
The link between cancer and exercise that patients should know
Exercise also improves outcomes in patients with cancer, according to a new study published in the New England Journal of Medicine. Patients with cancer who participated in a structured exercise program in a randomized-controlled trial lived longer without cancer recurrence and had a lower risk of dying within the trial period compared with people in the control group.
I was curious why and how exercise reduces cancer risk, and what everyone should know about incorporating exercise programs in their lives. To find out, I spoke with CNN wellness expert Dr. Leana Wen. Wen is an emergency physician and adjunct associate professor at George Washington University. She previously served as Baltimore's health commissioner.
CNN: Why are the results of this study so important?
Dr. Leana Wen: Previous research suggested that exercise could be beneficial for cancer survivors, but this is the first randomized trial that demonstrates exercise after cancer treatment can reduce recurrence and improve survival.
Researchers recruited nearly 900 patients from 55 cancer centers across six countries who had been treated for either stage III or high-risk stage II colon cancer. Even after cancer treatments such as surgery followed by chemotherapy, colon cancer comes back in an estimated 30% of patients, according to the American Society of Clinical Oncology. Many patients with recurrence of their colon cancer end up dying from their disease.
The patients in the new study were randomized to two groups. The control group received standard health education materials promoting healthy eating and physical activity. This is the current standard-of-care that is provided to patients in remission from their cancer.
The other group participated in a structured exercise program that involved working with a health coach for physical activity guidance and supervised exercise sessions. During the initial six months, patients had twice-a-month coaching sessions. After that period, they met with coaches once a month, with extra sessions available if needed.
Participants randomized to the structured exercise group had significantly higher improvements in physical function as measured by distance they could walk in six minutes and predicted VO2 max (your oxygen uptake), both indicators of cardiovascular fitness.
The two groups were followed for an average of about eight years. During this period, 131 patients in the control group had recurrence of their cancer, compared with 93 in the structured exercise group. In the control group, 66 people died, compared with 41 in the structured exercise group.
People in the structured exercise group had a 28% lower risk of developing recurrent or new cancers compared with those who followed standard-of-care protocols. Members of the exercise group also had a 37% lower risk of death in the trial period.
This study is important because its rigorous methodology confirms what previous research had suggested: Exercise extends disease-free survival for patients with cancer and should be incorporated as part of holistic treatment for patients to reduce their risk of recurrent and new cancers.
CNN: How might results of the study change treatment for patients with cancer?
Wen: Imagine if there were a clinical trial for a new drug that found it lowered the risk of developing recurrent or new cancers by 28% and lowered the risk of death in the trial period by 37%. Patients and doctors would hail this as a tremendous development and would be eager to try this new therapeutic.
That's the magnitude of the findings in this study. I believe they have the potential to substantially change cancer treatment protocols. Currently, after patients receive treatments such as surgery, chemotherapy and radiation, they are given advice to exercise, but many probably do not engage the services of a health coach or trainer. Their oncologists and primary care doctors may not be asking about their physical activity regimen during follow-up care.
I hope this will change, in view of these results. Patients can be counseled to have an 'exercise prescription,' and health care providers can follow up to track their exercise activity. Perhaps insurance companies could even consider reimbursement for a health coach for patients with cancer; this could be seen as an investment to reduce the need for costlier chemotherapy and other treatments down the line.
CNN: Why and how does exercise reduce cancer risk?
Wen: Population studies have long shown that regular physical activity is associated with lower risks of developing certain cancers. There are several theories as to why this is the case. One is that physical activity helps people stay at a healthy weight, which is notable because obesity is a risk factor for developing some cancers. In addition, exercise is thought to help regulate some hormones that are implicated in cancer development and to reduce inflammatory response that could also be involved in cancer.
CNN: How much exercise do people need?
Wen: The US Centers for Disease Control and Prevention recommends that adults participate in at least 150 minutes of moderate to high-intensity exercise per week. For someone who is exercising five times a week, that's about 30 minutes at a time of exercises such as a brisk walk or jog, riding a bike or swimming.
