A new study found that regular physical activity, particularly walking, can significantly reduce cancer-related fatigue and improve quality of life in people with colorectal cancer, especially in the post-treatment setting. The research will be presented at the 2026 American Society of Clinical Oncology (ASCO) Gastrointestinal Cancers Symposium, taking place January 8-10 in San Francisco. 

While there are medications that can help manage cancer-related fatigue, doctors often recommend physical activity to help reduce treatment-related side effects. However, there had been no clear evidence on the timing or type of physical activity that might be most helpful for people with colorectal cancer in managing fatigue. In this study, researchers aimed to learn what impact different levels of physical activity could have on cancer-related fatigue during the 2-year period immediately after a colorectal cancer diagnosis.

This study included 1,718 patients enrolled in the International ColoCare study. Nearly 1 in 5 participants had metastatic disease at the time of diagnosis. The average age of participants was 67, and almost half of them were female (48%). Among the participants, 75% were White, 15% were Black, and 4% were Asian. 

The researchers assessed the participants’ physical activity levels at the time of diagnosis and then again at 6 months, 1 year, and 2 years after diagnosis. Physical activity level was evaluated using the International Physical Activity Questionnaire (IPAQ), which asked patients to record how often and for how long they had engaged in physical activity over the past week. Moderate activities included brisk walking and vacuuming, while vigorous activities included running, cycling, and other high-energy options.

The researchers calculated the participants’ total number of Metabolic Equivalent of Task (MET) minutes per week. MET minutes indicate how much energy a person has spent during physical activity, with fewer MET minutes meaning less physical activity. The researchers classified physical activity levels as: 

• Low physical activity (less than 600 MET minutes per week) 
• Moderate physical activity (600 to 3,000 MET minutes per week) 
• High physical activity (more than 3,000 MET minutes per week) 

They then evaluated cancer-related fatigue and quality of life scores using a quality-of-life questionnaire from the European Organisation for Research and Treatment of Cancer (EORTC). 

“Fatigue is one of the most common struggles that cancer survivors face. This longitudinal study provides clear evidence that increased levels of physical activity in colon cancer survivors with early-stage disease can lead to improved quality of life,” said Joel Saltzman, MD, an ASCO Expert in gastrointestinal cancers and Vice Chair of Regional Oncology at Taussig Cancer Center, Cleveland Clinic.

• The study found that among patients with non-metastatic colorectal cancer:

1. Those who reported walking as an exercise regimen 6 to 12 months after their diagnosis saw the most benefit, with lower cancer-related fatigue scores and higher quality-of-life scores reported 2 years after diagnosis.
2. Specifically, fatigue scores improved significantly from 32.5 at diagnosis to 29 at 12 months and 26.8 at 24 months.

• Although patients with metastatic disease also showed reductions in fatigue—from 40.7 at diagnosis to 37.1 and 36.4 at 12 and 24 months, respectively—these changes were smaller and did not reach statistical significance.
• The researchers also found that physical activity levels at the time of diagnosis did not reliably predict long-term fatigue and quality-of-life outcomes.

1. Instead, a patient’s activity level maintained between diagnosis and one-year follow-up was a stronger predictor of better outcomes.
2. These findings suggest that the post-treatment recovery window may be a critical period for behavioural interventions to support physical activity and reduce long-term symptom burden.

Source: ASCO GI