Home›Oncology› Supervised exercise programs improve cardiorespiratory and muscular fitness in colorectal cancer
Supervised exercise programs improve cardiorespiratory and muscular fitness in colorectal cancerExercise Improves Fitness for Patients with Colorectal Cancer
European journal of sport sciencePublished November 3, 2026Study authors: Wang Jingyu, He Yuxuan, Wang Zhouluo, Lee So-Eun, Shim Yoo-Jin, Lee Si-Eun, Kim Hye-Ryeon, Lee Kyung…PubMed ↗DOI ↗Editorial oversight: Dr. Julia Lee, PhD · Oncology, Genomics & Drug Development
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Key Takeaway
Consider phase-tailored exercise to improve fitness in colorectal cancer, noting safety data were not reported.
This meta-analysis examined multidimensional health outcomes associated with exercise interventions lasting at least 4 weeks in patients with colorectal cancer, drawing on a pooled population of 1731. The authors report statistically significant improvements in cardiorespiratory fitness (effect size 0.35, p < 0.01) and muscular fitness (effect size 0.45, p < 0.01).
The authors describe a phase-dependent approach to prescribing exercise. They recommend high-frequency, moderate-to-high volume interventions with individualized load regulation during the pre-treatment phase. During active treatment, they advise a more cautious approach, with reduced exercise volume during peak symptom periods and gradual progression during recovery.
Quality of evidence was assessed using the GRADE approach, but the results were not specified in the abstract. Adverse events, discontinuations, tolerability, funding, and conflicts of interest were not reported, and the authors' stated limitations were not available.
The authors caution against overstating two claims: that prehabilitation interventions were the most effective, and that interventions during active treatment showed a decline-rebound trend over time. These should not be presented as established findings.
For practice, the findings support structured exercise as a component of colorectal cancer care, with intensity and volume tailored to treatment phase and symptom burden. The absence of reported safety data and the unspecified certainty of evidence mean clinicians should apply these recommendations with appropriate clinical judgment.
How this fits prior evidence
Prior coverage has focused on systemic therapy, biomarkers, and surgical prophylaxis in colorectal cancer, including EGFR inhibitor response without survival advantage over bevacizumab in CRLM, circulating tumor cell counts and survival, prophylactic HIPEC for peritoneal metastasis-free survival, germline panel testing yields, and periostin as a prognostic marker. This meta-analysis extends that coverage into supportive care, addressing fitness outcomes rather than oncologic endpoints. It does not confirm or contrast prior findings directly, and no survival or disease outcomes are reported here.
A review of clinical trials involving 1,731 patients with colorectal cancer found that exercise programs lasting at least four weeks can improve physical health. The study specifically looked at how these programs affected heart and lung health, known as cardiorespiratory fitness, and muscle strength.
The results showed that patients who participated in these exercise programs saw significant improvements in both cardiorespiratory fitness and muscular fitness. These improvements are important for maintaining strength and stamina during and after cancer treatment.
Because every patient is different, the timing of exercise is important. Experts suggest that high-frequency exercise is often recommended before treatment starts. During active treatment, a more cautious approach is suggested. This means reducing the amount of exercise when symptoms are severe and slowly increasing the amount as the patient recovers. Talk to your doctor to find a safe plan that fits your specific needs.
What this means for you:
Exercise programs can improve heart and muscle fitness for people with colorectal cancer.
Common questions
Can exercise help my physical fitness if I have colorectal cancer?
Yes, a review of trials involving 1,731 patients found that exercise programs lasting at least 4 weeks led to statistically significant improvements in both cardiorespiratory fitness and muscular fitness. These improvements help maintain overall physical health for those managing colorectal cancer.
Is it safe to exercise during cancer treatment?
Safety depends on your current symptoms. While high-frequency exercise is often recommended before treatment, a more cautious approach is advised during active treatment. This involves reducing the amount of exercise during peak symptom periods and gradually increasing it during your recovery phase.
How long should the exercise program last?
The study looked at exercise interventions lasting 4 weeks or longer. These programs were shown to improve muscular fitness and cardiorespiratory fitness in patients with colorectal cancer. You should speak with your doctor to determine the best duration and intensity for your specific situation.
This study aimed to investigate the dose-response relationships between exercise prescription parameters and a range of health outcomes in patients with colorectal cancer (CRC). The following PRISMA guidelines, a systematic search of five databases was conducted. The inclusion criteria were randomized controlled trials (RCTs) of exercise interventions lasting ≥ 4 weeks in patients with CRC. Robust Variance Estimation (RVE) was used to synthesize the overall effects of exercise interventions across six outcome domains, including cardiorespiratory fitness (CRF) and muscular fitness (MF). Univariable RVE regression models and MetaForest analyses were employed to examine the moderating effects of two groups of variables: exercise prescription moderators and patient background characteristics. Risk of bias was assessed using the Cochrane tool, and the quality of evidence was evaluated using the GRADE approach. A total of 26 RCTs, involving 1731 CRC patients and 266 effect sizes, were included. CRF (ES = 0.35, p < 0.01) and MF (ES = 0.45, p < 0.01) showed statistically significant improvements. Regression analyses revealed threshold effects for both CRF and MF, with maximal improvements requiring sustained engagement in moderate-to-high intensity exercise. Subgroup analyses indicated that prehabilitation interventions were the most effective, while interventions during active treatment exhibited a decline-rebound trend over time. Based on these findings, high-frequency and moderate-to-high volume interventions with individualized load regulation are recommended during the pre-treatment phase. During active treatment, a more cautious approach is advised, involving reduced exercise volume during peak symptom periods and gradual progression during recovery.
