The international CHALLENGE trial, whose results were published in 2025, showed that individuals treated for colorectal cancer have a higher likelihood of surviving the next eight years if they receive long-term exercise counseling.
Transformation in treatment approach
The main question for doctors now is not whether cancer patients should exercise, but how to integrate exercise into daily care. In the United States, this change is approaching hospital standards. Starting January 2027, breast cancer centers will be required to assess patients' physical performance and recommend exercise or physical therapy if needed. However, experts warn that the results of this trial may not be applicable to all patients or different types of cancer.
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Details of the CHALLENGE trial
The CHALLENGE trial was led by the Canadian Cancer Trials Group and began recruiting patients in 2009. In this study, 889 participants from six countries, primarily from Canada and Australia, were considered. All of them registered after undergoing surgery and chemotherapy for stage 2 or 3 colorectal cancer that had not spread to distant organs.
Half of the participants received only educational materials about exercise and healthy nutrition, while the other half met with a physical activity consultant for three years. The goal of the exercise group in this trial was similar to adding 45 to 60 minutes of brisk walking, three to four times a week. Tormod Skogstad Nilsen, a cancer exercise researcher from Norway, stated that the type and amount of activity varied by individual, but participants were able to achieve a consistent increase in their physical activity.
The results of this study showed that individuals in the exercise group were less likely to have their cancer recur, develop new cancer, or die. In total, 93 participants in the exercise group faced these issues, while this number reached 131 in the educational group.
Research indicates that living longer generally means that a higher percentage of people are alive at a given time, but there is no guarantee of an increase in the number of additional years of life. Anna Campbell, a professor of clinical sports science at Edinburgh Napier University, believes that patients with any type of cancer in stages II and III who have an adequate level of fitness can benefit from similar exercise counseling.
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