▎WuXi Adapt Content Team Editor
Colorectal cancer, also known as colorectal cancer, including colon and rectal cancer, is one of the most common cancers worldwide, with morbidity and mortality trending upwards.
Global cancer statistics in 2020 show that there were 1.93 million new cases of colorectal cancer, resulting in 935,000 deaths, ranking the third and third highest in the world in terms of new cancer incidences and deaths, respectively. No. 2. By 2040, 3.2 million new cases of colorectal cancer (a 63% increase) and 1.6 million (a 73% increase) of deaths are expected to occur globally each year.
Despite improvements in colorectal cancer survival with advances in early screening and treatment, they still face a high risk of recurrence and death. Some side effects produced by the treatment may also increase the risk of complications such as cardiovascular disease and infection, which will also affect the patient’s survival.
In addition to treatment, what canpatients do to reduce the risk of death? Greater physical activity in stage 3 colon cancer patients may help reduce the risk of recurrence and death, and be associated with better outcomes, according to a study published in the Journal of Clinical Oncology prognosis, including disease-free survival (DFS) and overall survival (OS).
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The study included 1696 participants who had stage 3 colon cancer and had undergone surgery and chemotherapy , the average age is 60.8 years old, and 55.5% are male.
Through a questionnaire, the researchers collected the basic information of the participants’ height, weight, ethnicity, etc.; tumor location, lymph node metastasis, and tumor invasion into the intestinal wall. , chemotherapy drugs, etc. clinical information; lifestyle information such as diet, smoking status, metabolic equivalents (MET) of different types of physical activity 3 months before and 6 months after chemotherapy >; and relapse and death information during follow-up.
Physical activity consists primarily of cardio and muscle strengthening exercises. MET is the ratio of energy expended during physical activity to energy expended at rest. When consuming the same amount of energy, the higher MET value means that the physical activity is more intense and takes less time; the lower MET value means that the physical activity is The intensity is small and it takes a long time.
In this study, a MET ≥ 6 was considered high-intensity physical activity, and a MET < 6 was considered high-intensity physical activity. Low to moderate intensity physical activity.
Take 18 MET hours/week of physical activity as an example, requiring approximately 180 minutes of MET 6 of vigorous-intensity physical activity; or >About 350 minutes of moderate-intensity physical activity with a MET of 3.
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A total of 457 participants developed colon cancer recurrence or death over a follow-up period of more than 6 years.
After controlling for other factors, researchers found that participants who were physically active had a lower risk of colon cancer recurrence and death.
In terms of total physical activity, physical activity was <3.0 MET hours/week, 3.0-8.9 MET hr/week, 9.0-17.9 MET hr/week, and ≥18 MET hr/week, 3-year DFS rate >76.5%, 82.2%, 86.1% and 87.1%, respectively; 5-year OS rates were 82.6%, 88.7%, 91.1% and 91.9%, respectively.
From various intensities and types of physical activity:
Participants with 0 hours, 0.1-1.49 hours, and ≥1.5 hours of low-to-moderate intensity physical activity per week, 3-year DFS rate strong>respectivelywere 65.7%, 82.0% and 87.1%; the 5-year OS rates were 69.5%, 88.1% and 91.9%, respectively.
Participants with 0 hours, 0.1-0.99 hours, and ≥1 hour of vigorous-intensity physical activity per week, 3-year DFS rates were 76.0%, 87.5% and 86.0%, respectively; the 5-year OS rates were 83.5%, 93.0% and 90.4%, respectively.
3-year DFS rate for participants with brisk walking times <1 hour, 1-2.9 hours, and ≥3 hours per week were 81.7%, 84.4% and 88.4%, respectively; the 5-year OS rates were 86.6%, 90.0% and 94.0%, respectively.
3-year DFS rate for participants with weekly muscle-strengthening hours of 0 hours, 0.1-0.49 hours, and ≥0.5 hours were 81.8%, 89.6% and 88.8%, respectively; the 5-year OS rates were 88.7%, 92.6% and 92.2%, respectively.
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Researchers have analyzed that physical activity may reduce the risk of recurrence and death in colon cancer patients through various ways, such as increasing the activity of antioxidant enzymes and effectively scavenging free radicals; Regulates tumor suppressors, affects and changes the tumor microenvironment; inhibits or reverses some metabolic pathways in tumors; accelerates postoperative functional recovery; improves treatment tolerance and curative effect, etc. However, the relevant mechanism is not yet clear, and more research is needed to explore.
Because this study is observational, it shows only an association between physical activity and the risk of cancer recurrence and death in colon cancer patients, not cause and effect . Moreover, the study also has some limitations, such as some data relying on participant recall, etc., which may also have an impact on the results of the study.
The study concludes that physical activity is generally safe and well-tolerated in cancer patients during and after treatment, and thatevery patient should “Avoid Inactivity”. There is substantial research evidence that aerobic exercise, muscle strengthening exercises, etc. can improve cancer-related symptoms, including anxiety, depression, fatigue, and improve physical function and quality of life.
Findings from this study suggest that more physical activity in colon cancer patients may also help reduce the risk of recurrence and death.
Researchers say Healthy lifestyle habits can have an impact on the overall health of cancer survivors. In view of the diversity of cancer types and the side effects of different treatment methods, cancer patients should consult medical staff for advice and conduct risk assessment before physical activity to avoid harm to health and life due to improper exercise.
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 Justin C. Brown, et al., (2022). Physical Activity in Stage III Colon Cancer: CALGB/SWOG 80702 (Alliance). Journal of Clinical Oncology, DOI: https : https://doi.org/10.1200/JCO.22.00171.
 Precision physical activity prescriptions improve survival in colon cancer. Retrieved Sep 26, 2022, from https:https://medicalxpress.com/news/2022-09-precision-physical- prescriptions-survival-colon.html.
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