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Exercise and Cancer Outcomes
A robust and expanding body of evidence demonstrates that structured exercise is a safe and effective intervention for people living with and beyond cancer. Across multiple cancer types and treatment phases, exercise has been shown to improve physical function, reduce treatment-related side effects, enhance quality of life, and positively influence clinical outcomes including recurrence and survival.
Systematic reviews and meta-analyses consistently show benefits from both aerobic and resistance exercise for cancer survivors, supporting its integration into standard supportive cancer care (1–4, 9–11, 18–19). International consensus guidelines now recommend exercise as a core component of survivorship care, tailored to individual needs and treatment status (2, 19).
Tumour-specific evidence is particularly strong in breast, prostate, and colorectal cancers. Exercise interventions reduce cancer-related fatigue, preserve bone and muscle mass, mitigate the adverse effects of hormone and radiation therapies, and improve psychological wellbeing (3–8, 12, 16–17). Emerging mechanistic research also suggests exercise may exert tumour-suppressive effects through inflammatory and myokine-mediated pathways (14–16).
Importantly, recent large-scale randomised trials have demonstrated that exercise may directly improve cancer outcomes. The CHALLENGE trial, published in the New England Journal of Medicine and involving Australian participants, showed that structured exercise following adjuvant chemotherapy significantly reduced recurrence and mortality in colorectal cancer (17–18). These findings mark a critical shift from exercise as supportive care to exercise as a disease-modifying intervention.
The following reference list compiles the key studies underpinning this evidence base.
1. Fuller JT, Hartland MC, Maloney LT, et al. Therapeutic effects of aerobic and resistance exercises for cancer survivors: a systematic review of meta-analyses of clinical trials. Br J Sports Med. 2018;52(20):1311.
2. Campbell KL, Winters-Stone KM, Wiskemann J, et al. Exercise guidelines for cancer survivors: Consensus statement from international multidisciplinary roundtable. Med Sci Sports Exerc. 2019;51(11):2375–2390.
3. Singh B, Toohey K. The effect of exercise for improving bone health in cancer survivors: A systematic review and meta-analysis. J Sci Med Sport. 2022;25(1):31–40.
4. Belloni S, Arrigoni C, Caruso R. Effects from physical exercise on reduced cancer-related fatigue: a systematic review of systematic reviews and meta-analysis. Acta Oncol. 2021;60(12):1678–1687.
5. Schumacher O, Luo H, Taaffe DR, et al. Effects of exercise during radiation therapy on physical function and treatment-related side effects in men with prostate cancer: A systematic review and meta-analysis. Int J Radiat Oncol Biol Phys. 2021;111(3):716–731.
6. Boing L, Vieira MCS, Moratelli J, et al. Effects of exercise on physical outcomes of breast cancer survivors receiving hormone therapy: A systematic review and meta-analysis. Maturitas. 2020;141:71–81.
7. Yunfeng G, Weiyang H, Xueyang H, et al. Exercise overcomes adverse effects among prostate cancer patients receiving androgen deprivation therapy: An update meta-analysis. Medicine (Baltimore). 2017;96(27):e7368.
8. Galvão DA, Taaffe DR, Spry N, et al. Exercise preserves physical function in prostate cancer patients with bone metastases. Med Sci Sports Exerc. 2018;50(3):393–399.
9. Friedenreich CM, Neilson HK, Farris MS, et al. Physical activity and cancer outcomes: A precision medicine approach. Clin Cancer Res. 2016;22(19):4766–4775.
10. McTiernan A, Friedenreich CM, Katzmarzyk PT, et al. Physical activity in cancer prevention and survival: A systematic review. Med Sci Sports Exerc. 2019;51(6):1252–1261.
11. Buffart LM, Kalter J, Sweegers MG, et al. Effects and moderators of exercise on quality of life and physical function in patients with cancer: An individual patient data meta-analysis of 34 RCTs. Cancer Treat Rev. 2017;52:91–104.
12. Moraes RF, Ferreira-Júnior JB, et al. Resistance training, fatigue, quality of life, and anxiety in breast cancer survivors. J Strength Cond Res. 2021;35(5):1350–1356.
13. Mizrahi D, Lai JKL, Wareing H, et al. Effect of exercise interventions on hospital length of stay and admissions during cancer treatment: A systematic review and meta-analysis. Br J Sports Med. 2024;58:97–109.
14. Kim JS, Wilson RL, Newton RU, et al. Myokine expression and tumour-suppressive effect of serum after 12 weeks of exercise in prostate cancer patients on androgen deprivation therapy. Med Sci Sports Exerc. 2022;54(2):197–205.
15. Hiensch AE, Mijwel S, Bargiela D, et al. Inflammation mediates exercise effects on fatigue in patients with breast cancer.
16. Cormie P, et al. The impact of exercise on cancer mortality, recurrence, and treatment-related adverse effects. Epidemiol Rev. 2017;39(1):71–92.
17. Courneya KS, Vardy JL, O’Callaghan CJ, et al. Structured exercise after adjuvant chemotherapy for colon cancer (CHALLENGE). N Engl J Med. 2025.
18. Booth C, Vardy J, O’Callaghan C, et al. A randomized phase III trial of structured exercise on disease-free survival in colon cancer: CCTG CO.21 (CHALLENGE). J Clin Oncol. 2025;43(suppl 17):LBA3510.
19. Courneya KS, Friedenreich CM (eds). Physical Activity and Cancer. Recent Results in Cancer Research. Springer; 2011.