Patients in a structured exercise program experienced a 37 per cent lower risk of death and a 28 per cent reduction in recurrence or development of new cancers compared to those who received only health education materials, a recent study found.
The study, called CO.21 (Challenge), was led by the Canadian Cancer Trials Group and the Waterloo Regional Health Network (WRHN) in partnership with the University of Waterloo's Centre for Community, Clinical and Applied Research Excellence (CCCARE) and other clinical sites.
This unique collaboration with the UW WELL-FIT program at CCCARE enabled patients to access supervised, evidence-based exercise interventions tailored specifically to individuals recovering from cancer treatment.
"This is a model of how regional hospitals can shape international research and how local partnerships, like ours with CCCARE, can deliver global impact. We are proud to be part of the solution," says Carla Girolametto, director of Research Operations at WRHN.
WRHN's Cancer Centre assisted 33 cancer patients from Waterloo Region since 2009 to contribute to the research findings. A total of 889 patients across 55 clinical sites comprised the study's findings that determined integrating exercise into survivorship care positively transforms outcomes for patients.
"This is a transformative moment in oncology and we're proud to have played a key role in this global research," says Dr. Stacey Hubay, medical oncologist and principal investigator at WRHN, who led WRHN's contribution to the global study.
"We've long known anecdotally that exercise benefits cancer patients, but to see such clear improvements in disease-free and overall survival, confirmed by rigorous data, is extraordinary. These results suggest that exercise should be incorporated into cancer care, not just as a recommendation, but as an integral part of the treatment plan from diagnosis through survivorship."
What began as an initiative to support individuals undergoing cancer treatment more than two decades ago, UW WELL-FIT has expanded to serve a broader patient population and offer ongoing exercise options, with clear evidence that exercise supports physical and mental well-being across the cancer experience.
Following the study's results, additional work is being done at CCCARE, in partnership with EXE-COPP, led by principal investigator Dr. Anupam Batra, who is currently examining how exercise can offset physical and cognitive decline in men with metastatic prostate cancer.
"It's the natural evolution of what CO.21 helped to prove: exercise is medicine," says Julia Fraser, PhD candidate, co-investigator and research and operations manager with CCCARE.
For patients, the impact is deeply personal and transformative.
"I was diagnosed with cancer in 2016, and Dr. Hubay introduced me to the CO.21 study while I was undergoing chemotherapy. At the time, I was still quite active, running and exercising, but I waited to formally join the study until I had completed treatment," said Russel Espiritu, one of WRHN's CO.21 study participants.
"The exercise program at the University of Waterloo gave me the motivation and energy I needed to recover from the harsh effects of chemotherapy. It also connected me with other cancer patients who truly understood the journey. After the study, I was able to return to practicing karate. Staying active during and after treatment helped me manage the side effects, physically and mentally. I truly hope these study results will encourage physicians to prescribe exercise as part of standard cancer care."
Dr. Nicole Thomson, vice-president of quality, research and patient experience at WRHN, reflects on the broader impact. "The CO.21 study is a powerful example of how community hospitals can meaningfully contribute to high-impact research. Our participation demonstrates that with the right partnerships and infrastructure, community-based cancer programs can drive innovation, improve outcomes, and help shape the future of care, not just locally, but nationally and beyond."
