Colorectal cancer is the second most common cause of cancer deaths in the United States, according to the American Cancer Society. This year, the organization estimates that more than 150,000 Americans will be diagnosed with it and nearly 53,000 will die from it.
New studies presented at the annual meeting of the American Society of Clinical Oncology, or ASCO, in the last few days offer promising findings for both pharmaceutical and lifestyle interventions, including the impact of diet and exercise.
Diagnoses of colorectal cancer have been decreasing overall for decades, the American Cancer Society says, thanks in large part to better screening. But case rates are rising among younger adults, and research estimates that colorectal cancer will become the leading cause of cancer death among adults ages 20 to 49 by 2030.
Earlier research has suggested that regular exercise can improve survival rates for colorectal cancer patients, and a new study – published in the New England Journal of Medicine and presented at the ASCO conference on Sunday – confirmed those findings with robust clinical trial data.
Between 2009 and 2024, researchers followed nearly 900 colon cancer patients who had completed chemotherapy – half of whom received an informational booklet that encouraged them to adopt a healthy lifestyle with good nutrition and exercise the other half of whom were also matched with a physical activity consultant for three years.
They found that there was a 28% reduction in the risk of recurrence or new cancer for patients on the exercise program, with a five-year disease-free survival rate of 80% for the group with an exercise consultant compared with 74% for the group who just received the booklet.
In other words, the exercise program was found to prevent 1 out of every 16 patients from developing recurrent or new cancer.
“That magnitude is comparable to – and in many cases exceeds – the magnitude of benefit offered by a lot of our very good standard cancer drugs,” said Dr. Christopher Booth, a professor of oncology with Queen’s University and co-author of the new study. “Exercise really should be considered an essential component of treatment of colon cancer.”
Work is still being done to understand why exercise can help reduce the risk of cancer, but experts say that it may have something to do with the ways exercise helps reduce inflammation in the body.
Another new study presented at the ASCO conference on Sunday found that anti-inflammatory diets also helped improve survival rates for people with stage 3 colon cancer.
Patients who consumed more anti-inflammatory diets – including coffee, tea and vegetables such as leafy greens – and engaged in higher levels of physical activity had a 63% lower risk of death compared to patients who consumed the most inflammatory diets – including things like red meat, processed meat, refined grains and sugar-sweetened beverages – and engaged in lower levels of physical activity, the study found.
“Actively, as a field, we’re learning about the role of the immune system in cancer development, and inflammation is an immune response,” said Dr. Sara Char, a clinical fellow in Hematology and Oncology at Dana-Farber Cancer Institute and lead author of the study, and the rise of colorectal cancer cases in younger people suggests it’s a critical piece of the puzzle.
“When we look at the incidence of colon cancer in younger individuals … that really suggests to us that there is something in the environment – either in the foods we eat, our lifestyles, the chemicals that could be in our foods, all sorts of different things – that are outside of just genetics alone that could be driving these rates,” she said. “So it is incredibly important for us, as a field, to be thinking about how our diet and lifestyle impacts not just our risk of developing this cancer, but then how people fare after it.”
Both Booth and Char said that colorectal cancer patients are often seeking ways to proactively manage their risk.
“I think that’s it’s very empowering for patients,” Booth said. “It’s also achievable for patients. This is a commitment, but it’s something that patients can achieve.”
In his study, an “exercise prescription” was developed based on each individual’s starting point. Most people were able to reach their target increase if they went for a brisk walk for about an hour three or four days per week, Booth said.
Lifestyle interventions like exercise and diet are also “sustainable for health systems,” he said, but it’s key that the system helps support patients in accessing the resources needed for behavioral interventions.
Another new study showed promising results that might represent a new standard-of-care for certain patients with advanced colon cancer.
On Friday, drugmaker Pfizer presented data on a colorectal cancer drug, Braftovi, used in combination with a standard chemotherapy and an antibody drug. During the trial, the drug combo was shown to double the length of time patients with an aggressive form of colorectal cancer lived with treatment: an average of 30 months compared with 15 months using currently available treatments.
Braftovi targets a mutation in a specific protein that can lead to abnormal cell growth, and it’s already approved by the US Food and Drug Administration to treat some forms of cancer. The study, which was funded by Pfizer, published Friday in the New England Journal of Medicine.
The latest data on treatment for colorectal cancer a “very, very important finding,” Bourla said, and the drugmaker plans to seek additional approval to add the new indication to the drug’s label.