Increased Physical Activity Linked With Survival in Metastatic Colorectal Cancer

Patients with metastatic colorectal cancer who engaged in more hours of physical activity at the time of their diagnosis had improvements in both progression-free and overall survival compared with patients who had less physical activity, according to the results of a study (abstract 659) presented at a press conference ahead of the 2017 Gastrointestinal Cancers Symposium in San Francisco.

“Total physical activity equivalent to 30 or more minutes of moderate activity daily was associated with a 16% reduction in disease progression and 19% reduction in mortality,” Brendan John Guercio, MD, a resident physician at Brigham & Women’s Hospital, said during the press conference.

According to Guercio, sedentary lifestyle or absence of physical activity is a known risk factor for the development of colon cancer. It has also been associated with increased recurrence and mortality in patients with early stage colorectal cancer, and patients who are physical active tend to yield other benefits, including better tolerance of chemotherapy.

The study included 1,231 patients from CALGB 80405 who completed voluntary questionnaires that included self-report on physical activity at the time of chemotherapy initiation. The researchers determined the total metabolic equivalent task (MET)-hours per week based on patient responses. The results excluded any patients who experienced disease progression or died within 60 days, and adjusted results for known prognostic factors, comorbid illness, and weight loss over the previous 6 months.

Patients considered to be the most physically active engaged in 18 or more MET-hours per week, equivalent to 30 or more minutes each day of moderate physical activity. These patients were compared with those who completed less than 3 MET-hours per week, equivalent to 30 minutes of physical activity per week. Patients engaged in 18-MET hours per weeks had significantly improved progression-free survival (adjusted hazard ratio [HR], 0.84; 95% CI, 0.71–1.00) and overall survival (adjusted HR, 0.81; 95% CI, 0.67–0.98) compared with patients who did less than 3 MET-hours per week.

The researchers also conducted a secondary exploratory analysis and found that those patients who spent 4 or more hours per week walking had a greater than 20% improvement in overall survival. However, walking pace was not associated with disease progression or survival. Finally, people who spent 5 or more hours per week engaged in non-vigorous activities had a 25% reduction in overall survival. 

Commenting on the results, conference moderator and ASCO Expert Nancy Baxter, MD, PhD, said, “I think this is something that we can definitely recommend to our patients. We know that physical activity has many positive impacts for patients, and for cancer patients in general, but now we can also recommend even moderate activity to colorectal cancer patients with metastatic disease as they are undergoing treatment.”