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March 2025 | George M. Pikler, M.D., Ph.D., FACP, Lead Oncology Advocate N1X10

Exercise May Close Survival Gap for Colon Cancer Patients

Observational studies have previously reported that physical activity after a colon cancer diagnosis is associated with significantly longer disease-free survival. (1,2,3) A recent study (4) investigated if physical activity during and after chemotherapy is associated with the survival disparity between patients with stage III colon cancer and the matched general population (MGP).

In the study, 1696 patients with stage III colon cancer participated in one of two National Cancer Institute (NCI)–sponsored Cancer and Leukemia Group B (CALGB) postoperative chemotherapy treatment trials (CALGB 89803 and CALGB 80702). Both trials enrolled patients from community and academic centers across the National Clinical Trials Network. Eligible patients underwent a complete surgical resection of the primary tumor within 56 days before starting protocol treatment and had pathologically confirmed stage III colon adenocarcinoma.

Among the 1696 patients with stage III colon cancer, physical activity during and after chemotherapy lowered the risk of tumor recurrence in the first postoperative year, which translated into an overall survival benefit, suggesting that physical activity may prevent—as opposed to delay—tumor recurrence in some patients. In both clinical trial cohorts, the difference between the observed and the expected (MGP) 3-year overall survival rates decreased with higher volumes of physical activity.

Most tumor recurrences after stage III colon cancer occur within 2 or 3 years of diagnosis. Tumor recurrence is often metastatic to the liver or lung, and curative-intent surgery is typically not feasible. Physical activity during and after chemotherapy is associated with a 33% relative extension in overall survival time after tumor recurrence in patients initially diagnosed with stage III colon cancer. This extension in overall survival time may be partly attributed to physical activity delaying tumor progression, a validated surrogate end point of overall survival in advanced colon cancer.

Enabling patients to understand how physical activity may influence their prognosis relative to a similar population without cancer may be valuable to medical and public health personnel and policymakers who seek innovative and evidence-based messages to promote physical activity to improve population health.

(1) J Clin Oncol. 2006; 24 (22): 3535-3541
(2) J Clin Oncol. 2023; 41 (2): 243-254
(3) Br J Sports Med. 2023; 57 (15): 965-971
(4) Cancer. 2025; February 24.
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Erica

Erica Cross, PA

PA

Erica is a board certified Physician Assistant. She obtained her Master’s degree in Physician Assistant studies from Our Lady of the Lake College in Baton Rouge, LA. She began practicing in 2011 and has worked clinically in Orthopedics and Dermatology. The majority of her career has been spent in a Dermatology practice where she assisted in Mohs surgery, treating various types of skin cancer. She also teaches in the medical simulation department at the University of South Alabama and enjoys every aspect of medical education.