Studies had already been done that show that exercise improves with cancer or reduces the side effects of chemotherapy and there were indications that their effects could go further. Now, a study that has just been presented at the annual meeting of the American Society of Medical Oncology (disgust), in Chicago, has verified that it also improves survival.
The Challenge essay, led by it, is the first to have tried to answer the question of whether the exercise can be used to treat cancer, such as medicines, surgery or radiotherapy. For 17 years, between 2009 and 2024, researchers followed, in periods of around 8 years, 889 people with colon cancer in stages II (when cancer has grown on the wall of the colon, but has not extended to the lymph nodes) and III (when it has reached nearby lymph nodes, but not to other parts of the body), high risk. After receiving the usual treatment of surgery and chemotherapy, half were assigned to a structured exercise program for three years, while the other half only received educational materials.
The structured exercise program aimed to increase recreational aerobic physical activity. Throughout the three years of intervention, the exercise group managed to meet and maintain the proposed objective, adding between 45 and 60 minutes of fast walking or 25 to 30 minutes of moderate trot between three and four times per week.
After eight years of monitoring, global survival was 90% in the group that did weekly aerobic exercise supervised by specialists, and 83% in the group that received educational material. The risk of death was 37% lower among those who exercised, reducing the number of deaths by 7 per 100 treaties. “Our study shows that the exercise is no longer just an intervention of quality of life, it is a treatment for colon cancer that should be available for all patients,” said Kerry Couneya, professor and head of the Canada Research Chair in Physical Activity and Cancer at the University of Alberta, and Co21 study coordinator.
Chris Booth, the other study coordinator, which has been published in the magazine New England Journal of Medicinepoints out that their results “do not imply that exercise replaces surgery or chemotherapy,” but is a new part of the treatment, at the same level. For researchers, the message is clear: to improve survival, it is necessary to help patients change habits, including trainers in medical equipment as an essential part of therapy.
The exercise program was integrated, with the guidance of a physiotherapist or a kinesiologist, in the treatment after surgery and chemotherapy and each participant chose their type of moderate intensity exercise. “We wanted to make something important clear: the benefits of exercise to survive cancer are as large as those of many medications, and even greater in some cases. Exercise enhances the effect of chemotherapy and this is a huge advance,” summarizes Booth.
To apply this type of treatments, the incorporation of professionals who can design the exercise programs and do personalized monitoring for each patient will be essential. “The feeling of commitment made all the difference. That a doctor simply told me that I exercised would not have been enough; what really made it possible was to have someone by my side, guiding me and monitoring regularly,” he said according to a note from the study organizers, Terri Swain-Collins, one of the trial participants.
Professor of the Department of Health Sciences at the Public University of Navarra, affirms that the study means “a before and after.” “It is a randomized trial, that means that a causal link is established between exercise and increased disease -free survival and mortality reduction,” he continues. And he adds: “It is a sufficient level of evidence to change clinical guides and introduce this type of intervention to treat cancer.”
Izquierdo, who this year was the first signatory with recommendations to use exercise as medicine for the elderly, warns that the application of the exercise “requires customizing it and giving the appropriate dose, as with drugs.” “Now we will have to see if the system is prepared to incorporate this metabolic immunotherapy, that if it had been discovered in the form of an encapsulated drug, it would have been the pump,” he says. “The health system has to invest, incorporate people formed to give these treatments, which are increasingly, but still is missing, and also lacks infrastructure,” he adds.
In recent years, scientific evidence on the benefits of exercise in cancer has accumulated. Some studies show that half an hour of aerobic exercise three times a week significantly reduces anxiety or depression, and that other programs of aerobic activity or resistance reduces fatigue related to the disease and that caused by treatments. Although the trials were not designed to prove the effectiveness of exercise as cancer medicine, an association between regular physical activity and an increase in survival in colon cancers, prostate or breast had already been observed. The study that has just been published opens a new line of cancer treatments, safe and with few side effects, although a learning process will be necessary to apply it on a large scale.
