Physical Activity Equal in Importance to Medications in Lowering Colon Cancer Recurrence Risk
Colon Cancer: Could Physical Activity Be a Game-Changer?
Colon cancer, the third most common malignancy worldwide, claims many lives annually. Present treatments encompass surgery, radiotherapy, and chemotherapy, followed by a lifestyle modification and additional drug therapies to minimize recurrence.
Now, a groundbreaking Canadian study suggests that a structured exercise program could outshine drug treatments in preventing colon cancer recurrence and even extending lifespan. Published in The New England Journal of Medicine (NEJM), the research found that a structured exercise regimen lowered the risk of recurrence by a staggering 28% and the risk of death by a significant 37% compared to patients who received standard health advice.
Some experts believe this result implies that exercise could be "superior to a drug" in terms of colon cancer recurrence prevention.
Structured Exercise Program vs Health Advice: A Comparative Study
To gauge the impact of structured exercise on colon cancer recovery, scientists studied 889 participants from Canada, Australia, the United States, the U.K., and France. The volunteers, who had undergone surgery and chemotherapy for stage 3 or high-risk stage 2 colon cancer, fell between the ages of 19 and 84, with an average age of 61.
Most participants displayed overweight or obesity symptoms, while none exercised more than 150 minutes per week prior to the trial.
Researchers randomly assigned participants to either the exercise group or the health-education group.
The exercise group, comprising 445 patients, worked closely with a certified physical activity consultant for three years. The consultants provided weekly guidance during the first six months, followed by fortnightly and monthly support for the remaining 24 and 24 months, respectively.
These patients could select their preferred exercise type, frequency, and intensity but aimed to achieve an equivalent of 3-4 brisk 45-60-minute walks weekly.
In contrast, the health-education group (444 patients) received general health education materials promoting physical activity and nutritious diets, as well as standard surveillance.
At a median follow-up of 7.9 years, 107 participants in total had either experienced a cancer recurrence, a new primary cancer, or died. 41 deaths occurred in the exercise group, while 66 deaths were reported in the health-education group.
Those undergoing the exercise program did not lose weight, but they exhibited substantial improvements in physical functioning and a significantly prolonged disease-free survival period, with an annual incidence of recurrence, new primary cancer, or death of 3.7%, compared to 5.4% in the health-education group.
5 years post-intervention, 80.3% of patients in the exercise group were disease-free, as opposed to 73.9% of those in the health-education group.
Exercise: A Game-Changer in Cancer Prevention?
The study's lead author, Kerry S. Courneya, PhD, explained that the most significant finding was the overall improvement in survival rates. Julie Gralow, MD, the Chief Medical Officer of the American Society of Clinical Oncology (ASCO), noted that the findings demonstrated that exercise could potentially exceed the effectiveness of drugs for certain patients, considering the benefits without thetypical side effects of pharmaceuticals.
However, she emphasized that her statement did not imply disregarding drugs in favor of exercise; rather, she aimed to compare the advantages gained from standard therapies with the reduction in recurrences and deaths that exercise achieved, while taking into account the treatment's toxicity.
Courneya highlighted the benefits of the program: "The 'side effects' of exercise are almost all good (improved fitness, enhanced strength, less fatigue, less depression, decreased cardiovascular disease risk, etc.). I believe exercise has an ongoing impact on new primary cancers and possibly other causes of death. Intervention participants were still exercising more than health education at years 4 and 5."
A supervised exercise program can also be far cheaper than medication. "The [physical activity] intervention was maybe 3,000 to 5,000 [Canadian dollars], whereas it is not unusual for some cancer drugs to cost tens of thousands and even reach 100,000," Courneya explained.
Support is Essential to Encourage Exercise
Although she advocates exercise to her own patients, Gralow acknowledged challenges in implementing exercise programs like those in the study: "I question whether most clinics have enough personnel to accommodate the number of required visits (especially since prior observational data suggests many other cancer types - including common ones like breast and prostate cancer - benefit from exercise). I also question whether all or even most patients are willing to come in this often."
"We need to find alternative ways to support patients in incorporating exercise into their lives that do not necessitate frequent clinic visits but offer regular encouragement and assistance," Gralow added. "And we must ensure we, the clinicians, recommend this (a prescription for exercise!)."
Vicky Coyle, the U.K. lead researcher for the trial and Clinical Professor at Queen's University Belfast, Northern Ireland, called for healthcare policymakers to adopt exercise interventions in cancer treatment plans.
Joe Henson, PhD, Associate Professor in Lifestyle Medicine at the University of Leicester, emphasized the requirement for tailored support: "Despite its proven benefits, many people still face barriers to regular exercise. This study shows how vital it is to incorporate exercise advice into cancer care and offer personalized support to patients."
The study on colon cancer recovery revealed that a structured exercise program significantly reduced the risk of recurrence and increased lifespan.
The research, published in The New England Journal of Medicine, found that structured exercise was more effective than standard health advice in preventing colon cancer recurrence, lowering the risk by 28% and the risk of death by 37%.
To investigate the impact of exercise, scientists studied 889 participants who had undergone surgery and chemotherapy for colon cancer, assigning them to either an exercise group or a health-education group for three years.
The exercise group, working closely with a certified physical activity consultant, aimed to achieve an equivalent of 3-4 brisk 45-60-minute walks weekly, while the health-education group received general health education materials.
At a median follow-up of 7.9 years, 107 participants had either experienced a cancer recurrence, a new primary cancer, or died, with the exercise group exhibiting a prolonged disease-free survival period and a lower annual incidence of recurrence, new primary cancer, or death.
Kerry S. Courneya, the study's lead author, emphasized the overall improvement in survival rates. Julie Gralow, MD, noted that exercise could potentially exceed the effectiveness of drugs for certain patients, considering the benefits without the typical side effects of pharmaceuticals.
Although implementing exercise programs can face challenges, researchers and clinicians like Gralow and Coyle call for healthcare policymakers to adopt exercise interventions in cancer treatment plans and for clinicians to prescribe exercise as a regular part of cancer care.
Joe Henson, PhD, emphasized the need for tailored support to help patients overcome barriers to regular exercise, suggesting alternative methods to encourage exercise that do not necessitate frequent clinic visits.
Furthermore, Courneya highlighted that a supervised exercise program is often much cheaper than medication, making it a cost-effective alternative or complement to drug treatments.
In conclusion, exercise emerges as a promising tool in the arsenal against chronic diseases such as colon cancer and could potentially have positive effects on other medical conditions like chronic kidney disease, COPD, type-2 diabetes, and mental health. CBD and rheumatoid arthritis may also benefit from regular exercise and improved fitness and wellness.
