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World-first trial: structured exercise improves colon cancer survival

Updated: 5 days ago

What it means for people living with Lynch syndrome



Cancer Research UK shared the results from a world-first clinical trial they funded showing that a tailored, supported exercise programme can help more people survive colon (bowel) cancer. It’s powerful evidence for something many of us have felt: taking care of our bodies can be an integral part of our cancer care and can even reduce our recurrence risks.


What the CHALLENGE trial tested

The CHALLENGE trial followed 889 people after treatment for stage II–III colon cancer. Half were offered a three-year structured exercise programme with regular sessions from trained physical-activity specialists; the others received high-quality health information. The goal was to steadily build activity (roughly the effort of a 30-minute jog every other day), adjusted to each person’s health, preferences and starting point.


The headline results

People in the supported exercise group lived longer and stayed cancer-free for longer:

  • Disease-free survival was higher (e.g., 80% vs 74% at five years).

  • The risk of the cancer coming back or a new cancer starting fell by about 28%.

  • The risk of dying from any cause fell by about 37%; at eight years, overall survival was 90% vs 83%.


These findings, published in the New England Journal of Medicine and showcased at ASCO 2025, make CHALLENGE the first large randomised trial to prove that structured exercise can improve survival after colon cancer treatment.


Why this matters to the Lynch community

Many in our community face colon cancer at younger ages, and many more ask, “What else can I do?” CHALLENGE doesn’t replace proven prevention like regular colonoscopy, conversations about aspirin, or, where relevant, risk-reducing surgery. But it shows that adding structured exercise to usual care can improve outcomes after colon cancer treatment. If you’re in recovery or remission, it’s worth asking your team about exercise support alongside your surveillance plan.


Getting started — safely, and with support

What “enough” activity looks like depends on your health, treatment history, and day-to-day life. UK guidance suggests aiming for 150 minutes of moderate activity a week (or 75 minutes vigorous), plus strength work twice weekly, but you can build up gradually, and your clinical team can help tailor this around fatigue, stomas, joint issues or other needs.


The trial’s big takeaway is the power of guided, personalised support. In the NHS, this may come via hospital-based programmes, local exercise-on-referral schemes, or cancer-specific services from charities. If you’re unsure where to start, ask your GP, oncology or rehabilitation team for options in your area, and check trusted cancer-exercise pages from CRUK and Macmillan.


A note on expectations

Exercise is not a cure, and it won’t be right for everyone all the time. The CHALLENGE results apply to people who were well enough to take part after treatment for colon cancer; more research will refine what works best for different cancers and at different times. If you’re mid-treatment, preparing for surgery, or living with long-term side effects, your clinical team can help you find a safe starting point, even if that’s light movement and short walks to begin with.


Read more


LSUK resources and next steps

  • Lynch Choices — step-by-step decision aids to prepare for conversations about aspirin and risk-reducing surgery, designed for use with your clinical team. (canchoose.org.uk)

  • Lynch Syndrome UK Information & Support — our Information Centre, Patient Passport, and peer community. (Lynch Syndrome UK)

  • Trusted exercise information — practical, evidence-based guidance from CRUK and Macmillan. (Cancer Research UK, Macmillan Cancer Support)


This is general information only and isn’t a substitute for medical advice. Please speak to your clinical team about what’s right for you.

 
 
 

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