Landmark clinical trial shows exercise improves colon cancer survival

News & Announcements | 02 Jun 2025

In a world-first clinical trial, researchers working with the Canadian Cancer Trials Group (CCTG) and Sinclair Cancer Research Institute at Queen’s University, Kingston Health Sciences Centre (KHSC), and the KHSC Research Institute, have demonstrated that a structured exercise program significantly improves survival for colon cancer patients by reducing the risk of disease recurrence and new primary cancers.

The trial, conducted over 17 years, is the first to conclusively show that physical activity after surgery and chemotherapy can improve long-term outcomes for people with colon cancer. The results, presented June 1 at the American Society of Clinical Oncology (ASCO) annual meeting mark a turning point in cancer care worldwide.

“As oncologists, one of the most common questions we are asked is ‘What else can I do to improve my outcome?’” says Dr. Christopher Booth (Professor, Departments of Oncology and Medicine), medical oncologist at KHSC, who co-chaired the study.

“The CHALLENGE trial answers that question. A structured exercise program after surgery and chemotherapy can reduce risk of recurrent or new cancer, improve quality of life and extend patients’ survival.

The trial involved 889 patients with stage III or high-risk stage II colon cancer who had completed surgery and chemotherapy. The study subjects were divided into two groups: one group engaged in a structured exercise program supervised by a physiotherapist or kinesiologist, while the other received health education materials promoting physical activity and healthy eating. All patients also received standard cancer surveillance and follow-up care.

Patients in the exercise group were challenged to add 2.5 hours of moderate-intensity exercise to their regular activities each week. They met with exercise specialists every two weeks during the first year and monthly for the next two years. The support made a significant difference in adherence to exercise goals, with many participants noting that having guidance and accountability was crucial for their success.

Dr. Kerry Courneya, co-chair from the University of Alberta, emphasized the importance of integrating exercise into cancer care.

“Exercise is no longer just a quality-of-life intervention – it is a treatment for colon cancer,” he says.

Results were impressive. After five years, the disease-free survival rate was 80 per cent for those in the exercise program, compared to 74 per cent for those who received educational materials. Patients in the exercise group had a 28 per cent lower risk of cancer returning or new cancers developing. Overall survival rates at eight years were 90 per cent for the exercise group, compared to 83 per cent for those who only received educational support, reflecting a 37 per cent reduction in risk of death for the structured exercise group.

“The Canadian Cancer Trials Group is delighted to have once again led an international cancer clinical trial that will change practice globally and improve outcomes for patients,” says Dr. Chris O’Callaghan, the study’s Senior Investigator and a member of the Sinclair Cancer Research Institute at Queen’s University. “With these results, the CHALLENGE trial will mark a turning point in the treatment of colon cancer.”

Since its establishment in 1980, CCTG has grown to become the largest research group at Queen’s with a network of scientific leaders from all the cancer centres and hospitals in Canada and a global network of nearly 20,000 investigators and clinical trial staff.

“CCTG is a point of pride for Queen’s,” says Dr. Nancy Ross, Vice-Principal (Research) at Queen’s. “The CCTG team has attained a position as a global leader, as evidenced in this latest research. They are continually setting the standard for expertise and quality, quickly getting platforms in place to launch important trials that have real impact on medical treatments and people’s lives.”

Landmark clinical trial shows exercise improves colon cancer survival

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