Exercise As Medicine: Study Shows Structured Exercise Routine Improves Survival & Reduces Recurrence Risk For Colon Cancer Survivors

“We know that healthy behaviors decrease the chance of getting colon cancer in the first place. Individuals who participate in exercise are more likely to have other associated health benefits, such as being a healthy weight and eating healthier as well, Dr. Heather Yeo, associate professor of surgery at Weill Cornell Medicine and colorectal surgeon at the New York Presbyterian Hospital, tells SurvivorNet.

“We know that good eating habits in particular can help lower your risk of cancer and or cancer recurrence. Diet low in sugar, high in fiber, low in red and processed meats are most likely to help. Exercise improves insulin responsiveness and cardiovascular health. We know that obesity and insulin resistance predispose to higher rates of cancer and cancer recurrence,” she continues. “I do think it’s exciting to have some data in a randomized fashion that shows that this not only helps with survival, but also with recurrence.”

The CHALLENGE Trial: A First-of-Its-Kind Study

The study, known as the CHALLENGE trial, is the first randomized phase III clinical trial to prove that exercise can improve survival outcomes in colon cancer. Researchers followed 889 patients over nearly eight years. All had undergone surgery and chemotherapy for stage III or high-risk stage II colon cancer.

Patients were split into two groups:

• Structured exercise program group (445 patients)
• Health education materials group (444 patients)

Both groups received the usual follow-up care for colon cancer, but only the first group worked directly with physical activity consultants over a three-year period.

What Did the Exercise Program Involve?

Each patient in the structured exercise group received personalized guidance from a physical activity consultant. This included:

• First 6 months: Two sessions per month for coaching and supervised workouts
• After 6 months: One session per month, with extra support if needed
• Goal: Add about 2.5 hours of moderate aerobic exercise per week

Patients could choose the type of exercise they preferred — most opted for walking, but others biked, jogged, swam, or even played pickleball. The idea was to integrate physical activity into daily life in a realistic, enjoyable way.

Key Findings: A Real Survival Advantage

At a median follow-up of 7.9 years, the results were clear: 80.3% of patients in the exercise group were alive and free of cancer at 5 years compared to 73.9% of patients in the health education group.

That’s a 28% lower risk of recurrence or new cancer in the exercise group.

After 8 years, 90.3% of patients in the exercise group were alive, compared to 83.2% in the health education group. That’s a 37% lower risk of death in the exercise group.

These benefits were specific to colon cancer outcomes — not just improvements in heart health or general wellness.

“The one thing they do note in the study is that people that were involved in the fitness regimen are more [likely] to have musculoskeletal injury. So that’s just a caveat to keep in mind,” Dr. Yeo explains. “But overall, I always tell my patients, I would rather they be active and exercise regularly as we know it’ll likely improve their chance of survival — and now we know their chance of disease free survival.”

What Does This Mean for Patients?

If you’ve been treated for stage III or high-risk stage II colon cancer, these results show that:

• Structured aerobic exercise — just 45 minutes, 4 times a week — can help prevent your cancer from coming back.
• This type of program can also reduce the chances of developing a new cancer.
• Most importantly, it can help you live longer.

This isn’t just about adding years to your life — it’s about improving your strength, mood, energy, and confidence during recovery.

Side Effects: Manageable and Mild

Like any treatment, exercise can come with side effects — though in this case, they were mostly minor and musculoskeletal (like strains or mild fractures).

In the exercise group, 18.5% of patients had musculoskeletal side effects compared to 11.5% in the health education group.

Only about 10% of side effects in the exercise group were directly linked to the exercise program.

Doctors emphasize that these risks are low and manageable, especially when exercise is introduced gradually and tailored to the individual.

Why Does Exercise Help?

While researchers are still investigating the exact reasons, exercise is known to:

• Reduce inflammation in the body
• Improve insulin sensitivity
• Boost the immune system
• Enhance overall physical function and energy

All of these may play a role in reducing the chances of cancer coming back.

What Should You Do Now?

If you or someone you love has completed treatment for colon cancer:

• Talk to your doctor about incorporating exercise into your recovery plan.
• Start small: Even short walks count, especially if you’re new to physical activity.
• Seek support: Working with a trainer, physical therapist, or coach can help you stay consistent.

Cancer survivors often feel like they’re left to navigate recovery on their own. But you don’t have to be. Structured exercise gives you a tangible, empowering way to take control of your health.

Whether you’re newly diagnosed or years into survivorship, know this: there are steps you can take — literally — that can make a difference. And now, we have the proof.

Learn more about SurvivorNet's rigorous medical review process.

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