The benefits of these exercise minutes are cumulative, meaning that individuals don't need to do them all at once to have an effect. People who are unable to commit a period of time to exercise could consider how they could incorporate physical activity into their daily routines. Could they take the stairs instead of the elevator at work? If they do this five times a day, that could be as many as 10 minutes of exercise. Could they take a 10-minute phone meeting while walking in their neighborhood instead of sitting at a desk? Could they park a bit farther away to get in a few more minutes of physical activity? Small changes add up.
CNN: What other advice do you have for people who want to begin exercise programs?
Wen: Many studies show that while it's ideal to get the recommended 150 minutes a week of exercise, there is a significant benefit from even a small amount of physical activity. The best advice I can offer is to not let the perfect be the enemy of the good — start with what you can.
For instance, consider the idea of 'exercise snacks,' or bursts of activity that could be as short in duration as 15 or 30 seconds. These are as simple as doing a few squats or performing household chores. Getting up from your chair and just moving around helps, which is especially important for desk-bound workers who need additional exercise to counter the negative health impacts of sitting.
Sign up for CNN's Fitness, But Better newsletter series. Our seven-part guide will help you ease into a healthy routine, backed by experts.
Hashtags

Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles


CNN
an hour ago
- CNN
States, cities face loss of vaccination programs and staff after ‘baffling' cuts to federal funding
Vaccines Federal agencies Children's healthFacebookTweetLink Follow Millions of dollars have been pulled from state and local vaccination programs with no explanation, after a review of the funding agreements by the US Department of Health and Human Services. Affected programs say they will probably have to cut staffers and services because of the shortfall, and they worry that vaccination rates will also drop as they lose the ability to assist people who are low-income or uninsured. Immunization programs across the country are already struggling to address an increase in vaccine-preventable diseases. These include pertussis – also known as whooping cough – which has sickened more than 10,000 Americans and killed five children this year, as well as a smoldering outbreak of measles that has killed three people in the US and threatens to end the country's elimination status. 'That's the baffling part,' said one policy expert who spoke to CNN on the condition that they not be named for fear of government retaliation. 'Why anyone would create this disruption in the midst of the worst measles outbreak in 30 years.' Most money spent by states on vaccination comes from the federal government. The grant money, which is appropriated by Congress under Section 317 of the Public Health Services Act, enables states, territories and some large cities to collect data on vaccination, as well as provide shots to underserved children and adults. The funds also help monitor the safety of vaccines and fight misinformation. The money is doled out in five-year grants overseen by US Centers for Disease Control and Prevention, and the most recent awards were due to states on July 1. This year, however, HHS conducted lengthy reviews of the awards, which delayed their arrival in some cases. HHS Director of Communications Andrew Nixon said the reviews were part of agency cost-cutting efforts. 'The Defend the Spend initiative is a department-wide effort to ensure that taxpayer dollars are being used effectively, transparently, and in alignment with this administration,' Nixon said in a statement to CNN. 'As part of this oversight, grant recipients may be asked to provide additional information, which is essential to preventing waste, fraud, and abuse. HHS is committed to working all grantees to resolve outstanding issues as quickly as possible while maintaining the highest standards of accountability.' Public health advocates say the latest funding cuts appear to be part of a larger pattern of efforts by HHS Secretary Robert F. Kennedy Jr. to disrupt and dismantle the America's vaccination infrastructure. 'Millions of children missed their routine vaccinations during the pandemic,' and never caught back up said Dr. Caitlin Rivers, director of the Center for Response Outbreak Innovation at the Johns Hopkins Bloomberg School of Public Health. Vaccine hesitancy has also increased, driven by a deluge of misinformation, some of it now coming from official channels. As a result, vaccination rates have dropped, and some communities are no longer protected by herd immunity, the threshold of vaccination required to prevent certain infectious diseases from easily spreading. If state vaccination programs are not adequately resourced, 'we're just going to continue to fall further and further behind, and that sets the stage for things like measles and pertussis outbreaks, which we're seeing,' Rivers said. Public health programs often become victims of their own success, she said. 'When there is a large public health emergency … there are huge investments made in public health, because we can see very clearly what the consequences are of having inadequate resourcing and inadequate infrastructure. But over time, those investments begin to work, and the threats recede, and we start to forget why it's so important to maintain those defenses,' Rivers said. 