5 days ago
Brisk walking ‘cuts cancer deaths by a third'
Exercise is 'better than a drug' at cutting the chance of cancer returning, a landmark study has revealed.
A brisk walk several times a week could also cut the risk of death by a third, the global study found.
Oncologists are calling for rollouts of personal trainers and health coaches to extend thousands of lives, after the research found that just telling people to exercise more did not work.
The findings were unveiled at the American Society of Clinical Oncology (ASCO) annual meeting in Chicago, the world's largest cancer conference.
Experts said the findings suggest exercise could help 'turbocharge' the body's defences, calling it 'the highest level of evidence' yet on exercise boosting cancer recovery.
Scientists studied the effect a structured exercise programme would have on the survival of patients after treatment for advanced colon cancer – the most common bowel cancer.
The world-first trial, published in the New England Journal of Medicine, tracked 889 colon cancer patients across six countries, including the UK, in a study taking place from 2009 to 2023.
Preventing deaths
Led by the Canadian Cancer Trials Group, researchers compared the effect of a 'structured' exercise programme with just being given standard health advice.
All participants had colon cancer – mostly at stage three – and had completed surgery and chemotherapy. None were meeting recommended physical activity levels at the start.
Prescribed personal trainers had fortnightly sessions, involving motivational advice and exercise supervision, with the patients for the first year, which then dropped to a monthly basis.
The trial aimed to increase exercise by at least 10 'metabolic equivalent task hours' per week. This is roughly 45 to 60 minutes of brisk walking three to four times a week, or 25 to 30 minutes of jogging three to four times a week.
Most opted to boost their exercise by walking.
After five years, those with health coaching had a 28 per cent lower risk of cancer recurrence or the appearance of new cancer. After eight years, they had a 37 per cent lower risk of death compared to those given health advice only.
Survival among those with personal trainers was 90 per cent, compared with 83 per cent in the group who only received advice.
For every 14 people on the 'structured' programme, exercise prevented one person from dying.
The study also found signs that the lifestyle overhaul was also cutting other major cancers, such as in the breast and prostate.
'A no-brainer'
Dr Julie Gralow, ASCO chief medical officer, said the study, which was funded by Cancer Research UK, provided the 'highest level of evidence' that doctors should prescribe exercise to cancer patients.
Asked about the extent of the effect exercise has on disease-free survival, she said: 'We titled the session 'As Good as a Drug'. I would have retitled it 'Better Than a Drug', because you don't have all the side effects.
'It's the same magnitude of benefit as many drugs that get approved – 28 per cent decreased risk of recurrence, 37 per cent decreased risk of death. Drugs get approved for less than that, and they're expensive and toxic,' she said.
Dr Gralow later told the conference: 'I would say it's better than a drug.'
However, Dr Gralow stressed that exercise should not replace prescribed cancer treatments. All trial patients had already undergone conventional treatments like surgery and chemotherapy.
The oncologist said she personally uses a seven-minute workout app to get her heart rate up and recommends it to her patients.
Dr Pamela Kunz, from Yale School of Medicine, said: 'This is the first randomised phase-three trial in patients with stage-three and high-risk stage II colon cancer to demonstrate that post-treatment exercise is both achievable and effective in improving disease-free survival.'
'Exercise as an intervention is a no-brainer and should be implemented broadly,' she added, speaking on behalf of ASCO.
Dr Christopher Booth, the study's lead author from Queen's University in Kingston, Canada, said around a third of the patients would normally see their disease recur.
'As oncologists, one of the most common questions we get asked by patients is, 'What else can I do to improve my outcome?' These results now provide us with a clear answer: an exercise programme that includes a personal trainer will reduce the risk of recurrent or new cancer, make you feel better, and help you live longer,' he said.
The costs of health coaching – about £2,000 to £3,000 for the three years – were 'remarkably affordable' given what health systems would normally spend on cancer care, he said.
The study could not determine which mechanism made the difference, but said exercise induces changes in the insulin pathway that may protect against cancer.
Prof Sir Stephen Powis, the national medical director of the NHS, said: 'These landmark findings suggest that focused steps to exercise, from walks to workouts, could help turbocharge the body's ability to prevent cancer returning after treatment and help save more lives.
'Being more active can have significant benefits in helping maintain a healthy weight, strengthen the immune system, reduce inflammation and lift mood – and it's now really encouraging to see that exercise really could have the power to help more people survive cancer.'
Prof Charles Swanton, Cancer Research UK's chief clinician, said: 'This fascinating study captures the power of exercise to transform people's health and boost their chances of surviving cancer after treatment.
'For an intervention that isn't a drug, exercise offers remarkable benefits for patients. For some people with colon cancer, physical activity can be a game changer that shifts the course of their recovery.'
Huw Edwards, chief executive of ukactive, the UK's trade body for the physical activity sector, said: 'This study shows that exercise is vital in our battle to beat cancer. The key is structured, supported physical activity, such as circuit classes, swimming, and cycling.'
He urged the Government to use the upcoming 10-year health plan to roll out such plans.
