Exercise improves colon cancer survival, high-quality trial finds

Any type of aerobic exercise works for the improvements, study finds.

See full article...

 

[muddledzen]

I was really happy to read this as colon cancer runs rampant through my family (my mom, her sister, my grandfather, and 3 of his siblings have all had colon cancer).

More motivation to not skip my daily walks.

 

[Mostly Ignorant]

I think we're at a point with cardiovascular and resistance training that unless specifically instructed by your physician to avoid it, it'll have beneficial aspects to whatever disease state or injury you're recovering from, and will improve your chances of maintaining a health state.

 

[Findecanor]

Having survived colon cancer twice, my suspicion is that the big factor is stress. Exercising regularly reduces stress. And stress is known to reduce the immune system's function: the immune system that fights cancer. The truth is that everyone gets cancer mutations all the time and that the immune cancer fights these off all the time: it is so good at it that we only "get cancer" when the immune system fails.

I had got mine during especially stressful periods of my life, despite also exercising.

 

[VelvetGlove]

I think we're at a point with cardiovascular and resistance training that unless specifically instructed by your physician to avoid it, it'll have beneficial aspects to whatever disease state or injury you're recovering from, and will improve your chances of maintaining a health state.

Yes, my understanding of the data is that increasing exercise improved life expectancy for:
- people without colon cancer
- people with colon cancer
- people who recovered from colon cancer
(i.e. everyone)

 

[Lil' ol' me]

Just like mom always said:

Eat your vegetables! (Eat a varied diet.)

Go out and play! (Go outside and have some fun.)

Everything in moderation.

Don't just sit & watch a screen or play computer games. Get rid of the Media Room, the movie seats, and the gaming chair.

Buy a pot and a pan and cook once in a while. With friends.

But yeah, oligarchs taking all our money & time makes that hard, I get it.

 

[Mostly Ignorant]

Yes, my understanding of the data is that increasing exercise improved life expectancy for:
- people without colon cancer
- people with colon cancer
- people who recovered from colon cancer
(i.e. everyone)

Many will likely not have an uptodate subscription, but Drs. Sullivan, Feigenbaum and Baraki wrote the Strength training for health in adults: Terminology, principles, benefits, and risks article, and the short answer to the question of "what areas of human health does resistance training improve?" is "pretty much all the areas, in multiple ways".

 

[wastrel]

Yeah, getting off your butt does seem obviously good.

 

[Findecanor]

I was really happy to read this as colon cancer runs rampant through my family (my mom, her sister, my grandfather, and 3 of his siblings have all had colon cancer).

That sounds like there could be a hereditary gene-mutation in your family. You should get yourselves tested, if you haven't already.
Those of you that test positive should have a yearly colonoscopy.

And everyone else should have a colonoscopy at least every ten years after the age of 45.

Colonoscopies are not actually that bad. The prep is worse than the actual procedure. Just relax and look at the screen (if you want to). You could also opt to be sedated, or even sleep through the whole procedure.
For normal people (without any hereditary risk), a polyp takes many years to develop from initial state to cancer. If you have one, then it can be snipped off by an instrument during the colonoscopy. It's simple, painless and then you are safe for a decade. It goes without saying that it is preferable to the alternative ...

I've had thirteen colonoscopies and never been sedated or needed any sedative. The colon can be fascinating to look at.
And there is of course nothing sexual about it. My doctors and nurses have always been very professional. If you have done the prep correctly, there is no poop left, and you are clean.

 

[muddledzen]

That sounds like there could be a hereditary gene-mutation in your family. You should get yourselves tested, if you haven't already.
Those of you that test positive should have a yearly colonoscopy.

And everyone else should have a colonoscopy at least every ten years after the age of 45.

Colonoscopies are not actually that bad. The prep is worse than the actual procedure. Just relax and look at the screen (if you want to). You could also opt to be sedated, or even sleep through the whole procedure.
For normal people (without any hereditary risk), a polyp takes many years to develop from initial state to cancer. If you have one, then it can be snipped off by an instrument during the colonoscopy. It's simple, painless and then you are safe for a decade. It goes without saying that it is preferable to the alternative ...

