Exercise and bowel cancer

Physical activity plays a key role before, during and after treatment for bowel cancer. Numerous studies have shown exercise to be hugely beneficial from the point of diagnosis, throughout every form of treatment and into recovery. 

‘Prehabilitation’

Prehabilitation is a term used to describe the process of getting your mind and body ready for the treatment road ahead. In her book ‘Everything you hoped you would never need to know about bowel cancer’, Dr Anisha Patel likens readying your body for cancer treatment to training for a marathon. You wouldn’t consider running a marathon without putting in some serious training and in terms of both duration and physical challenge, cancer treatment is probably more demanding than a marathon.

Making time for exercise in your daily routine will not only help your body to be better prepared for the rigours of surgery, chemo and/or radiotherapy, it will have a positive impact in your mental health too. Exercise gives you back a sense of control over your body, it will help you manage better during treatment, and help you recover more quickly.

Exercise after surgery and during chemo/radiotherapy

Once your surgeon has given you the go-ahead to exercise, think about gradually reintroducing exercise and activity into your daily routine. Start with something that is achievable, such as walking or light weights and slowly build up the time and intensity. Fatigue is a something you are likely to experience at any point during your treatment so listening to your body it really important. If you’re fatigued, you are more likely to sustain an injury so there’s no point in setting unrealistic expectations. Little and often, gradually building up the length and strength of exercise is the way forward.

If you are having chemotherapy your fatigue is going to be more extreme on the days immediately after a session so concentrate exercise during your ‘week off’ and just do what you can on other days.

How much and how often?

The WHO recommends 150 minutes of moderate or 75 minutes of vigorous exercise a week but rather than setting specific goals, aim to do what you can when you can. Some days are going to be better than others, so just listen to your body.

Moderate activity includes housework, yoga, gardening and walking – activities that require some effort and make you feel warm but not breathless. Vigorous exercise might include sports, power walking, jogging, swimming and running (for instance).

Exercising to prevent recurrence

Exercise has been shown to not only aid recovery but to significantly reduce the chances of cancer recurrence.

Structured exercise significantly lowers the risk of bowel (colon) cancer recurrence and death; a major 2025 study found that a three-year structured, supported exercise program reduced the risk of cancer returning or death by 28% in stage III and high-risk stage II colon cancer patients.

Key Findings and Recommendations

• Reduced Recurrence & Improved Survival: Data from the international CHALLENGE trial showed 80% of patients in a structured exercise program remained cancer-free after five years, compared to 74% with only health education.
• The “Exercise Benefit”: The study, published in the New England Journal of Medicine, found exercise can be as impactful as some drugs in improving survival without negative side effects.
• Effective Routine: The successful program involved at least 45–60 minutes of physical activity (like brisk walking, swimming, or cycling) three to four times a week.
• When to Start: The benefits were observed when a structured program was started after completing surgery and chemotherapy.

READ MORE ABOUT THIS STUDY

Getting started…

If you are not quite sure where to start, your GP should be able to refer you to local training sessions that are designed specifically for people recovering from cancer and cancer treatment.

If you have been treated at the Royal Surrey, the Fountain Centre run their own exercise programmes so ask about these. Other cancer centres may offer similar support.