Previous research has pointed to numerous potential benefits of physical activity for colorectal cancer survivors, with studies indicating it can lengthen survival and improve health. A new study now suggests that exercise helps colorectal cancer patients feel and move better whether they are active at home on their own or under supervision in a clinical setting.

The paper gathered data from randomized controlled trials—considered one of the strongest types of studies—adding practical insights into how colorectal cancer survivors can best follow exercise prescriptions. It was published in Nature’s Scientific Reports and builds on the well-studied benefits of physical activity related to cancer. AICR research has found strong evidence that regular physical activity lowers the risk of developing colorectal cancer. After a diagnosis, AICR recommends that colorectal cancer survivors—and cancer survivors in general—follow the same physical activity recommendations as the general population, when and if they are able.

Home or supervised, adherence key
For this study, researchers identified 13 trials that investigated the effects of either home-based, supervised or mixed exercise interventions on the daily functions and quality of life of colorectal cancer patients. The trials included slightly more than 700 patients.

Patients’ quality of life was measured through questionnaires, asking about fatigue, pain and other physical, psychological and social issues. Functional capacity—the ability to perform daily activities—was generally measured by a walk and/or treadmill test.

The first analysis found that only supervised or mixed intervention exercises improved quality of life and daily functions. But in looking closer, the study found that patients who actually did the assigned exercises—at least 80 percent of the time or more— all groups experienced improvements, no matter the level of supervision.

This does not necessarily mean that lower levels of adherence to exercise prescriptions do not provide benefits, the authors note. However, the higher the adherence, the higher the chances of improving quality of life and daily functions.

Exercise, lifestyle and survivorship
This study hones in on the practical aspects of exercising after a cancer diagnosis, given the time, cost and other challenges survivors face. In general, exercise both during and after a cancer diagnosis has been found to be safe for cancer survivors and provide many benefits, concluded a 2019 review of the evidence by a group of experts. That paper found that specific doses of aerobic, combined aerobic plus resistance training and/or resistance training could improve common cancer-related health outcomes, such as anxiety, physical functioning and health-related quality of life. All cancer survivors should avoid inactivity, the paper recommends.

Ongoing research continues to investigate questions related to physical activity and cancer survivors, such as what amount and type of activity is best? Activity and inactivity among different cancer types is also an active area of research. A study published last year suggested that moderate to vigorous activity is linked to better health-related quality of life and less fatigue for colorectal cancer survivors. Combining more activity with less sitting time was especially associated with better quality of life, including less fatigue.

Being physically active—when able— is part of an overall lifestyle that connects to better health for survivors.

Independent research has found that following AICR’s Diet and Physical Activity Recommendations can help survivors in several ways. One study, for example, found that colorectal cancer survivors who most adhered to AICR’s Recommendations reported better overall physical, social and quality of life functions along with less fatigue compared to those who least followed the Recommendations.

The current Scientific Reports paper has several caveats, such as the variability in study lengths and types of exercises of the included trials. Also, there were three trials that mixed both home and supervised intervention and none of them measured for quality of life. Future trials that detail the exercise intensity, prescription, duration and more are needed, the authors note.

For evidence-based guidance on lifestyle and cancer survivorship, visit AICR’s Cancer Survival section.

This story was published by the American Institute for Cancer Research on March 9, 2022. It is republished with permission.