I've had thirteen colonoscopies and never been sedated or needed any sedative. The colon can be fascinating to look at.
And there is of course nothing sexual about it. My doctors and nurses have always been very professional. If you have done the prep correctly, there is no poop left, and you are clean.

Oh yeah, I'm mid 40's and I've already had two scopes. My first one was at 38 because of all the family history.

Also why I quit eating meat (other than fish) 20 years ago, and haven't had more than a couple of drinks of alcohol per year since I was in my mid-20s. None of this (including exercise) is a silver bullet, but if it's within my ability to minimize my risk why not?

 

[tsunam]

Am I reading this right? A 28% increase for just 5+ additional METs/week? If so, that is amazing. Or is the “Over 20 METs” per week significantly over 20?

 

[DrewW]

How do I convert my VR time into MET?

 

[Danathar]

This is why I recommend people read Philipp Dettmer’s book Immune.

Intense exercise mobilizes T-cells.

Your immune system is amazing and if people understood how hard a job it has they would be far less likely to make it’s job harder. Your immune system system is fighting cancer ALL THE TIME.

 

[Mhajicek]

Consider all the knock-on effects from long covid/ chronic fatigue which prevents regular exercise...

 

[andygates]

How do I convert my VR time into MET?

Rhythm games are warmups and HIIT stuff is intense, so I'd class them like brisk walking and jogging.

 

[FinallyAnAccount]

dammit! sigh...

 

[runemail]

That sounds like there could be a hereditary gene-mutation in your family. You should get yourselves tested, if you haven't already.
Those of you that test positive should have a yearly colonoscopy.

And everyone else should have a colonoscopy at least every ten years after the age of 45.

Colonoscopies are not actually that bad. The prep is worse than the actual procedure. Just relax and look at the screen (if you want to). You could also opt to be sedated, or even sleep through the whole procedure.
For normal people (without any hereditary risk), a polyp takes many years to develop from initial state to cancer. If you have one, then it can be snipped off by an instrument during the colonoscopy. It's simple, painless and then you are safe for a decade. It goes without saying that it is preferable to the alternative ...

I've had thirteen colonoscopies and never been sedated or needed any sedative. The colon can be fascinating to look at.
And there is of course nothing sexual about it. My doctors and nurses have always been very professional. If you have done the prep correctly, there is no poop left, and you are clean.

Damn you are a pro!
Worst part is the prep, the actual colonoscopy is a relief because you know it's soon over. Weird to have something lurking around in your insides, but cool to watch the video feed. Next time I'll ask for a recording. OnlyFans here I come!

 

[Fatesrider]

How do I convert my VR time into MET?

Treadmill... Walk anywhere in the world. Add fans for sensory effects.

 

[MrMcLargeHuge]

commonest

Is this a King’s English thing? Can’t recall ever encountering this phrasing as an American who reads a lot.

 

[runemail]

Having survived colon cancer twice, my suspicion is that the big factor is stress. Exercising regularly reduces stress. And stress is known to reduce the immune system's function: the immune system that fights cancer. The truth is that everyone gets cancer mutations all the time and that the immune cancer fights these off all the time: it is so good at it that we only "get cancer" when the immune system fails.

I had got mine during especially stressful periods of my life, despite also exercising.

It has always been my understanding that exercise adds stress to the body, and the recovery is when the body gets stronger and learn how to deal with it. If you add too much additional stress from your life in recovery you end up with just wearing your body and immune system down. So you should reduce your training load of you have a very stressful period in your life. But that's easy to say, but hard to do. Because athletes tend to regard their training as their "happy time" where they are in control. Especially when everything else is chaos. I know it because I know it, but still do it

 

[Keith Tanner]

Exercise is truly a wonder drug. I'm really happy to see the results of this study, because it's such a welcome change from a $2000/month wonder drug. Exercise really doesn't cost much, if anything.

I'm usually quite active - I'm on the ice playing hockey three days a week and hit the gym at least twice for strength training. I also ride my bike because who doesn't love riding bikes? I'm in my mid-50s, so it's not as easy as it used to be. I just got back from visiting my mom for two weeks during which I was fairly sedentary, and I could feel myself stiffening up and getting creaky even over that short period. My sleep patterns changed as well. No word on whether I developed colon cancer, we'll have to wait and see...

