Supportive Care in Cancer

, Volume 21, Issue 6, pp 1605–1612 | Cite as

Patterns of physical activity participation across the cancer trajectory in colorectal cancer survivors

  • Jae Youn Chung
  • Dong Hoon Lee
  • Ji-Hye Park
  • Mi Kyung Lee
  • Dong-Woo Kang
  • Jihee Min
  • Dong-Il Kim
  • Duck Hyoun Jeong
  • Nam Kyu Kim
  • Jeffrey A. Meyerhardt
  • Lee W. Jones
  • Justin Y. JeonEmail author
Original Article



The purpose of the present study was to explore the participation in physical activity (PA) by colorectal cancer survivors across cancer trajectories and based on selected demographic and medical variables.


A total of 431 participants were surveyed individually at the Shinchon Severance Hospital, Seoul, Korea, to determine their PA levels before diagnosis, during treatment and after completion of cancer treatment.


Percentage of survivors meeting American College of Sports Medicine guideline significantly reduced from 27 % before diagnosis to 10 % during treatment due to reduced strenuous intensity PA (28.8 ± 106.2 vs 11.8 ± 95.9 min, p = 0.042), while total PA and mild intensity PA did not change. Total (187.2 ± 257.7 vs. 282.6 ± 282.0 min, p < 0.001) and mild (99.1 ± 191.5 vs. 175.1 ± 231.2 min, p < 0.001) intensity PA significantly increased after the completion of treatments compared with their PA level before diagnosis. Further analyses showed that age (more vs. equal or less than 60 years) and chemotherapy (chemotherapy vs. no chemotherapy) significantly influenced the level of physical activity (p = 0.004). Survivors who were older or received chemotherapy increased their total PA and mild intensity PA after the completion of treatment more than those who did not receive chemotherapy.


The level and the pattern of physical activity by colorectal cancer survivors differed across cancer trajectories, which were significantly influenced by age and adjuvant chemotherapy.


Physical activity Exercise Cancer trajectory Colorectal cancer 


Research support

The current study was supported by the national research foundation of Korea (NRF)(No.2011-0004892) and the National R & D program for Cancer Control, Ministry of Health and Welfare, Republic of Korea (No.1120230).

Conflict of interest

The authors have declared no conflicts of interest. The authors have full control of all primary data and that we agree to allow the journal to review the data if required.


