For decades, doctors have recommended exercise to help cancer patients manage treatment side effects and improve their quality of life. But a landmark new study suggests exercise doesn’t just help cancer patients feel better—it may help keep cancer from returning.
The 2025 CHALLENGE Trial, published in the New England Journal of Medicine, was the first large randomized controlled study to test whether a structured exercise program could improve long-term outcomes for colon cancer patients after they had completed surgery and chemotherapy. After a median follow-up of eight years, patients with stage 2 and 3 colon cancer who participated in the program had a 28 percent lower risk of disease recurrence, a new primary cancer, or death than those who received exercise education alone. They also had a 37 percent lower risk of death from any cause. According to the study authors, the magnitude of the survival benefit was similar to that seen with many approved cancer drug therapies.
The findings mark a turning point for the growing field of exercise oncology. While no one is suggesting exercise should replace standard cancer treatments, mounting evidence suggests it should be integrated into standard cancer care alongside these therapies, says Sharlene Gill, an oncologist at the University of British Columbia and a co-author of the CHALLENGE Trial.
“The conventional pillars of cancer treatment are surgery, radiation, and chemotherapy with everything else being supportive,” says Gill. “Exercise has moved from not supporting that fight but having the ability to change the outcome of that fight.”
The results are “remarkable,” says Melinda L. Irwin, deputy director of the Yale Cancer Center and Susan Dwight Bliss professor of epidemiology and associate dean of research at Yale School of Public Health. Beyond demonstrating a statistically significant benefit, she says, the study found an effect large enough to meaningfully improve patients’ lives.