than many drugs that are sometimes given to cancer patients and this is quite significant.”
Other cancer doctors, too, hoped that the new evidence will make way for emphasis on physical activity while managing malignancies.
“In our hospital, we do prehabilitation in which we encourage patients to start exercising prior to surgery. It has proven to improve surgical outcomes and to benefit patients as a whole. Now, the latest evidence further concretises what we have observed,” said Dr Madhavi Nair, surgical oncologist with Manipal Hospitals in Bengaluru.
In her experience, said the oncologist, the advantages of exercise go beyond recovering.
“It can influence the way the disease reacts and develops. As oncologists, we strongly recommend that patients prioritise regular physical activity throughout their cancer care and recovery—from before surgery, to during chemotherapy or radiation treatments, to after therapy ends—for the optimal long-term benefit,” Nair stressed.
(Edited by Ajeet Tiwari)
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