  1. 1.
    Jung KW, Park S, Kong HJ, Won YJ, Lee JY, Seo HG, Lee JS (2012) Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2009. Cancer Res Treat Off J Kor Cancer Assoc 44:11–24CrossRefGoogle Scholar
  2. 2.
    GLOBOCAN 2008: cancer incidence and mortality worldwide in 2008 (2011) World Health Organization, GenevaGoogle Scholar
  3. 3.
    Baade PD, Meng X, Youl PH, Aitken JF, Dunn J, Chambers SK (2011) The impact of body mass index and physical activity on mortality among patients with colorectal cancer in Queensland. Cancer Epidemiol Biomarkers Prev 20:1410–1420PubMedCrossRefGoogle Scholar
  4. 4.
    Haydon AM, Macinnis RJ, English DR, Giles GG (2006) Effect of physical activity and body size on survival after diagnosis with colorectal cancer. Gut 55:62–67PubMedCrossRefGoogle Scholar
  5. 5.
    Haydon AM, Macinnis RJ, English DR, Morris H, Giles GG (2006) Physical activity, insulin-like growth factor 1, insulin-like growth factor binding protein 3, and survival from colorectal cancer. Gut 55:689–694PubMedCrossRefGoogle Scholar
  6. 6.
    Meyerhardt JA, Giovannucci EL, Ogino S, Kirkner GJ, Chan AT, Willett W, Fuchs CS (2009) Physical activity and male colorectal cancer survival. Arch Intern Med 169:2102–2108PubMedCrossRefGoogle Scholar
  7. 7.
    Meyerhardt JA, Heseltine D, Niedzwiecki D, Hollis D, Saltz LB, Mayer RJ, Thomas J, Nelson H, Whittom R, Hantel A, Schilsky RL, Fuchs CS (2006) Impact of physical activity on cancer recurrence and survival in patients with stage III colon cancer: findings from CALGB 89803. J Clin Oncol Off J Am Soc Clin Oncol 24:3535–3541CrossRefGoogle Scholar
  8. 8.
    Meyerhardt JA, Tepper JE, Niedzwiecki D, Hollis DR, McCollum AD, Brady D, O'Connell MJ, Mayer RJ, Cummings B, Willett C, Macdonald JS, Benson AB 3rd, Fuchs CS (2004) Impact of body mass index on outcomes and treatment-related toxicity in patients with stage II and III rectal cancer: findings from Intergroup Trial 0114. J Clinical Oncol Off JAm Soc Clin Oncol 22:648–657CrossRefGoogle Scholar
  9. 9.
    Ehrmann-Josko A, Sieminska J, Gornicka B, Ziarkiewicz-Wroblewska B, Ziolkowski B, Muszynski J (2006) Impaired glucose metabolism in colorectal cancer Scand. J Gastroenterol 41:1079–1086Google Scholar
  10. 10.
    Meyerhardt JA, Giovannucci EL, Holmes MD, Chan AT, Chan JA, Colditz GA, Fuchs CS (2006) Physical activity and survival after colorectal cancer diagnosis. J Clin Oncol 24:3527–3534PubMedCrossRefGoogle Scholar
  11. 11.
    Dimeo F, Fetscher S, Lange W, Mertelsmann R, Keul J (1997) Effects of aerobic exercise on the physical performance and incidence of treatment-related complications after high-dose chemotherapy. Blood 90:3390–3394PubMedGoogle Scholar
  12. 12.
    Galvao DA, Newton RU (2005) Review of exercise intervention studies in cancer patients. J Clin Oncol 23:899–909PubMedCrossRefGoogle Scholar
  13. 13.
    Knols R, Aaronson NK, Uebelhart D, Fransen J, Aufdemkampe G (2005) Physical exercise in cancer patients during and after medical treatment: a systematic review of randomized and controlled clinical trials. J Clin Oncol 23:3830–3842PubMedCrossRefGoogle Scholar
  14. 14.
    Mock V, Dow KH, Meares CJ, Grimm PM, Dienemann JA, Haisfield-Wolfe ME, Quitasol W, Mitchell S, Chakravarthy A, Gage I (1997) Effects of exercise on fatigue, physical functioning, and emotional distress during radiation therapy for breast cancer. Oncol Nurs Forum 24:991–1000PubMedGoogle Scholar
  15. 15.
    Schwartz AL (1999) Fatigue mediates the effects of exercise on quality of life. Qual Life Res 8:529–538PubMedCrossRefGoogle Scholar
  16. 16.
    Schwartz AL, Mori M, Gao R, Nail LM, King ME (2001) Exercise reduces daily fatigue in women with breast cancer receiving chemotherapy. Med Sci Sports Exerc 33:718–723PubMedGoogle Scholar
  17. 17.
    Bellizzi KM, Rowland JH, Jeffery DD, McNeel T (2005) Health behaviors of cancer survivors: examining opportunities for cancer control intervention. J Clin Oncol off J Am Soc Clin Oncol 23:8884–8893CrossRefGoogle Scholar
  18. 18.
    Speed-Andrews AE, Rhodes RE, Blanchard CM, Culos-Reed SN, Friedenreich CM, Belanger LJ, Courneya KS (2012) Medical, demographic and social cognitive correlates of physical activity in a population-based sample of colorectal cancer survivors. Eur J Cancer Care 21:187–196CrossRefGoogle Scholar