'And I think now, five years out of Covid, we're very clearly in the neglect cycle, and we're seeing a lot of the investments we made during the pandemic be pulled back,' she added. Of 66 jurisdictions awarded federal immunization funding this year, about 40 received awards lower than their funding targets. And more than a dozen states and cities received lower awards this year than they did in 2019, just before the Covid-19 pandemic began, the last time these awards were offered through the CDC, according to a CNN analysis of federal data. Massachusetts, New York, Indiana, California and Arizona were among those awarded less this year than in 2019, the year before the Covid-19 pandemic began. 'That's really, really unbelievable to us,' said one public health advocate who asked not to be named for fear of political retaliation for speaking out against the cuts. 'How could we come out of a pandemic with half of states being less prepared?' Other states found that their awards were far lower than they'd been told to expect. In January 2025, the CDC sent out a Notice of Funding Opportunity – essentially an invitation – to states, territories and certain large cities. It came with a funding target: the amount they could expect if their grant proposals were accepted. Washington, for example, was told it could expect about $9.5 million, so the Department of Health planned for that amount for the 2026 fiscal year. When the state got its Notice of Award on July 1, however, it was for $7.8 million, an 18% reduction. Massachusetts was told it could expect $7.7 million for the upcoming fiscal year, already a 20% reduction from its 2025 budget. When the award arrived, it was $1 million under the targeted amount, at $6.7 million, which means the department expects to operate with about 30% less funding next year than it has this year. Colorado received almost $500,000 less than it expected, a decrease of about 5% from the amount it budgeted for, according to federal data California, Illinois, Michigan and New York also received lower-than-expected funding awards, according to a CNN analysis of federal data. Sometimes, the delays and errors in funding caused chaos: At least one state, Idaho, furloughed its immunization program staff with no notice after the money didn't arrive when expected. When the award did come through a day later, they were put back to work, but medical providers who reached out in the interim to submit their regular data updates had no one to help them and didn't know when services would be restored. The cuts didn't just affect state health departments. The city of New Haven, Connecticut, had to lay off immunization positions that were supported by subawards it receives from the state grant. When the grant didn't arrive in time, the state directed the city not to incur any more expenses, and when the federal money did come through, it was 20% less than anticipated. Chicago is also preparing to lay off immunization workers, according to multiple sources with knowledge of the city's plans, who asked not to be named because they feared retaliation by the Trump administration. Not all awardees saw reductions, however. About two dozen jurisdictions, including Alabama, Idaho and Wyoming and Montana, got significant funding increases over their award targets for this year. State officials who spoke to CNN for this story say they were given no explanation for why the awards were reduced or increased this cycle. The cuts come on top of the loss of billions in unspent Covid relief funding that was being used by states, in part, to help staff immunization programs. In late March, HHS directed the CDC to roll back about $11.4 billion in Covid-era funding granted to state and local health departments. Another $1 billion was reclaimed from the Substance Abuse and Mental Health Services Administration. A survey conducted by the Association of Immunization Managers found that the Covid money clawback alone has led to the elimination 579 staff positions in state vaccination programs. After the new grant cuts, some jurisdictions said they would probably need to lay off even more workers but were trying to assess the changes that would be needed. Some programs said they hoped state funding could help fill the gaps. In the past, the funding amounts that jurisdictions were told they could expect have been determined by a relatively simple formula that primarily relied on an area's population. This year, however, federal officials deployed a more complicated formula that took into account population levels as well as how much of a state was rural and how many providers participate in the Vaccines for Children program compared with the overall population, according to a public health advocate familiar with the awards who asked not to be named for fear of political retaliation. Immunization programs were told they could expect about $418 million in funding. All told, what they were awarded totaled roughly $398 million. Changes to the funding formula don't appear to account for the reductions, however. The formula was applied to the target amounts that were distributed in January. Instead, changes to the awards came after the HHS review, which in some cases delayed the release of the money and left programs hanging. Hawaii, for example, received authorization to borrow up to $100,000 from the state government to pay salaries and cover operational expenses until its award came through, about two weeks late. Public health advocates blasted the funding decision. 'Stripping 317 waiver funds combined with other losses is starving state and local public health budgets and is not just short-sighted, it's reckless,' said Dr. Brian Castrucci, president and chief executive officer of the nonprofit deBeaumont Foundation, which advocates for the public health workforce. 'We're watching the deliberate dismantling of the public health safety net in real time,' Castrucci said.


