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The first randomised trial to show that a coached exercise programme after cancer treatment reduces recurrence and death, in colon cancer.
889 patients across Canada, Australia, UK, Israel and the US were randomised within 2-6 months of completing adjuvant chemotherapy to a structured exercise programme delivered by physical activity consultants (behavioural support sessions and supervised exercise, tapering over three years, targeting an increase of 10 MET-hours/week) or to health-education materials. Median follow-up 7.9 years. Disease-free survival at 5 years 80.3% vs 73.9% (HR 0.72, 95% CI 0.55-0.94); overall survival at 8 years 90.3% vs 83.2% (HR 0.63, 95% CI 0.43-0.94). Physical functioning and VO2 improved in the exercise arm; musculoskeletal adverse events were more common (18.5% vs 11.5%). The effect size is comparable with adding oxaliplatin to fluoropyrimidine adjuvant therapy. Limitations: one disease, open-label, participants were relatively fit volunteers, and the intervention required a trained workforce.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
889 enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Disease-free survival at 5 yearsprimary | Structured exercise | 445 | 80.3% | 0.72 (0.55 to 0.94) | 0.02 | link |
| Health education | 444 | 73.9% | ||||
| Overall survival at 8 years | Structured exercise | - | 90.3% | 0.63 (0.43 to 0.94) | - | link |
| Health education | - | 83.2% |
Shares CHALLENGE: a structured exercise programme after chemotherapy improves survival in colon cancer, Supportive care and survivorship roadmap: making treatment bearable → proving it extends life → caring for tens of millions afterwards, Diet, exercise and lifestyle roadmap: causes established → interventions that disappointed → exercise proven as treatment, Exercise & lifestyle oncology.
Shares Decentralised trial, Energy balance, Pragmatic trial, Event-free / disease-free survival (EFS, DFS, iDFS, RFS).
Shares CHALLENGE: a structured exercise programme after chemotherapy improves survival in colon cancer, Structured exercise prescribed like a drug in all curative-intent cancer care, Diet, exercise and lifestyle roadmap: causes established → interventions that disappointed → exercise proven as treatment, Exercise & lifestyle oncology.
Shares Pay for supervised exercise the way we pay for drugs, Structured exercise programmes after curative treatment, The exercise prescription after cancer: the dose the guidelines state, Recovery and rejuvenation roadmap: cure is not enough → survivorship gets a name → the cohorts that measured the cost → exercise proven as treatment → biological ageing measured and sold → repair, if anyone funds it.
Shares Energy balance, Structured exercise programmes after curative treatment, Diet, exercise and lifestyle roadmap: causes established → interventions that disappointed → exercise proven as treatment, Prevention we already have is not deployed.
Shares Decentralised trial, Pragmatic trial, Randomised trial, Event-free / disease-free survival (EFS, DFS, iDFS, RFS).
Shares Christopher M. Booth, Canadian Cancer Trials Group (CCTG), Colorectal cancer.
Shares Energy balance, Structured exercise programmes after curative treatment, Diet, exercise and lifestyle roadmap: causes established → interventions that disappointed → exercise proven as treatment, Exercise & lifestyle oncology.