Can exercise during chemotherapy reduce fatigue for colorectal cancer patients?

Fatigue is one of the most common and distressing side effects of chemotherapy for colorectal cancer (CRC). Many patients wonder if exercise can help. Research suggests that structured exercise programs during chemotherapy can significantly reduce fatigue and improve quality of life. While the evidence is not overwhelming, multiple meta-analyses of randomized controlled trials support the benefit, and exercise is generally safe and feasible for most patients.

What the research says

A 2020 systematic review and meta-analysis of 19 randomized controlled trials found that exercise significantly reduced fatigue in colorectal cancer patients compared to usual care, with a moderate effect size (standardized mean difference [SMD] = 0.21-0.66, p < 0.05) ⁶. Another meta-analysis focusing specifically on CRC patients undergoing adjuvant chemotherapy reported that exercise interventions significantly reduced fatigue (SMD: -0.53) and depression (SMD: -0.34) ⁵. A separate systematic review of older CRC patients receiving chemotherapy also found a moderate effect of exercise on reducing fatigue (SMD: -0.49) ⁸. These studies included various exercise modes such as aerobic, resistance, and combined training, and most were supervised. Importantly, no increase in adverse events was observed with exercise, and adherence rates were high (median 86%) ⁶. The evidence is strongest for supervised programs, but home-based or flexible programs are also being studied ⁷.

What to ask your doctor

• What type and intensity of exercise would be safe for me during my chemotherapy?
• Are there any cancer-related or health conditions that might limit my ability to exercise?
• Can you refer me to a physical therapist or exercise specialist experienced with cancer patients?
• How should I adjust my exercise routine on days when I feel very fatigued?
• Are there any local supervised exercise programs for cancer patients that you recommend?