Research has long supported the role of vigorous exercise (such as running) in health, disease prevention and quality of life, but a new study goes much further, showing that even people with advanced colon cancer can significantly extend their lives with a structured exercise program.
On Sunday, The New England Journal of Medicine published the results of a study, called the CO.21 Challenge, co-chaired by oncologist and Queen’s University professor Christopher Booth of Kingston, Ont., and Kerry Courneya of the University of Alberta. The study, which began almost two decades ago, in 2009, included 889 patients with Stage 3 or high-risk Stage 2 colon cancer who had had both surgery and chemotherapy.
Survival rates significantly higher with exercise
Patients were randomly assigned to one of two groups: those who received (and followed) a structured exercise program under the guidance of a trainer for a three-year period, and those who were given educational materials about exercise and nutrition. Those who exercised had a significantly higher overall survival and disease-free survival rate than those who only received information, achieving a 37-per-cent lower risk of death and a 28-per-cent lower risk of recurrence of their cancer, or development of other cancers–astonishingly good results.
Put in more human terms: for every 16 patients enrolled in the exercise program, one person was prevented from developing a recurrence of their cancer or a new cancer, and for every 14 patients enrolled, one person’s life was saved.
Ontario man runs Boston Marathon while battling stage 4 cancer
For Booth, the study co-chair, the results were particularly gratifying, given that he is a former competitive varsity cross-country and track runner (and still runs eight to 10 km along Lake Ontario in Kingston every day). He and his colleagues wrote the study protocol in 2007, when he was a young oncologist and a serious runner. They were interested in some observational data that had been published a couple of years previously, showing a reduced relapse rate for cancer patients who engaged in regular exercise.
“As we know, however, people who exercise can be different in a variety of ways from people who don’t,” Booth explained, “so we wanted to know if it’s the exercise itself that’s delivering the benefits, or some other factors that differentiate exercisers from non-exercisers?” And they launched the world’s first randomized trial to find answers.
The Globe and Mail quoted Booth as saying the results demonstrate that exercise can now be considered a significant treatment with potential for extending life, rather than simply an intervention to improve quality of life–even implying that these results are better than those associated with some cancer drugs (while he acknowledged that the study participants had also benefited from surgery and chemotherapy).
He added that giving patients information on how exercise can benefit them is not enough; they must be prescribed a routine, and the aid of an exercise therapist as part of their health care team, who would be there to support patients as they take their exercise “medicine.”
The study did not include participants who were already regular exercisers; all were either sedentary or did minimal exercise before participating. They could choose in any form of aerobic exercise, and most chose brisk walking (45 to 60 minutes, three to four times weekly). Those who preferred some other form of exercise, such as cycling, would work out a regime equivalent to the walking protocol.
The results echo what popular health gurus, such as Canadian Outlive author Peter Attia, have long asserted: that “exercise might be the most potent ‘drug’ we have for extending the quality and perhaps quantity of our years of life”–though, granted, he is talking about disease prevention and “healthspan,” rather than situations where disease is already present.
