Exercise Helps Colon Cancer Survivors Live as Long as Cancer-Free Peers

New research on colon cancer suggests higher amounts of exercise may elevate patients’ expected survival rates to those of the general population.

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A diagnosis of colon cancer doesn’t have to be a death sentence. Research in recent years may have uncovered a powerful cancer-fighting tool—physical activity. While we may not always envision regular exercise as part of a cancer survivor’s lifestyle, it can make a meaningful difference.

In a recent study published in the American Cancer Society, researchers from Louisiana State University (LSU) found that exercisers with colon cancer may live approximately as long as those without it.

People who have had cancer face special challenges in getting enough physical activity, but experts offer advice on how to meet exercise goals.

Exercise and Colon Cancer Survival

The authors assessed data from two post-treatment clinical trials involving 2,876 people with stage 3 colon cancer. Stage 3 colon cancer means that the cancer has spread beyond the colon to nearby lymph nodes but hasn’t yet reached distant organs. Participants self-reported their exercise levels following cancer surgery, as well as during and after chemotherapy. Researchers then compared these data with that from the general population, matched according to sex, age, and year.

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The pooled data from the two trials indicated that among the 1,908 individuals alive in the third year following cancer treatment, those who engaged in less than three MET (metabolic equivalent) hours of activity had a 3.1 percent lower likelihood of surviving three additional years, whereas those exercising 18 or more MET hours per week had a 2.9 percent higher likelihood of survival.

Three MET hours is the equivalent of one hour of brisk walking, while 18 MET hours equate to five hours of brisk walking, lead author Justin C. Brown of the Louisiana State University Health Sciences Center told The Epoch Times in an email.

“This new information can help patients with colon cancer understand how factors that they can control—their physical activity levels—can have a meaningful impact on their long-term prognosis,” Brown said in a statement. “Quantifying how physical activity may enable a patient with colon cancer to have a survival experience that approximates their friends and family without cancer could be a simple but powerful piece of information that can be leveraged to help everyone understand the health benefits of physical activity.”

The current study builds on findings from a 2022 study by the same group of LSU researchers. The earlier study suggested that exercise can prevent, as opposed to delay, cancer recurrence. Its findings demonstrated that in patients with a history of colon cancer, those who were physically active had improved survival rates three years after surgical resection compared with those who were inactive.

Underlying Mechanisms

The LSU study authors believe the main factor by which exercise prolongs survival is by reducing tumor recurrence. Although the exact mechanisms remain unclear, several factors may play a role, including decreasing systemic inflammation, reducing belly fat, and boosting insulin sensitivity, which helps regulate blood sugar.

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“These factors are an active area of research,” Dr. Cynthia Owusu, an oncologist at Case Comprehensive Cancer Center, told The Epoch Times in an email. She explained how exercise may influence mechanisms that drive tumor formation and cancer growth:

• Inflammatory markers: Exercise can reduce levels of inflammatory markers—substances in the blood that indicate the presence of inflammation and contribute to tumor proliferation.
• Insulin and insulin-like growth factors: Physical activity can improve insulin sensitivity and reduce levels of insulin and insulin-like growth factor 1, both associated with cancer progression.
• Body composition: Exercise promotes increased lean body mass and reduced fat mass, particularly in the belly. Fat cells release adipokines, which influence inflammation, insulin resistance, and tumor growth.
• Oxidative stress: Exercise helps manage oxidative stress—an imbalance between free radicals (unstable molecules) and antioxidants in the body—which can otherwise cause DNA damage and lead to tumor development.
• Microbiome: Regular exercise promotes a healthier and more diverse gut microbiome, which enhances the body’s immune response and reduces inflammation, both crucial for cancer prevention.

“Whether exercise influences these mechanisms independently or through interrelated mechanisms remains an active area of research,” Owusu said.

Exercise and Survival of Other Cancers

According to the National Cancer Institute (NCI), research shows that exercise may also lengthen survival in people with breast and prostate cancer.

