Exercise Is Medicine: a Turning Point in Cancer Care
In 2018, when we launched the first 5K Your Way, Move Against Cancer group in Nottingham, many colleagues were sceptical. “People living with cancer won’t want to be told to exercise”. Even now, that view persists. Some assume my background as a professional triathlete clouds my judgement. But after seven years I’ve witnessed first hand how movement can empower people physically, mentally, and emotionally. I’ve seen confidence grow, communities build and stories of hope and resilience emerge. Yet most people joining a group tell me no healthcare professional has ever encouraged them to exercise. Often, they’ve simply been told to rest.
We’ve long known that exercise during and after cancer treatment reduces fatigue, boosts mood and improves health related quality of life. Observational studies have linked it to lower recurrence and better survival. For years, I’ve ended conference talks anticipating definitive trial data to confirm this. Now, that time has come.
The CHALLENGE Trial: A Landmark Study
Published this month in The New England Journal of Medicine, the CHALLENGE trial (Courneya et al., 2025) is the first published randomised controlled trial that has tested exercise in exactly the same way as drugs are tested. In the study, 889 people who had completed chemotherapy after surgery for bowel cancer were either given a 3 year, personalised exercise programme with the support of a personal trainer or were given general health education materials promoting exercise and nutrition. The results were astounding. The risk of developing a cancer recurrence or a new cancer was 28% lower in the group given the exercise programme. And after 8 years the risk of dying from any cause was 37% lower in the group given the exercise programme. These benefits are huge. They’re of an equivalent magnitude to many of the drugs that we prescribe, many of which have horrible short and long-term side effects and are expensive. For the first time ever, we now have definitive proof that we should be prescribing exercise, alongside our prescriptions for drugs and radiotherapy. Exercise isn’t just about feeling better. It’s about living longer.
Validation, at Last
When I read the results, I felt deeply moved, not just as an oncologist, but as a co-founder of a movement built on belief. For years, we’ve relied on observational data, anecdotal evidence, and lived experience to argue that movement matters in cancer recovery. Through our Move Against Cancer community, I’ve watched exercise change lives yet I’ve simultaneously observed barriers from colleagues who aren’t willing, or perhaps don’t feel able, to discuss exercise with their patients. But now, that belief that movement matters is backed by a trial as rigorous as any drug study. This is the kind of evidence oncologists are trained to trust.
What This Means for People Living with and Beyond Cancer
The implications of this study are profound.
Exercise is not an optional extra. It has to become part of the treatment plan.
That doesn’t mean running a marathon or cycling up mountains. It means tailored, achievable movement. Walking, cycling, roller skating, dancing. Movement that fits into someone’s life and works for them. In the trial, the increased activity in the exercise group compared with the control group was the equivalent to adding just 45 to 60 minutes of brisk walking or 25 to 30 minutes of jogging, three to four times a week. This is achievable for most people, given the right kind of support.
The study showed that written advice to be active isn’t enough. Patients need individualised support from trained exercise professionals who understand cancer care.
As health care professionals, we have to stop assuming people with cancer don’t want to be told to move. In my experience, most people with cancer want to know what they can do that will improve their outcome. Now we have proof that exercise does, it’s imperative that we start supporting people to move in a way that works for them.
How This Should Change Oncology Services
If we had a pill with minimal side effects and low costs with these results, we’d be prescribing it tomorrow.
Based on the results of this study, exercise must become a standard part of cancer care, alongside treatments like anti-cancer drugs and radiotherapy. We need exercise specialists integrated into cancer centres, discussions about physical activity starting at diagnosis, funding for community exercise programs, and national guidelines that reflect this evidence. Just as cardiac rehab supports heart patients in their recovery, we should create a similar model for cancer patients to help them regain control, improve their health and reduce their risk of recurrence. As oncologists, our role is not only to treat cancer but to empower patients to optimise their own physical and mental health. Exercise is something patients can do, for themselves, at a time when so much feels out of their control. We need to support and empower patients to harness its benefits in a way that works for them.
