A wave of headlines has cheered that exercise is “better than drugs” for preventing colon cancer recurrence, suggesting an exciting shift in how survivors might chart their recovery. But a closer examination of the latest landmark research, published in the New England Journal of Medicine in June 2025, brings a far more nuanced—and ultimately more practical—message for cancer patients and the health community, including here in Thailand. The real story isn’t a competition between medicine and movement, but a call for a more holistic approach in which structured exercise and medical care both play distinctive and powerful roles in ensuring long-term health and survival.
Why does this story matter for Thai readers? Colorectal cancer is the third most common cancer in Thailand, and its incidence is projected to increase in the coming years, as reported by the National Cancer Control Program. In a landscape where cancer remains the leading cause of death in the country, any development that offers hope for improving survivorship and quality of life merits close attention. The international trial at the heart of recent media coverage turns out to offer important, actionable lessons not just for individual patients, but for Thailand’s growing network of cancer hospitals and support programs.
According to the pivotal study reported in The New England Journal of Medicine, 889 patients who had gone through colon cancer surgery and completed chemotherapy were randomly assigned into two groups, beginning roughly three to six months after finishing their treatment. The first group received a rigorous, professionally supervised exercise program for three years, including mandatory behavioral support sessions, supervised exercise classes, and guidance from certified trainers. The second group received only health education materials—informational brochures and advice on the benefits of exercise and healthy eating, with no hands-on support.
After nearly eight years of follow-up, the outcomes were clear: those in the structured exercise group had significantly longer disease-free survival, with five-year disease-free survival rates of 80.3% compared to 73.9% in the health education group, and eight-year overall survival of 90.3% versus 83.2% (NEJM article). The implication? Engaging in regular, structured, and socially supported exercise—such as brisk walking or moderate jogging three to four times per week; supervised sessions in gyms, parks, or clinics; and ongoing contact with fitness professionals—can provide tangible long-term survival benefits for colon cancer survivors.
But these results do not mean that exercise alone is a “replacement” for life-saving cancer drugs or chemotherapy. Every participant in the study already completed chemotherapy before the start of the exercise program. The real finding is that exercise serves as a critical complement—alongside, not instead of, established medical treatments. As epidemiology and public health experts have repeatedly emphasized, the best outcomes for cancer survivors happen when medical science is integrated with supportive lifestyle interventions, not when one is chosen instead of the other (The Guardian).
Why did structured exercise make such a difference when mere health advice did not? The study’s lead investigators point to three main factors: regular professional coaching, social support from group participation, and encouragement to maintain new habits over time. Telling patients to “go exercise” is easy; helping them actually adopt and sustain this new behavior—especially after chemotherapy, when fatigue and anxiety are common—is a far greater challenge. The trial showed that a support system, including supervised sessions and peer encouragement, is essential for lasting change.
For Thai cancer patients and the country’s health system, the study aligns closely with findings from local rehabilitation research. A recent quasi-experimental study published in Thailand showed that nurse-patient collaboration, tailored physical activity plans, and motivational support play a crucial role in postoperative recovery and functional independence for colorectal cancer patients (Thai Journal of Nursing Research). Likewise, hospitals and cancer rehabilitation clinics in Thailand are beginning to implement integrative programs that blend physiotherapy, guided group exercise, and psychological support—a trend encouraged by Thailand’s National Cancer Institute and in line with Ministry of Public Health guidelines to promote “no more belly fat” and a culture of physical activity across all ages (PMC).
Expert voices around the world highlight that structured, supervised exercise is one of the strongest non-drug interventions now proven for cancer survivors—helping improve not just survival, but quality of life, strength, mood, and social cohesion. As one physical medicine specialist commented, “This is not about pitting fitness against pharmaceuticals. We’re learning how to harness the power of both, together, for optimal recovery.”
Yet no intervention is without risks. The NEJM study noted that musculoskeletal adverse events—strains and overuse injuries—were more common in the exercise group (18.5%) than in the education-only group (11.5%), underlining the importance of supervision and graduated programs, especially for older or frail patients. Thai clinicians and nurses overseeing rehabilitation programs must be vigilant, routinely adjusting activity levels based on individual patient tolerance.
Looking at the broader Thai context, the National Cancer Control Program projects more than 19,000 new colorectal cancer cases in 2025. Screening campaigns targeting residents aged 50-70, early intervention, and multidisciplinary recovery programs are increasingly vital. While access to physical therapy and supervised exercise is best in major urban centers, initiatives such as affordable outdoor “boot camps,” hospital-based exercise groups, or even suburban walking clubs offer scalable and culturally appropriate solutions. Thailand’s experience in leveraging health education campaigns—like anti-smoking, anti-liver fluke, and healthy eating efforts—can serve as a model for promoting structured exercise among cancer survivors.
Historically, many Thais are familiar with the concept of communal exercise in parks, temple courtyards, or village centers. Traditional practices such as group aerobics and early morning “ram wong” dances in Lumpini Park show that social exercise resonates with national culture, making it easier to adapt structured exercise models to local customs. Integrative health clinics in Bangkok and elsewhere have already begun offering group rehabilitation sessions modeled on Western evidence, but tailored with Thai values of community, mutual support, and holistic wellbeing (Bumrungrad Esperance Integrative Cancer Clinic).
Globally, cancer survivors everywhere are living longer, but also seeking better quality of life after treatment. Thailand is no exception. The challenge is to ensure that evidence-based exercise programs are affordable, safe, and easily accessible, especially to patients in rural areas or those with mobility limitations. Future developments may include digital platforms for remote coaching, national health insurance coverage for supervised exercise, and expanded nurse-led community rehabilitation teams.
Taken together, the latest global and Thai research sends a clear message: rigorous, socially supported exercise should be standard—not optional—during remission for cancer patients, especially those recovering from colorectal cancer. But it cannot replace chemotherapy, drugs, or the close guidance of oncology specialists. Instead, combining medical care and movement delivers the best hope for long-term remission, lower recurrence, and a full, vibrant life after cancer.
For Thai readers, the takeaway is both practical and empowering: if you or a loved one is recovering from colon cancer or any cancer, ask your oncology nurse or doctor about structured exercise programs—ideally with professional supervision and a group component. Seek out local hospital- or community-supported rehabilitation. Use Thailand’s culture of social activity to make exercise part of daily life, not a solitary struggle.
And above all, beware misleading headlines—whether in English or Thai. The real power comes not from a single miracle pill or a lone exercise routine, but from embracing the best of medical science and active living, together.
Sources:
- The Guardian: Is exercise really better than drugs for cancer remission? It’s an appealing idea – but it’s misleading (2025)
- Structured Exercise after Adjuvant Chemotherapy for Colon Cancer, NEJM (2025)
- Effectiveness of the Rehabilitation Program after Colorectal Surgery for Patients with Colorectal Cancer: A Thai Study (2023)
- National Cancer Control Program of Thailand
- Esperance Integrative Cancer Clinic, Bangkok