Original article © 2003 Blackwell Publishing Ltd European Journal of Cancer Care, 2003, 12, 347–357 A randomized trial of exercise and quality of life in colorectal cancer survivors K. S. COURNEYA, phd, University of Alberta, Edmonton, Alberta, C. M. FRIEDENREICH, phd, Alberta Cancer Board, Alberta, Calgary , H. A. QUINNEY, phd , University of Alberta, Edmonton, Alberta, Calgary , A. L. A. FIELDS, md , Alberta Cancer Board, Alberta, Calgary , L. W. JONES, phd , University of Alberta, Edmonton, Alberta Calgary & A. S. FAIREY, ms , University of Alberta, Edmonton, Alberta, Calgary, Canada COURNEYA K.S., FRIEDENREICH C.M., QUINNEY H.A., FIELDS A.L.A., JONES L.W. & FAIREY A.S. (2003) European Journal of Cancer Care 12 , 347–357 A randomized trial of exercise and quality of life in colorectal cancer survivors We conducted a randomized controlled trial to determine the effects of a home-based exercise intervention on change in quality of life (QOL) in recently resected colorectal cancer survivors, most of whom were receiving adjuvant therapy. Participants were randomly assigned in a 2 : 1 ratio to either an exercise ( n = 69) or control ( n = 33) group. The exercise group was asked to perform moderate intensity exercise 3–5 times per week for 20–30 min each time. The primary outcome was change in QOL as measured by the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) scale. Adherence in the exercise group was good (75.8%) but contamination in the control group was problematic (51.6%). Intention-to-treat analysis revealed no significant differences between groups for change in the FACT-C (mean difference, - 1.3; 95% CI, - 7.8 to 5.1; P = 0.679). In an ‘on-treatment’ ancillary analysis, we compared participants who decreased versus increased their cardiovascular fitness over the course of the intervention. This analysis revealed significant differences in favour of the increased fitness group for the FACT-C (mean difference, 6.5; 95% CI, 0.4–12.6; P = 0.038). These data suggest that increased cardiovascular fitness is associated with improvements in QOL in colorectal cancer survivors but better controlled trials are needed. Keywords: adherence, anxiety, contamination, depression, fatigue, physical fitness. Correspondence address: Kerry S. Courneya, Faculty of Physical Education, University of Alberta, E-424 Van Vliet Center, Edmonton, Alberta, Canada, T6G 2H9 (e-mail: kerry.courneya@ualberta.ca). Accepted 18 June 2003 INTRODUCTION Cancer and its treatments often produce significant mor- bidities that undermine quality of life (QOL) in survivors (Shapiro & Recht 2001). Research has accumulated to sug- gest that physical exercise may be one strategy to enhance QOL both during and after cancer treatments (see Cour- neya 2001; Courneya et al. 2003c for reviews). Almost all intervention studies to date have focused on breast cancer or bone marrow transplant survivors. Yet, any cancer that is associated with QOL decrements from the disease or its treatment may potentially benefit from exercise (Cour- neya & Friedenreich 1997). It may be unwise, however, to generalize the results from one group of cancer survivors to another because each cancer is unique in terms of the natural history and pathology of the disease, the treatment protocols used to manage the disease, the side- effects of the disease and treatment, and the characteris- tics of the survivors including their demographic profile, medical history and lifestyle. Colorectal cancer is the third most common cancer in the US for both men and women (American Cancer Soci- ety 2002). It is estimated that 135 400 new cases of col- orectal cancer will be diagnosed in the US in 2001, Blackwell Science, LtdOxford, UKEJCCEuropean Journal of Cancer Care1365-2354Blackwell Publishing Ltd, 200312 4347357Original ArticleExercise, QOL and colorectal cancerCOURNEYA et al.