Exercise and Colon Cancer

The COURAGE Trial: Colon Recurrence and Aerobic Exercise: A Feasibility Study

Despite the success of surgery and chemotherapy among people with colon cancer, 30-50% of patients develop recurrent disease. Physical activity has emerged as a potential lifestyle intervention to reduce cancer recurrence and improve survival among people with colon cancer (CC). This pilot study aims to identify the dose-response effects of aerobic exercise on molecular and cellular pathways associated with physical activity and CC outcomes among patients with stage II and III CC.

Inclusion Criteria:

1. histologically confirmed TNM stage II-III CC;
2. completed surgical resection and adjuvant chemotherapy (if applicable) within 1-24 months before entering the study;
3. ≤120 min/wk of self-reported moderate or vigorous intensity physical activity using the Paffenbarger physical activity questionnaire;
4. age ≥18 years;
5. written physician approval;
6. no additional surgery planned within the 6-month intervention (including colostomy reversal);
7. ability to walk unaided for 6-minutes;
8. no contraindications to exercise using the PA readiness questionnaire (PAR-Q), unless physician approves participation with specific knowledge of this contraindication.

Exclusion Criteria:

1. history of another primary invasive cancer (other than non-melanoma skin-cancer);

2. evidence of metastatic CC (i.e., TNM M1);

3. planning to receive any additional adjuvant chemotherapy;

4. pregnant or breast feeding;

5. unable to provide baseline blood sample;

6. cardiac conditions, including the following:

   1. myocardial infarction or coronary revascularization procedure within prior 3 months;
   2. uncontrolled hypertension (systolic ≥180 mmHg or diastolic ≥100 mmHg);
   3. high-risk or uncontrolled arrhythmias;
   4. clinically significant valvular disease;
   5. decompensated heart failure;
   6. known aortic aneurysm;

7. any other condition that may impede testing of the study hypothesis or make it unsafe to engage in the exercise program (determined by the investigative team).