 

[TechnicaGratiaArs]

The finding comes from a phase 3, randomized clinical trial led by researchers in Canada, who studied nearly 900 people who had undergone surgery and chemotherapy for colon cancer.

This study shows exercise provides a 28% reduction in colon cancer incidence of people who survived colon cancer and the surgery or chemotherapy that put it in remission. Which is indeed awesome.

But I don't think it shows what effect that exercise has on people who haven't got colon cancer yet, though they would later. It seems obvious that the exercise would have the same effect on them as on the cancer survivors, but "obvious" isn't how science or legitimate medicine work. Is there a scientific reason to be sure that the exercise has the same benefits to those who haven't yet had the cancer, reducing its chances?

 

[Jackattak]

Sorry if I sound like a broken record.

Never. Stop. Moving.

Exercise until you die (of old age).

 

[omniron]

For now, it's not entirely clear how exercise keeps cancers at bay, but it squares with numerous other observational studies that have linked exercise to better outcomes in cancer patients

Anecdotally as someone with prediabetic issues, my immune system is noticeably worse when I’m eating poorly and not exercising. Allergies are worse, skin conditions are worse, more likely to get colds, etc. it’s long been known too that skin tags are an early indicator of diabetes. There’s a lot of emerging research on the metabolic connection to immune functioning.

Even explains why glp1 agonists seem like miracle drugs, having healthy blood sugar boosts the immune system and helps fight all sorts of ailments.

 

[whobeme]

If that amount of exercise reduces recurrence by such a large amount one might also expect that it would reduce occurrence by a measurable extent. Seems like something that would have shown up already in studies if true. Studies like this one:

https://pmc.ncbi.nlm.nih.gov/articles/PMC10311389/

CRF = Cardiorespiratory fitness

In the theoretical calculation of prevented cases, we noted that avoiding having very low CRF levels could have prevented 4% to 8% of all colon cancer cases, 4% of all deaths from lung cancer, and 4% to 19% of deaths from prostate cancer.

The two studies are apples and oranges in approach though, with the one cited in this post being a very long term retrospective study and the one in the article being a relatively short study of just a few years.

There is an odd result in the Swedish study where they found the rate of prostate cancer incidence has a peak in the middle of the CRF range, whereas the mortality rate from the disease goes down with increasing CRF (albeit with fairly large error bars). I do wonder if the reduced cancer mortality with increasing CRF for various cancers might not in part be the result of people who had been diagnosed with a cancer, and exercise more, having more heart attacks, strokes, or getting hit by a truck while exercising/jogging/biking, after developing the disease, which would shift them out of the mortality category for that cancer since they died from something else. Just like playing Russian roulette once a year will nearly guarantee that a man will not die of prostate cancer, yet it is definitely not a good life choice.

 

[bioMatrix]

Damn you are a pro!
Worst part is the prep, the actual colonoscopy is a relief because you know it's soon over. Weird to have something lurking around in your insides, but cool to watch the video feed. Next time I'll ask for a recording. OnlyFans here I come!

The worst part of a colonoscopy is tryna get a ride. U can’t drive yourself, take an uber, or use public transport. U hafta inconvenience every1 and create yuge drama.

 

[Mungus the Unhyphenated]

It has always been my understanding that exercise adds stress to the body, and the recovery is when the body gets stronger and learn how to deal with it. If you add too much additional stress from your life in recovery you end up with just wearing your body and immune system down. So you should reduce your training load of you have a very stressful period in your life. But that's easy to say, but hard to do. Because athletes tend to regard their training as their "happy time" where they are in control. Especially when everything else is chaos. I know it because I know it, but still do it

It's all about "good" stress ('eustress') versus "bad" stress ('distress'). What we think of generically as "stress" is typically the bad kind, (Think being overworked, debt concerns, doomscrolling, etc.) which stimulate cortisol overproduction, lead to poor-quality sleep, and depression of the immune system. The fight-or-flight response is triggered constantly, even at low levels, which leads to physical and metabolic exhaustion with no resolution.

