Scientists talked about the impact of training on cancer survival
Structured physical training may be associated with a higher survival rate for cancer patients and a lower risk of disease recurrence. According to the combined data, participants in such programs had a 23% lower relative risk of death and a 17% lower risk of relapse than in the control groups. The most noticeable result was observed in the early stages of cancer, aerobic and combined exercise, as well as in patients who completed most of the prescribed program. This is stated in a systematic review and meta-analysis published in the British Journal of Sports Medicine.
What scientists have studied
Physical exercises are already used in the supportive care of cancer patients. They help fight fatigue, stay physically active, and improve quality of life during and after treatment. At the same time, the question of whether training can directly affect life expectancy and the likelihood of relapse has long remained controversial.
The authors of the new study attempted to summarize the most reliable data obtained in randomized controlled trials. They studied scientific papers published before the end of 2025 in which adult patients with confirmed cancer participated in structured exercise programs.
A structured program does not mean random or episodic activity, but a pre-designed training regime with a specific type of load, intensity, duration and regularity. In some studies, classes were conducted under the supervision of specialists; in others, patients were assigned an individual plan and monitored for its implementation.
Initially, the scientists found 123 potentially suitable works. After verification, 21 clinical trials conducted in North America, Europe, Asia and Australia met the established criteria. The total sample consisted of 8,449 people, 88% of whom were women.
The average age of the participants reached 54 years, while in individual trials the figure ranged from 47 to 76 years. The patients' condition was monitored for an average of 64 months, but the duration of control in different studies ranged from two to 99 months.
Most of the data was obtained on patients with breast cancer. Bowel cancer and pancreatic cancer were the next most common in the studies. According to the authors of the review, after surgery and chemotherapy performed for the purpose of healing, cancer returns in about 20-40% of patients. Therefore, the search for additional ways to reduce the risk of recurrence remains one of the important tasks of oncology.
How did training affect survival?
The combined analysis showed that participation in structured training was associated with improved overall survival. In patients from the physical activity groups, the relative risk of death during the follow-up period was 23% lower than in people who did not participate in such programs. The risk of disease recurrence was 17% lower.
With additional analysis of individual endpoints, the researchers found that the probability of death from any cause in the training groups was 18% lower. The risk of death directly from cancer decreased by 26%.
At the same time, we are talking about a relative, not an absolute reduction in risk. These figures do not mean that training can prevent 23 deaths for every 100 patients. The real difference for a particular person depends on the type of tumor, stage of the disease, age, state of health, treatment performed and the initial risk of recurrence.
The researchers also found no convincing evidence that exercise increased the period before tumor progression or increased the likelihood of complete disappearance of signs of invasive cancer after standard treatment. Thus, positive results were not obtained for all the studied indicators.
The authors emphasize that training cannot be considered as a substitute for surgery, drug therapy, or radiation. We are talking about a possible additional component of oncological care, which is used together with the main treatment.
Which loads showed the best result
The most favorable estimates of overall survival were obtained for aerobic exercise and programs that combined aerobic and strength training. Aerobic activity includes prolonged movements that increase breathing and pulse while simultaneously engaging large muscle groups.
For strength training without an aerobic component, it was not possible to establish an unambiguous link with survival. However, this conclusion is based on only one study involving 129 people. Therefore, it does not prove the futility of strength exercises and rather indicates a lack of data.
Strength training may have other practical implications for patients: to help maintain muscle mass, strength, and the ability to perform daily activities. However, the new meta-analysis does not allow us to separately assess their impact on the risk of death and the return of the disease.
Compliance with the prescribed regime turned out to be an important factor. In an additional analysis, the most pronounced association with improved survival was observed among patients who completed at least 70% of the training program.
However, this result requires careful interpretation. People who are able to exercise regularly may initially be in better physical condition, easier to tolerate treatment, and less likely to experience complications. Therefore, the fact that most of the program was completed does not prove that discipline was the only reason for the higher survival rate.
Why physical activity can affect the tumor
The authors of the review named several possible biological mechanisms that could explain the results. Aerobic exercise strengthens the cardiovascular system, affects the movement of immune cells, and can improve blood supply to tumor tissue.
Normalization of blood flow potentially helps antitumor drugs more effectively reach the desired areas. However, this explanation is still being considered as a probable mechanism, rather than as a proven effect for all types of cancer.
Regular exercise can also affect the functioning of the immune system, which is involved in the recognition and destruction of altered cells. In addition, physical activity can reduce the concentration of certain sex hormones in the blood. This may be important for tumors whose growth depends on hormonal signals.
During exercise, muscles absorb glucose more actively. As a result, less of it remains in the bloodstream and potentially becomes less accessible to tumor cells. The researchers also suggest that physical exercise can support the repair of damaged DNA and thus limit the accumulation of changes that contribute to more aggressive tumor behavior.
At the same time, these processes should not be perceived as a universal scheme. Oncological diseases differ in their origin, molecular features, sensitivity to hormones, and response to treatment. A mechanism that is potentially significant in one type of tumor may be much less important in another.
What results have already been obtained in intestinal cancer
One of the most compelling individual studies in this area was the international CHALLENGE trial, the results of which were published in 2025 in the New England Journal of Medicine. The study involved 889 patients with removed stage III or stage II colon cancer with a high risk of disease recurrence. All of them have completed adjuvant chemotherapy.
The participants were randomly divided into two groups. The first one has been undergoing a structured exercise program for three years with the support of a physical activity consultant. The second received information materials about a healthy lifestyle.
After five years, the disease-free survival rate was 80.3% in the training group and 73.9% in the control group. After eight years, the overall survival rate reached 90.3% and 83.2%, respectively. The absolute difference in this indicator was 7.1 percentage points.
At the same time, physical activity was not completely risk-free. Disorders and injuries of the musculoskeletal system were registered in 18.5% of the participants in the training group and 11.5% of the patients who received only recommendations. Experts recognized about 10% of such cases among the trained participants as directly related to the program.
These data show why not only the call to move more is important in oncology, but also a professionally designed program. It must be adapted to the patient's condition, the consequences of surgery, side effects of treatment, physical fitness level and concomitant diseases.
Can training become a part of treatment
The researchers believe that the accumulated data is already sufficient to consider structured exercises as part of comprehensive cancer care. According to them, doctors can reasonably recommend such programs to patients, although the optimal regimen has yet to be clarified.
The main change lies in the approach to physical activity itself. Previously, it was considered primarily as a way to reduce fatigue and restore a person's ability to engage in daily activities. New data indicate that its possible role may go beyond rehabilitation and affect indicators that are traditionally associated with the effectiveness of treatment.
However, this does not mean that cancer patients should dramatically increase their workload on their own. Exercises should be selected taking into account the diagnosis, the stage of the disease, the operation performed, the condition of bones, heart and blood vessels, the level of anemia, the risk of infections and side effects of therapy.
The authors called for continued clinical trials, especially among men, patients with advanced stages of the disease, and people with poorly understood types of tumors. Further research should determine which loads, intensity and duration of classes have the greatest effect and to whom they are suitable.
Переведено сервисом «Яндекс Переводчик»
