‘Move More, Sit Less’: Physical Activity Improves Quality of Life in Colon Cancer Survivors

HealHeal Fall 2021

Performing the recommended 150 minutes of physical activity per week could lead colorectal cancer survivors to “a happy and healthy life” post treatment, according to an expert.

Survivors of colorectal cancer could have improved quality of life, social and physical functioning, and feel less fatigued up to two years post treatment, if they participate in light-intensity physical activity, according to study results recently published in Quality of Life Research.

“It is advisable for colorectal cancer survivors to follow the recommendations to move more and sit less. This will very likely contribute to leading a healthy and happy life after colorectal cancer,” Dr. Martijn Bours, from the department of epidemiology of Maastricht University in The Netherlands, said in an interview with CURE®.

Colorectal cancer survivors go through treatment that often results in long-term side effects such as fatigue and bowel problems, which can negatively impact a person’s quality of life.

Evidence from previous studies demonstrated that higher levels of light-intensity physical activity are associated with health-related quality of life improvements in colorectal cancer survivors, however those studies did not assess the long-term benefits. In addition, other study results have demonstrated that colorectal cancer survivors are often physically inactive and spend on average about two-thirds of their time sitting or lying down.

The researchers evaluated questionnaire responses from 325 stage 1-3 colorectal cancer survivors (67.1% men; average age, 67 years). The questionnaires included information on a survivor’s hours per week spent doing light-intensity physical activity and their quality of life and were administered at six weeks and six, 12- and 24-months post treatment. Survivors were also asked to wear activity monitors at these moments, to objectively measure their sedentary habits.

The study results demonstrated statistically significant long-term associations between a survivor performing more light-intensity physical activity (eight hours per week) and them having an improved quality of life, social functioning, physical functioning and feeling less fatigued.

Median self-reported time spent participating in light-intensity physical activity at diagnosis was 10.5 hours per week, which later decreased at six weeks post treatment to 7.5 hours, but then increased again further after treatment. Most of the participants said the physical activity consisted of light housework. At diagnosis, 74% of the patient population reported to adhere to Dutch physical activity guidelines. That total decreased to 60% at six weeks, then increased to 68% at 12 months. However, at 24 months post treatment, that number dropped to 63%.

Of note, the mean fatigue scores decreased, and the mean scores of quality of life and functioning outcomes increased between the six-week and 24-month period post treatment.

Bours noted that performing physical activities that require moderate to vigorous strength can often be difficult for this patient population due to their past cancer treatment, as well as the fact that these individuals are often over the age of 70 and frequently have other health conditions such as diabetes or rheumatoid arthritis. Instead, those individuals can take part in light-intensity physical activity like slow-paced walking, playing billiards and doing housework while standing such as cooking or cleaning dishes.

Although there are no specific recommendations for light-intensity physical activity, he noted that these results highlight the fact that participating in any kind of physical activity may positively impact quality of life, level of daily functioning and fatigue symptoms. He also mentioned a previous study which demonstrated that replacing one hour of sedentary time per day with one hour of standing resulted in better quality of life, functioning and less fatigue.

“Importantly, a physically active lifestyle includes both increasing physical activity and decreasing sedentary behavior,” Bours said. “Besides having a positive influence on quality of life after colorectal cancer, moving more and sitting less can, for instance, also decrease the risk and impact of several health conditions, such as obesity, diabetes, cardiovascular disease and cancer.”

He noted that although the results of their study in colorectal cancer survivors are promising, further research is needed to identify which activities are most beneficial for these survivors.

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