Regular exercise after treatment cuts the risk of death in cancer patients by more than a third, a new study has found.
Sports and movement could help stop the disease from coming back, as well as boosting mood, energy levels and strength, researchers found in a trial which could "transform" medical practice.
Various types of moderate intensity exercise met the bar, including 40 minutes of brisk walking, a half-hour jog, circuit classes, cycling, or swimming.
What did the study involve?
The CO21 Challenge trial recruited 889 people with colon cancer from six countries, including the UK.
All patients had had surgery and chemotherapy for their cancer and were deemed well enough to exercise, but were not very active.
One group was given a highly tailored three-year exercise programme, which included in-person coaching sessions for the first six months, and regular meetings with a physical activity consultant.
The other group were simply offered materials promoting exercise and nutrition.
After five years, the risk of dying, relapse or developing a new cancer was 28% lower in the group with bespoke exercise plans - even though adherence to the programme decreased.
And after eight years, the risk of death had fallen to 37%.
Margaret Tubridy from North Belfast said she was "chuffed to bits" after taking part in the study.
"I had never been to a gym before, but once I was shown how to use the machines and do the exercises, I loved it," the 69-year-old said.
"Now I do weight training twice a week, pole walking, and I'm in a walking group... I am stronger, fitter, and my anxiety is better."
The paper adds to a stash of evidence of the multifarious benefits of exercise, from treating depression to reducing the chances of dementia.
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Professor David Sebag-Montefiore from Leeds University, who was not involved with the new study, called it an "exciting breakthrough".
The "great appeal" of such exercise is that it "offers the benefits without the downside of the well-known side effects of our other treatments".
Why recommendations might not be adopted
Colon cancer kills around 9,500 people a year in the UK.
Dr Marco Gerlinger, professor of gastrointestinal cancer medicine at Queen Mary University of London, said the results indicate that "exercise has a similarly strong effect as previously shown for chemotherapy, which is really quite impressive".
"The exercise is after patients have completed their chemotherapy, so it can't replace it," he told Sky News.
"But the effect size of exercise is similar to what chemo achieves. So it's not a replacement, but further reduces the risk."
Patients are usually keen to know what they can do to reduce the chances of the cancer returning, he added.
"Oncologists can now make a very clear evidence-based recommendation."
But he said support from a professional would very likely be necessary, and other experts raised concerns about the costs of labour-intensive programmes.
Caroline Geraghty, senior specialist information nurse at Cancer Research UK, which part-funded the CO21 Challenge through Stand Up To Cancer, said: "This trial has the potential to transform clinical practice, but only if health services have the necessary funding and staff to make it a reality for patients."
Dr Joe Henson, associate professor in lifestyle medicine at the University of Leicester, said: "Leading the exercise sessions in Leicester, I saw first-hand that this reduced fatigue, lifted people's mood, and boosted their physical strength.
"We know that physical activity regulates several key biological processes that could explain these results, and further research will help us uncover why exercise is having such a positive impact."
The findings were published yesterday in the New England Journal of Medicine.
(c) Sky News 2025: Exercise may benefit colon cancer patients as much as some drugs, study finds