A groundbreaking 17-year international study has found that a structured exercise program, prescribed and monitored for people recovering from colorectal cancer, can reduce risk of death by 37% and lower recurrence rates by 28%. The findings, published in the New England Journal of Medicine, are being hailed as a major shift in the standard of care for one of the world’s most common and deadly cancers, with direct implications for Thai patients and healthcare providers grappling with rising colorectal cancer rates.
The research, led by teams from the University of Sydney, Queen’s University in Canada, and the University of Alberta, meticulously tracked 889 patients in six countries who had recently completed surgery and chemotherapy for colon or bowel cancer. Participants were randomly assigned to either a “health education” group—which received standard post-cancer advice on healthy living—or to a group that received personalized, structured exercise plans. Over three years, the latter group engaged in 250 minutes of aerobic activity per week, such as brisk walking—an intervention monitored and tailored much like any medical prescription.
Colorectal cancer is the third most common cancer globally and claims the second highest number of cancer-related deaths worldwide (World Cancer Research Fund). This trial, known as the Challenge study, addressed a crucial issue: about 30% of stage III patients experience a return of their cancer even after aggressive treatment (newatlas.com). The researchers set out to determine whether exercise could go beyond improving post-cancer quality of life and instead play an active role in preventing relapse and extending survival.
As Professor of Medicine at the University of Sydney’s Faculty of Medicine and Health, one of the study co-chairs emphasized, “This should really change the standard of care for colon cancer patients worldwide and it may even be able to be generalized to other cancer groups.” The results were indeed dramatic: five-year disease-free survival rates climbed from 74% to 80% in the exercise group, and overall survival at eight years increased from 83% to 90%. “This actually equates to a 28% reduction in the risk of having a cancer recurrence,” explained the faculty member. “Importantly, overall survival… was 90% compared to 83% in the health education group only. And again, this equates to a large difference. This was a 37 % reduction in the risk of death.”
The structured exercise program was not limited to athletes or those already fit. Instead, each participant received a plan—often as attainable as 150 minutes of brisk walking a week, broken into 30-minute sessions five times a week—tailored to their preference and capacity, and monitored in partnership with clinical teams. The study’s co-chair at the University of Alberta affirmed, “Our study shows that exercise is no longer just a quality-of-life intervention – it is a treatment for colon cancer that must be made available to all patients.” Another leading researcher, Professor of Oncology at Queen’s University, summarized the clinical impact: “An exercise program after surgery and chemotherapy reduces the risk of recurrent or new cancer and improves survival, allowing patients to live longer and better lives.”
For Thailand, where colorectal cancer incidence has risen sharply as diets and lifestyles have westernized (World Health Organization), and with the mean patient age aligning with the study’s population (68 years), these findings carry immediate significance. Standard discharge protocols after surgery and chemotherapy in many Thai hospitals currently revolve around general lifestyle advice. This new research urges a more proactive approach: prescribing, personalizing, and supporting exercise as an integral part of recovery and long-term health, not merely an afterthought.
Traditionally, the belief in Thai medical culture has emphasized rest and gentle rehabilitation after major illness, but global research now increasingly points toward the biological benefits of exercise in fighting cancer recurrence. According to guidance from Thailand’s Ministry of Public Health (กรมอนามัย), physical activity guidelines are broad, generally recommending at least 150 minutes per week for health. The new evidence means these guidelines could soon become more specific and integrated into oncology practice across major urban medical centers and into regional community hospitals.
The Thai social context—where extended families often play a key role in patient care, and where temple-based community activities such as morning group exercise are common—could support implementation of structured exercise programs. Family encouragement and culturally familiar group activities like walking in parks, joining aerobic dance classes at temples, or cycling may help survivors adhere to their plans, especially for elderly patients who might otherwise struggle with isolation or motivation.
Beyond immediate implications for colorectal cancer, this trial supports a fast-growing body of evidence that tailored exercise can act as medicine for a range of conditions, from diabetes and heart disease to recovery from other cancers (Harvard Health Publishing). Several Thai medical schools are now considering protocols for “exercise prescriptions,” taught alongside pharmacological and surgical therapies in their curricula.
Looking ahead, researchers plan to further investigate how specific types of exercise may benefit different groups of cancer survivors, and whether similar results hold for other common malignancies such as breast and prostate cancer. They are also developing digital support tools, including smartphone apps and remote coaching systems, to help survivors maintain activity levels over the long term—a move likely to resonate in Thailand, where mobile health initiatives have gained traction nationwide (Thai National eHealth Strategy).
For Thai readers confronting, surviving, or helping a loved one recover from colorectal cancer, the take-home message is clear: physical activity—specifically, structured and consistent aerobic exercise—should be considered a cornerstone of the treatment plan. Cancer survivors are advised not to wait for further international guidelines but to consult with their oncologists about safe, supervised ways to get active as soon as post-treatment recovery allows. Participation in community group exercises, walking clubs, or personalized plans developed with Thai physical therapists can make a measurable difference in survival and quality of life.
For families and caregivers, supporting the survivor’s exercise plan—offering company on walks, joining in community activities, or helping overcome logistical barriers—can be as vital as reminding them to take medication. Healthcare professionals in Thailand are encouraged to integrate exercise planning into discharge protocols, refer survivors to specialized physiotherapists or community health volunteers (อาสาสมัครสาธารณสุขประจำหมู่บ้าน), and track adherence using digital or paper tools.
As this study’s co-chairs noted, the era when exercise was seen as merely a “bonus” for cancer patients is over. It is now, unequivocally, part of the cure.
For those seeking further information or personalized advice, reliable resources include the Thai Ministry of Public Health’s cancer patient guidelines (กรมการแพทย์), patient support organizations, and oncology centers at leading hospitals where multidisciplinary cancer clinics already provide holistic care.
In summary, structured exercise is not just safe for colorectal cancer survivors—it is life-extending, evidence-based medicine. Thai readers should seize the opportunity to move more, and stakeholders across the health system should act without delay to embed these findings into practice.
Sources:
- NewAtlas: Post-cancer program lowers risk of death by 37%, 17-year study finds
- World Cancer Research Fund: Colorectal Cancer Statistics
- World Health Organization: Cancer Fact Sheets
- Thai Ministry of Public Health: Cancer Guidelines
- Harvard Health Publishing: Prescribing Exercise
- Thai National eHealth Strategy