Terri Swain-Collins and Alison MacDonald, a registered physiotherapist who worked with her during participation in the CO.21 Challenge, a trial for colon cancer patients.Supplied
For nearly two decades, researchers from around the world have explored a question in a clinical trial considered the first of its kind: Can physical activity improve cancer survival?
The answer, according to their research, is a resounding yes.
The study from a trial called the CO.21 Challenge, published in the New England Journal of Medicine on Sunday, says a structured exercise program significantly improves survival for colon cancer patients.
From 2009 until 2024, researchers looked at the impact of physical activity on patients with Stage 3 or high-risk Stage 2 colon cancer. The trial included 889 patients who’d had surgery and chemotherapy.
The participants were randomly assigned to participate in a structured exercise program with an exercise therapist over a three-year period, or they received health education materials on the benefits of physical activity and nutrition. The patients also received cancer surveillance and follow-up care.
The results showed a significant improvement in overall survival and disease-free survival among participants assigned to the exercise program in comparison with those who only received the health education materials.
The research found patients in the structured exercise program had a 37-per-cent lower risk of death and a 28-per-cent lower risk of recurrence or developing other cancers.
Dr. Christopher Booth, who co-chaired the global trial, says the results open ‘an entirely new avenue of cancer therapy.’Supplied
Christopher Booth, an oncologist at Kingston Health Sciences Centre and a professor of oncology at Queen’s University who co-chaired the global cancer trial, said that he didn’t sleep for days after first seeing the results.
He experienced a sense of joy and exhilaration, for both patients and for the future of cancer care.
“I think this really does change the landscape of cancer treatment; it opens an entirely new avenue of cancer therapy,” Dr. Booth told The Globe and Mail by phone.
Dr. Booth’s fellow chair is Kerry Courneya, a professor and Canada Research Chair in physical activity and cancer at the University of Alberta.
He said the study shows exercise is no longer only an intervention for quality-of-life. “It is a treatment for colon cancer that must be made available to all patients,” Dr. Courneya said.
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Terri Swain-Collins, a 62-year old who lives in Kingston and who participated in the trial, said working with a trainer over a three-year period helped her establish and maintain a fitness plan. She was diagnosed with colon cancer in June, 2021.
Ms. Swain-Collins said the sense of accountability made “all the difference” and simply being told to work out by a doctor would not have been enough. She appreciated the regular check-ins, as well as being able to have someone with her while she logged steps on a treadmill.
Dr. Booth, Ms. Swain-Collins’s oncologist, said researchers were thrilled to see behavioural changes could lead to positive outcomes for patients. For example, he said they felt better; their fitness improved.
On top of that, he said, the scale of the benefit of exercise is, in some cases, better than what is offered through many standard cancer drug regimes. Dr. Booth said it is important to note that the exercise program offered added benefits on top of those from surgery and chemotherapy.
After nearly two decades of working on the research (for reference, Dr. Booth started working on it when his wife was pregnant with their child who is now 18), he is hopeful the findings can help change the standards for colon cancer care.
But he said knowledge of the benefits of exercise won’t be sufficient to see most people change their lifestyle and to sustain change.
A new model, he said, should see patients who have had surgery and received chemotherapy treatments with oncologists like himself referred to an exercise specialist who can then work with them over the next three years.
“We need to ensure the health systems provide this structured behaviour change intervention,” he said, adding an exercise consultant should be part of the health care team.