Exercise and physical training fall into the 'eustress' category. Yes, the body and metabolism are taxed, but there is an end to it and usually a psychological "resolution" and satisfaction at completing something. It produces a positive psychological and metabolic feedback loop.

 

[irnoob]

Am I misreading this or did people who got swole/bulked up have better outcomes? So putting on muscle mass is good for avoiding cancer recurrence? If that's the case I'd advise people take up swimming, which is a low-impact hybrid of resistance training and cardio. You get more muscle but also get better cardio at the same time, and the only time you really have joint-jarring impacts are during flipturns or pullturns. Good for your knees. Good for your heart. Good for your lungs, and good for your... ...colon?

 

[NoMoreSecrets]

Others have beaten me to the PSA, but please please please don't hold off on a colonoscopy. My wife (a colorectal surgeon) had me go right at 45, and the gastroenterologist found a 5cm mass that required an EMR to remove. The biopsy was negative and the 6 month followup colonoscopy came back clean, but the GI doctors said it could have been a much different story had I waited until 50.

I know this isn't directly related to the article, but colon cancer is so damned treatable when caught early that I always get on a soapbox about it. Get it done!

 

[Tam-Lin]

And, of course, the MAHA folks will completely take the wrong lessons from the study. Because to them, this will be evidence that people can cure themselves of cancer, if they exercise enough. But as with so many things, it’s usually not that people don’t want to exercise. It’s that it’s very difficult for them to do so, if not impossible. With the right support, they would exercise. But that’s not what they’ll take away from the study.

 

[el_oscuro]

That sounds like there could be a hereditary gene-mutation in your family. You should get yourselves tested, if you haven't already.
Those of you that test positive should have a yearly colonoscopy.

And everyone else should have a colonoscopy at least every ten years after the age of 45.

Colonoscopies are not actually that bad. The prep is worse than the actual procedure. Just relax and look at the screen (if you want to). You could also opt to be sedated, or even sleep through the whole procedure.
For normal people (without any hereditary risk), a polyp takes many years to develop from initial state to cancer. If you have one, then it can be snipped off by an instrument during the colonoscopy. It's simple, painless and then you are safe for a decade. It goes without saying that it is preferable to the alternative ...

I've had thirteen colonoscopies and never been sedated or needed any sedative. The colon can be fascinating to look at.
And there is of course nothing sexual about it. My doctors and nurses have always been very professional. If you have done the prep correctly, there is no poop left, and you are clean.

I only had 2. The worst part is the prep the night before. During the first one, I looked up at the clock and was mad. They were supposed to have started 30 minutes ago. Then my wife came and told me they were already finished.

I was due for the next one, but kept putting it off. The prep is a pain. But at my wife's insistence, I scheduled it.

A few weeks before, my wife asked if I was also getting an endoscopy. "You can get them both done at the same time and only do the prep once. Might as well get that heartburn checked anyway." It took a lot of calls (and my wife's insistence) to get it added, but I finally did.

And afterwards, the doctor said: "Your colonoscopy was perfect. No polyps. But the endoscopy is bad. You have a LOT of damage from acid reflux." They immediately put me on prescription strength Nexium to get it under control, with a followup endoscopy 3 months later to make sure it hadn't turned cancerous. Which fortunately it hadn't.

I'm pretty much on that Nexium for life, and the doctor explained the warnings on the OTC stuff: "Don't take this for more than 2 weeks without seeing your doctor". According to him, the warnings were to prevent precisely what I had.

So if you have chronic heartburn, see your doctor and get an endoscopy if needed. Also, listen to your SO. It can save your life.

 

[inboulder]

Wow, this is an exciting finding and impressively designed and executed study; 3 years is no joke when trying to herd human-cats and get them to exercise.
Anyone have access to NEJM full article know the dropout rate for the exercise cohort? And, would be interesting to understand how they're calculating the 80.3% vs 73.9%, does the 80.3% include all dropouts or only those that completed the exercise program for 3 years? Basically any specifics on the trial method for randomization and control vs test and any filters applied to test or control cohorts would be really interesting to understand especially with the relatively small numbers in the trial, n=~900. Thanks!