  19. 19.
    Speed-Andrews AE, McGowan EL, Rhodes RE, Blanchard CM, Culos-Reed SN, Friedenreich CM, Courneya KS (2013) Correlates of strength exercise in colorectal cancer survivors. Am J Health Behav 37:162–170PubMedCrossRefGoogle Scholar
  20. 20.
    McGowan EL, Speed-Andrews AE, Rhodes RE, Blanchard CM, Culos-Reed SN, Friedenreich CM, Courneya KS (2012) Sport participation in colorectal cancer survivors: an unexplored approach to promoting physical activity. Support Care Cancer 21:139–147Google Scholar
  21. 21.
    Belanger LJ, Plotnikoff RC, Clark A, Courneya KS (2011) Physical activity and health-related quality of life in young adult cancer survivors: a Canadian provincial survey. J Cancer Surviv 5:44–53PubMedCrossRefGoogle Scholar
  22. 22.
    Gjerset GM, Fossa SD, Courneya KS, Skovlund E, Jacobsen AB, Thorsen L (2011) Interest and preferences for exercise counselling and programming among Norwegian cancer survivors. Eur J Cancer Care (Engl) 20:96–105CrossRefGoogle Scholar
  23. 23.
    Jones LW, Courneya KS (2002) Exercise counseling and programming preferences of cancer survivors. Cancer Pract 10:208–215PubMedCrossRefGoogle Scholar
  24. 24.
    Jones LW, Guill B, Keir ST, Carter K, Friedman HS, Bigner DD, Reardon DA (2007) Exercise interest and preferences among patients diagnosed with primary brain cancer. Support Care Cancer 15:47–55PubMedCrossRefGoogle Scholar
  25. 25.
    Vallance JK, Courneya KS, Jones LW, Reiman T (2006) Exercise preferences among a population-based sample of non-Hodgkin's lymphoma survivors. Eur J Cancer Care (Engl) 15:34–43CrossRefGoogle Scholar
  26. 26.
    Meyerhardt JA, Heseltine D, Niedzwiecki D, Hollis D, Saltz LB, Mayer RJ, Thomas J, Nelson H, Whittom R, Hantel A, Schilsky RL, Fuchs CS (2006) Impact of physical activity on cancer recurrence and survival in patients with stage III colon cancer: findings from CALGB 89803. J Clin Oncol 24:3535–3541PubMedCrossRefGoogle Scholar
  27. 27.
    Jones LW, Guill B, Keir ST, Carter BSK, Friedman HS, Bigner DD, Reardon DA (2006) Patterns of exercise across the cancer trajectory in brain tumor patients. Cancer 106:2224–2232PubMedCrossRefGoogle Scholar
  28. 28.
    Schmitz KH, Courneya KS, Matthews C, Demark-Wahnefried W, Galvao DA, Pinto BM, Irwin ML, Wolin KY, Segal RJ, Lucia A, Schneider CM, von Gruenigen VE, Schwartz AL (2010) American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc 42:1409–1426PubMedCrossRefGoogle Scholar
  29. 29.
    Courneya KS, Friedenreich CM (1997) Relationship between exercise pattern across the cancer experience and current quality of life in colorectal cancer survivors. J Altern Complement Med 3:215–226PubMedCrossRefGoogle Scholar
  30. 30.
    Jones LW, Courneya KS, Vallance JK, Ladha AB, Mant MJ, Belch AR, Stewart DA, Reiman T (2004) Association between exercise and quality of life in multiple myeloma cancer survivors. Support Care Can Off J Multinatl Assoc Support Care Can 12:780–788CrossRefGoogle Scholar
  31. 31.
    Courneya KS, Karvinen KH, Campbell KL, Pearcey RG, Dundas G, Capstick V, Tonkin KS (2005) Associations among exercise, body weight, and quality of life in a population-based sample of endometrial cancer survivors. Gynecol Oncol 97:422–430PubMedCrossRefGoogle Scholar
  32. 32.
    Irwin ML, Crumley D, McTiernan A, Bernstein L, Baumgartner R, Gilliland FD, Kriska A, Ballard-Barbash R (2003) Physical activity levels before and after a diagnosis of breast carcinoma: the Health, Eating, Activity, and Lifestyle (HEAL) study. Cancer 97:1746–1757PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Jae Youn Chung
    • 1
  • Dong Hoon Lee
    • 1
  • Ji-Hye Park
    • 1
  • Mi Kyung Lee
    • 1
  • Dong-Woo Kang
    • 1
  • Jihee Min
    • 1
  • Dong-Il Kim
    • 1
  • Duck Hyoun Jeong
    • 2
  • Nam Kyu Kim
    • 2
  • Jeffrey A. Meyerhardt
    • 3
  • Lee W. Jones
    • 4
  • Justin Y. Jeon
    • 1
    Email author
  1. 1.Department of Sport and Leisure StudiesYonsei UniversitySeoulKorea
  2. 2.Department of Surgery, Yonsei University College of MedicineYonsei UniversitySeoulKorea
  3. 3.Department of Medical OncologyDana Farber Cancer InstituteBostonUSA
  4. 4.Duke Cancer InstituteDurhamUSA

Personalised recommendations