Supervised Resistance Exercise May Help QOL Outcomes in Colorectal Cancer

The implementation of a supervised resistance exercise program enhanced specific health-related quality-of-life (HRQOL) outcomes among patients undergoing chemotherapy and/or immunotherapy for colorectal cancer, according to findings from a randomized pilot study (NCT06404359) published in Current Oncology.¹

Specifically, significant improvements were found in both fatigue and constipation per European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) scores among patients who underwent supervised resistance exercise vs those who did not. The median difference in score for each metric was –11.11 (95% CI, –22.49 to 5.82; P = .040) and –33.33 (95% CI, –54.46 to –11.20; P = .015), respectively. Nonsignificant differences were observed in all other subscales of the QLQ-C30, including dyspnea (P = .341), sleep disturbance (P = .382), diarrhea (P = .638), appetite loss (P = .739), pain (P = .777), and nausea (P = .954).

Additionally, no significant differences were observed within groups between the supervised and unsupervised cohorts. Furthermore, regarding pre-post changes between groups using the Hospital Anxiety and Depression Scale (HADS) and the Minimal Insomnia Symptom Scale (MISS) revealed no significant differences as well. The P values between each group for the HADS and MISS scales were 0.732 and 0.149.

“In this pilot randomized clinical trial, adding a supervised resistance exercise program to a home-based physical activity plan resulted in improvements in key symptoms commonly experienced by patients with colorectal cancer undergoing chemotherapy and/or immunotherapy, particularly fatigue and constipation,” lead author Juan Luis Sánchez-González, PhD, professor at the University of Salamanca, wrote in the publication with study coinvestigators. “Overall, the findings indicate that supervised resistance training is a safe and feasible strategy that may enhance selected aspects of [QOL] during active treatment. Larger and longer-term trials, including broader biomarker profiling, are warranted to confirm these preliminary results and to better understand the mechanisms underlying these benefits.”

The parallel-group study enrolled 44 patients, and 40 underwent random assignment after 4 withdrew from the study. A total of 27 patients were included in the analysis, which included 12 assigned to a home-based physical activity plan and 15 assigned to the supervised group.

In the supervised, or hybrid, group, patients underwent resistance training for 2 days each week over 8 weeks in combination with a home-based physical activity plan. The home-based group received the same home-based physical activity plan but were not required to attend supervised training. Patients in both cohorts were contacted weekly to assess adherence.

In the home and hybrid groups, respectively, the mean age was 61.66 years (SD, 13.61) and 59.66 years (SD, 8.70), and 50% and 66% of patients were male. All patients had colon cancer, 59% vs 40% had stage III cancer, and 75% vs 54% underwent chemotherapy alone.

The primary end point of the trial was HRQOL. Secondary end points included anxiety and depression, sleep quality, and inflammation. Intervention adherence exceeded 80% in all cases, and no adverse effects related to physical exercise were observed in the trial.

Patients 18 years and older were eligible for enrollment on the trial if they had not undergone a previous exercise program within 8 weeks of study start and were willing and able to perform physical activity. Those who experienced contraindications of physical exercise, had other cancer types aside from colorectal cancer, and experienced early treatment discontinuation due to therapy intolerance were ineligible for study entry.

Reference

Sánchez-Gonzalez JL, Perez J, Fernández-Rodríguez, et al. Effects of resistance exercise on quality of life, anxiety, depression, sleep quality and inflammatory parameters in patients with colorectal cancer undergoing active treatment: a pilot randomized clinical trial. Curr Oncol. 2025;32(15):651. doi:10.3390/curroncol32120651