 

[Thinker_in_TX]

The worst part of a colonoscopy is tryna get a ride. U can’t drive yourself, take an uber, or use public transport. U hafta inconvenience every1 and create yuge drama.

Yeah. That's a problem unless you have family at home or close by. A few years ago, I was scheduled for a colonoscopy but had no one at the time to chauffeur me. I talked the doctor into a Colo-guard test which is pretty good but not as conclusive. In a couple of days, I need a medical procedure where they will lightly sedate me and also have to have someone drive me afterwards. Fortunately, I now have good friends and one had volunteered to shepherd me. I promised her that I'll treat her and her partner to a dinner either afterwards if I'm not to drugged sleepy or later. Having good friends is good for your mental and physical health.

 

[Emon]

Sorry if I sound like a broken record.

Never. Stop. Moving.

Exercise until you die (of old age).

Yep. It's been the scientific consensus for decades now, at least.

Literally every fucking time there's a study that says "exercise good" on Reddit, the comments are chock full of morons thinking they've debunked it by saying, "correlation doesn't equal causation!"

They'll literally just assume that the study was low quality and didn't control for confounding variables. They'll literally be afraid to click on it and read it.

It doesn't matter if it's a meta review of 20 years of research.

"Correlation doesn't equal causation" is like an incantation for educated people to use against any study they don't like the results of.

 

[Thinker_in_TX]

It's all about "good" stress ('eustress') versus "bad" stress ('distress'). What we think of generically as "stress" is typically the bad kind, (Think being overworked, debt concerns, doomscrolling, etc.) which stimulate cortisol overproduction, lead to poor-quality sleep, and depression of the immune system. The fight-or-flight response is triggered constantly, even at low levels, which leads to physical and metabolic exhaustion with no resolution.

Exercise and physical training fall into the 'eustress' category. Yes, the body and metabolism are taxed, but there is an end to it and usually a psychological "resolution" and satisfaction at completing something. It produces a positive psychological and metabolic feedback loop.

I became a fitness advocate some 8 years ago after having an embolism. I lost weight and started walking 5 miles on days I don't go to the gym. I find my 5 mile walks good for my mood and haven't been depressed since. I think about design problems or creative things as I walk.

 

[plugh]

Great study and great finding! I wish there were more of this type of research study done, but most require Pharma money and profit opportunity to get funded. We should have more like this.

And of course, publish negative findings as well as positive. Learning what doesn’t have an impact can be almost as valuable.

 

[Astro-CCD]

Get rid of the Media Room, the movie seats, and the gaming chair.

Not really, just use them properly. I watch a couple hours of something every day but not until I have had a full day of moving about including at least 40 minutes of brisk walking.

Moderation.

 

[llanitedave]

Am I misreading this or did people who got swole/bulked up have better outcomes? So putting on muscle mass is good for avoiding cancer recurrence? If that's the case I'd advise people take up swimming, which is a low-impact hybrid of resistance training and cardio. You get more muscle but also get better cardio at the same time, and the only time you really have joint-jarring impacts are during flipturns or pullturns. Good for your knees. Good for your heart. Good for your lungs, and good for your... ...colon?

Muscle mass is good, weight training is good, but that's not what this article was about. Simple aerobic exercise provides the recorded benefits. It's not a competition between methods.

 

[jock2nerd]

Exercise helps your bowels move, which helps reduce incidence of constipation.

I believe there is a correlation between irregular bowel movements and colon cancer.

 

[Veritas super omens]

With the new preps even the cleanout is really not that bad. My last one in 2020 I used Suprep. It is 2 bottles of medication, each 2 oz of fluid. You also drink copious amounts of gatorade. A pharmacist friend told me the latest is Sutab. Its some tablets you take. Also must drink lots of appropriate electrolye fluids, of course. Coincidentally I got approval from my care plan just today for a colonoscopy and am on the waiting list for a cancellation. Eat right, get plenty of exercise and do appropriate interval hemoccult and endoscopic prevention. Colon cancer is one that has very good treatment numbers, especially if caught early.