An international clinical trial has revealed that a structured exercise program can significantly reduce the risk of cancer recurrence and death in patients after treatment—outperforming many common pharmaceuticals. The findings, presented at the American Society of Clinical Oncology (ASCO) annual meeting in Chicago and published in the New England Journal of Medicine, are being described as transformative for global cancer care and hold powerful significance for Thai cancer patients and healthcare providers alike (The Guardian).
This groundbreaking study, the first of its kind, involved 889 colon cancer patients across the US, UK, Australia, France, Canada, and Israel. Participants who followed a structured exercise routine with guidance from personal trainers or health coaches saw a 37% lower risk of death and a 28% lower risk of developing recurrent or new cancers, compared to those who received only general health advice. Notably, these results suggest that purposeful exercise intervention surpasses pharmaceuticals in efficacy but without the attendant costs and side-effects associated with many cancer drugs.
Historically, Thai oncologists and health authorities have championed a holistic approach to cancer prevention, emphasizing healthy diets and moderate physical activity to reduce cancer risks. However, concrete evidence of exercise’s direct post-treatment impact, especially in comparison to drug therapies, has been sparse. Now, with robust data from this major international study, cancer survivors and doctors in Thailand have more reason than ever to prioritize rehabilitation through exercise as part of the standard post-treatment protocol.
The trial, spanning 2009 to 2023, specifically enrolled patients recovering from stage three colon cancer, most of whom had already undergone surgery and chemotherapy. Participants were randomly divided: one group received a structured exercise regime with supervised and coached sessions (reducing to monthly check-ins after initial biweekly support), while the other was given only a healthy lifestyle booklet. Over the course of three to eight years, the exercise group consistently demonstrated superior outcomes in survival and disease prevention.
Dr Julie Gralow, chief medical officer at ASCO, highlighted the magnitude of the impact: “It’s the same magnitude of benefit of many drugs that get approved for this kind of magnitude of benefit—28% decreased risk of occurrence, 37% decreased risk of death. Drugs get approved for less than that, and they’re expensive and they’re toxic.” Her endorsement underscores a major shift in international cancer care priorities and raises important possibilities for sustainable, accessible, and holistic approaches in Thailand, where resource limitations and rural remoteness often restrict patient access to high-cost therapies.
The study’s lead researcher, a senior clinician at Queen’s University in Kingston, Canada, provided context for these findings: “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.” This statement may resonate particularly with Thai patients and families often seeking supplementary therapies and lifestyle interventions, particularly during the lengthy recovery phase common in Thai health system pathways.
Local and global cancer experts agree that integrating exercise into post-treatment care could be a “gamechanger.” The chief clinician at Cancer Research UK, which helped fund the study, added: “For an intervention that isn’t a drug, exercise offers remarkable benefits for patients.” Similarly, the national medical director of NHS England characterized the results as “really exciting,” highlighting that “being more active can have significant benefits in helping maintain a healthy weight, strengthen the immune system, reduce inflammation and lift mood.”
While these findings were obtained in colon cancer patients, many oncologists believe they are likely generalizable to other cancers—a point of particular interest to the Thai health community, given rising incidence rates of colorectal and breast cancer countrywide (WHO Thailand Profile). In Thailand, colorectal cancer is among the top five most common cancers, with incidence and recurrence rates on the rise, especially in urbanized areas and among older adults. The application of structured physical rehabilitation within Thai hospital oncology wards and community health settings could thus substantially alter expected outcomes for thousands of survivors.
Nevertheless, clinicians urge caution: exercise is not appropriate for every patient. A leading Cancer Research UK representative advised, “It’s important to remember that exercise isn’t the best option for everyone. My advice to cancer patients is to speak to your doctor before taking on any new physical activity.” This reminder is crucial in the Thai context, where comorbidities or physical limitations may be more prevalent among populations with restricted access to early screening or comprehensive care—a challenge recognized by healthcare authorities such as the Ministry of Public Health (Thai Ministry of Public Health).
From a broader socio-cultural perspective, the sheer accessibility and affordability of exercise is particularly relevant for Thai communities, including rural provinces where healthcare resources and post-discharge support are stretched thin. Unlike pharmaceuticals, structured exercise can be tailored to local environments and cultural preferences—whether through group walking sessions in city parks, village aerobics (ae-ro-bik lumpang), or even traditional activities like dancing or light martial arts, which also provide crucial social outlets that support mental well-being during the difficult recovery period.
Reflecting on Thai society’s approach to health, physical activity after cancer treatment aligns with the national ‘Healthy Thailand’ initiative, which emphasizes prevention through grassroots health promotion and community involvement. Increasing evidence from local studies supports the role of moderate physical activity in improving quality of life among Thai survivors of various cancers (PubMed study: Exercise among cancer survivors in Asia-Pacific), but this new landmark research substantially raises the bar for what may be achieved through more ambitious, structured post-treatment programs.
Looking ahead, these findings are expected to catalyze significant policy and practice shifts globally and in Thailand. Healthcare providers may soon be expected to deliver clearer, evidence-based exercise prescriptions alongside medical treatments, and hospitals may need to invest in physical therapy teams or partnerships with certified fitness professionals. There may also be opportunities for philanthropic and local community organizations to support public awareness campaigns and facilitate access to supervised exercise programs for survivors, particularly in regions with pronounced healthcare disparities.
As the international oncology community anticipates broader trials in breast, prostate, and other cancers, Thailand’s own clinicians and health policymakers are poised to harness these insights for nationwide benefit. The adaptation of structured exercise interventions into the Universal Health Coverage program or various hospital-based “Cancer Survivor Clubs”—already growing in popularity across Bangkok and the provinces—could prove transformative in improving outcomes and reducing the burden of recurrence.
For Thai cancer survivors and families, the takeaway is both hopeful and practical: consistent, supervised exercise can yield health protection on par with, or better than, high-tech pharmaceuticals—at a fraction of the cost and with broad accessibility, especially when tailored to local needs and capabilities.
In conclusion, cancer survivors in Thailand are encouraged to consult their healthcare teams about the safest ways to begin or increase physical activity, and to seek support from community health promotors, fitness groups, or rehabilitation services where possible. The country’s healthcare system, support organizations, and wider society can work together to make evidence-based exercise a core feature of survivorship—improving not just statistics, but real lives, nationwide.
For more information, readers can consult the original study as reported in The Guardian, the latest recommendations published by the New England Journal of Medicine, and resources from the Thai Ministry of Public Health.