A systemic review and meta-analysis published in Breast examined 10 studies involving more than 23,000 breast cancer survivors. Results indicated that those who exercised the most had a 42 percent lower risk of death from any cause and a 40 percent lower risk of death from breast cancer, as compared with those who exercised the least.

Another study published in Medicine & Science in Sports & Exercise reviewed limited research and found that exercise following a prostate cancer diagnosis was associated with a 45 percent lower risk of death from all causes and a 33 percent lower risk of death from prostate cancer, compared with the average risk of all those with the diagnosis.

Randomized controlled clinical trials are currently underway to establish a causal link between physical exercise and cancer outcomes, Owusu said. The NCI noted that ongoing clinical trials involve people with breast cancer, colon cancer, and metastatic prostate cancer.

Challenges and Exercise Options

Cancer survivors face numerous challenges when it comes to staying active, Ashley Perry, a physical therapist and cancer rehab navigator at Brooks Rehabilitation, told The Epoch Times in an email.

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“Most patients experience high levels of tiredness, or they have multiple doctor’s appointments tying up their schedules. A lot of patients are unsure if they are even able to exercise and often believe that staying sedentary is their only option. They are also subject to all the psychosocial factors we all face that keep us from exercising like we should.”

Despite the additional challenges, Brown believes most cancer patients have the physical capacity to get the recommended exercise.

“Instead of recommending marathon running, we are talking about walking around the neighborhood. If cancer survivors start with a small amount and progress slowly, many can do it,” Brown said.

Exercise can take various forms, Perry said. While walking is always an option, any enjoyable physical activity—such as gardening—can also be beneficial, as it makes it easier to develop a lasting habit.

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The Department of Health and Human Services Physical Activity Guidelines for Americans, 2nd edition recommends the following exercise levels to reduce the risk of chronic disease, including cancer:

• 150 to 300 minutes (2.5 to 5 hours) of moderate intensity aerobic activity per week, 75 to 150 minutes of vigorous activity, or a combination of both.
• Muscle strengthening exercises at least two days per week.
• Balance training.

According to Perry, both resistance training and aerobic exercise are essential but serve different functions.

“Most patients demonstrate a cardiovascular fitness decline during and after cancer treatments, so aerobic activity is a great way to get back to that prior level of endurance. Strength training helps improve circulation, decreases fall risk, and makes everyday activity easier,” she said.

Finding the Right Dose

People may wonder whether a dose-response relationship exists, with more exercise producing more benefits. The LSU study indicates that higher recommended activity levels provide a survival advantage. However, Perry believes that more isn’t always better, especially when a person first starts an exercise regimen.

“We often see that patients tend to overdo it on the days that they are feeling good and then crash for the next couple of days,” she said. “Additionally, we often observe a wave-like pattern of highs and lows that can be very difficult to break, so we spend a lot of time in therapy with patients trying to find that sweet spot of activity. ... It can take some trial and error to find the right exercise dose.”

The general viewpoint on physical activity and cancer survivors is that some exercise is better than none, said Perry. She often encourages her patients to start with just 10 minutes per day of low to moderate intensity activity and gradually build up to the recommended minimum of 150 minutes per week. If patients were highly active before their cancer diagnosis, she advises starting at a lower level and progressing slowly until they know how their body responds. Seeing a physical therapist to get personalized guidance is always a great idea.

It’s worth the effort involved in slowly working up to the recommended exercise levels. In addition to promoting survival, regular physical activity can help reduce tiredness, anxiety, and depression, the NCI stated. Yet there is even more to gain, Dr. Kyle Eldredge, a colorectal surgeon in Palm Beach Florida, told The Epoch Times in an email.

“For those with colon cancer undergoing treatment, exercise has also been shown to decrease the side effects of chemotherapy, increase the completion rate of treatment regimens, and boost quality of life.”