A walk to combat cancer-related fatigue, induced by colorectal cancer, is at the heart of a large study presented at the American Society of Clinical Oncology’s congress dedicated to gastrointestinal cancers (ASCO GI). The analysis highlights the potential of regular physical activity, with walking playing a predominant role, in reducing fatigue associated with cancer therapies and significantly improving quality of life.
The Study
The international ColoCare study involved more than 1,700 patients with colorectal cancer across all stages, with about one in five presenting metastatic disease at diagnosis. Participants were 48% women, with an average age of 67 years.
Patients were followed for two years after diagnosis to collect data on physical activity, perceived fatigue, and quality of life at regular intervals (at diagnosis, and at 6, 12, and 24 months). Data were gathered using a validated questionnaire – the International Physical Activity Questionnaire (IPAQ) – to calculate energy expenditure across different activities, distinguishing walking, moderate activities (such as swimming or cycling), and vigorous activities (such as running or intense sports), and classifying patients into three categories: low activity (fewer than 600 units per week), moderate (600–3000), and high (>3000).
Fatigue and quality of life were measured using the EORTC QLQ-C30 scale, a tool for assessing quality of life in cancer patients.
Initial results appear to show that in the first year after diagnosis, after completing chemotherapy, maintaining a steady level of physical activity may yield lasting benefits in the years that follow. Cancer-related fatigue, unlike ordinary fatigue, generally does not fade with extra rest and can substantially impact quality of life and a person’s functional capacity, persisting well beyond the end of cancer treatment. Almost 40% of colorectal cancer survivors report experiencing moderate to severe fatigue years after treatment ends. Quality of life was measured using a cancer-specific instrument from the European Organisation for Research and Treatment of Cancer (EORTC).
Key Findings
The study found that among non-metastatic colorectal cancer patients, those who reported walking as their prescribed exercise regimen from 6 to 12 months after diagnosis achieved the greatest benefits, with lower cancer-related fatigue scores and higher quality-of-life scores reported 2 years after diagnosis. Specifically, fatigue scores improved from 32.5 at diagnosis to 29 at 12 months and 26.8 at 24 months.
Although patients with metastatic disease also showed a reduction in fatigue, from 40.7 at diagnosis to 37.1 and 36.4 at 12 and 24 months, these changes were smaller and did not reach statistical significance. This led to the conclusion that the initial level of physical activity at diagnosis was not a reliable predictor of long-term fatigue or quality-of-life outcomes.
By contrast, the level of activity maintained from diagnosis to the one-year follow-up emerged as a stronger predictor of better outcomes. In conclusion, these results suggest that the post-treatment recovery window could be a critical period for behavioral interventions that support physical activity and reduce long-term symptom burden.
Furthermore, the study emphasizes that physical activity recommendations for colorectal cancer patients should be tailored to disease stage and treatment trajectory. Walking stands out as the most accessible and safe intervention, particularly useful in the early period after diagnosis and during treatments, when functional capacity may be diminished.
Next Steps
Future research efforts should focus on demonstrating through which biological and behavioral pathways physical activity can influence cancer-related fatigue and quality of life.
Researchers plan to integrate biomarkers assessed via wearable devices to monitor real-time activity and sleep patterns, along with metabolic evaluations to assess muscle function and recovery.
Additionally, the team plans to explore barriers to physical activity across diverse patient populations, including socioeconomic, racial, ethnic, and treatment-related disparities, to provide insights for more personalized survivorship interventions.
Source
Liu L. Longitudinal study on the influence of physical activity in managing cancer-related fatigue in patients with colorectal cancer. https://www.asco.org/abstracts-presentations/255091
Abbonati a Karla Miller
