Structured exercise programs can reduce the long-term risk of recurrence and extend survival for cancer patients, according to findings from the CHALLENGE trial published last year. While past research linked physical activity to easing fatigue and surgery recovery, the trial provides evidence that exercise alters cancer outcomes. Karen H. Schmitz, PhD, MPH, professor at the University of Pittsburgh and deputy director of the Hillman Cancer Center, stated that the trial puts exercise in a whole new evidentiary category where it is now saving lives.
Evidence From the CHALLENGE Trial
The CHALLENGE trial reshapes how oncologists view physical activity by tracking patients with colon cancer who were randomly assigned to a 3-year exercise program. This structured intervention involved 50 to 70 hours of supported activity. Conversely, the control group received educational materials encouraging physical movement. Oncology practices typically mirror the control group rather than the trial’s intensive framework. Clinic schedules remain tight, physical activity discussions frequently drop out of appointments, and third-party payers generally do not fund onsite exercise programs.
Implementing Exercise in Oncology Care
Community practices can still bridge this gap using a practical framework of assessing, advising, and referring, according to Jessica Scott, PhD, director of the exercise oncology program at Memorial Sloan Kettering Cancer Center. Clinicians routinely screen for pain and weight loss but rarely ask about physical activity habits. Asking patients how many days per week they are active opens a direct door for clinical intervention. Jennifer Ligibel, MD, professor at Harvard Medical School and director of the Leonard P. Zakim Center for Integrative Therapies and Healthy Living at Dana-Farber Cancer Center, noted that readiness builds when patients hear about the value of movement during appointments.
Collaborative Activity Prescriptions
Oncologists do not need to act as behavioral specialists to guide patients toward fitness. A recommendation from a trusted clinician stands as one of the strongest predictors of patient participation. However, experts advise against handing out generic exercise regimens like standard prescriptions. Instead, clinicians should ask patients what physical activities they enjoy and what feels realistic. Ligibel emphasized that daily movement can counterintuitively increase energy levels for fatigued patients, while virtual seated yoga serves as a viable alternative on days when conventional walking feels too demanding.
Community and Virtual Referral Resources
Structured programs yield better results, but third-party payment barriers persist. To counter this, providers can direct patients to the American College of Sports Medicine Moving Through Cancer directory, which lists about 2,300 programs nationwide. The YMCA network also provides free exercise programs specifically tailored for people with cancer. For virtual options, Scott highlighted Moving For Life, a free platform offering programming for patients, caregivers, and older adults up to their nineties. Alternatively, Greatly Health provides a monthly subscription service developed by Sloan Kettering experts for active treatment and aftercare patients.
Upcoming Standards in Cancer Care
National medical organizations are incorporating physical activity into official hospital and clinical requirements. The American College of Surgeons released breast care standards for 2027 requiring accredited programs to perform functional screenings and issue exercise referrals. The group's Commission on Cancer has proposed exercise oncology standards projected for finalization by January 2028. These updates build on existing guidelines from the American Society of Clinical Oncology, signaling a shift toward routine exercise integration.
Frequently Asked Questions About Cancer Exercise
Does exercise truly extend survival for cancer patients?
Yes. The CHALLENGE trial proved that structured exercise programs reduce long-term recurrence risks and extend survival for colon cancer patients.
Are there free exercise programs available for cancer patients?
Yes. The American College of Sports Medicine maintains a directory of about 2,300 programs, the YMCA offers free cancer exercise networks, and platforms like Moving For Life provide free virtual classes.
What physical activity target should patients aim for weekly?
Rather than pushing standard adult targets like 150 weekly minutes, experts recommend asking patients what amount of exercise feels realistic given their current fatigue levels.
Which medical groups are updating standards to include exercise?
The American Society of Clinical Oncology, the American College of Sports Medicine, and the American College of Surgeons are implementing or proposing exercise oncology standards.
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