CNN
an hour ago
- CNN
States, cities face loss of vaccination programs and staff after ‘baffling' cuts to federal funding
Millions of dollars have been pulled from state and local vaccination programs with no explanation, after a review of the funding agreements by the US Department of Health and Human Services. Affected programs say they will probably have to cut staffers and services because of the shortfall, and they worry that vaccination rates will also drop as they lose the ability to assist people who are low-income or uninsured. Immunization programs across the country are already struggling to address an increase in vaccine-preventable diseases. These include pertussis – also known as whooping cough – which has sickened more than 10,000 Americans and killed five children this year, as well as a smoldering outbreak of measles that has killed three people in the US and threatens to end the country's elimination status. 'That's the baffling part,' said one policy expert who spoke to CNN on the condition that they not be named for fear of government retaliation. 'Why anyone would create this disruption in the midst of the worst measles outbreak in 30 years.' Most money spent by states on vaccination comes from the federal government. The grant money, which is appropriated by Congress under Section 317 of the Public Health Services Act, enables states, territories and some large cities to collect data on vaccination, as well as provide shots to underserved children and adults. The funds also help monitor the safety of vaccines and fight misinformation. The money is doled out in five-year grants overseen by US Centers for Disease Control and Prevention, and the most recent awards were due to states on July 1. This year, however, HHS conducted lengthy reviews of the awards, which delayed their arrival in some cases. HHS Director of Communications Andrew Nixon said the reviews were part of agency cost-cutting efforts. 'The Defend the Spend initiative is a department-wide effort to ensure that taxpayer dollars are being used effectively, transparently, and in alignment with this administration,' Nixon said in a statement to CNN. 'As part of this oversight, grant recipients may be asked to provide additional information, which is essential to preventing waste, fraud, and abuse. HHS is committed to working all grantees to resolve outstanding issues as quickly as possible while maintaining the highest standards of accountability.' Public health advocates say the latest funding cuts appear to be part of a larger pattern of efforts by HHS Secretary Robert F. Kennedy Jr. to disrupt and dismantle the America's vaccination infrastructure. 'Millions of children missed their routine vaccinations during the pandemic,' and never caught back up said Dr. Caitlin Rivers, director of the Center for Response Outbreak Innovation at the Johns Hopkins Bloomberg School of Public Health. Vaccine hesitancy has also increased, driven by a deluge of misinformation, some of it now coming from official channels. As a result, vaccination rates have dropped, and some communities are no longer protected by herd immunity, the threshold of vaccination required to prevent certain infectious diseases from easily spreading. If state vaccination programs are not adequately resourced, 'we're just going to continue to fall further and further behind, and that sets the stage for things like measles and pertussis outbreaks, which we're seeing,' Rivers said. Public health programs often become victims of their own success, she said. 'When there is a large public health emergency … there are huge investments made in public health, because we can see very clearly what the consequences are of having inadequate resourcing and inadequate infrastructure. But over time, those investments begin to work, and the threats recede, and we start to forget why it's so important to maintain those defenses,' Rivers said. 'And I think now, five years out of Covid, we're very clearly in the neglect cycle, and we're seeing a lot of the investments we made during the pandemic be pulled back,' she added. Of 66 jurisdictions awarded federal immunization funding this year, about 40 received awards lower than their funding targets. And more than a dozen states and cities received lower awards this year than they did in 2019, just before the Covid-19 pandemic began, the last time these awards were offered through the CDC, according to a CNN analysis of federal data. Massachusetts, New York, Indiana, California and Arizona were among those awarded less this year than in 2019, the year before the Covid-19 pandemic began. 'That's really, really unbelievable to us,' said one public health advocate who asked not to be named for fear of political retaliation for speaking out against the cuts. 'How could we come out of a pandemic with half of states being less prepared?' Other states found that their awards were far lower than they'd been told to expect. In January 2025, the CDC sent out a Notice of Funding Opportunity – essentially an invitation – to states, territories and certain large cities. It came with a funding target: the amount they could expect if their grant proposals were accepted. Washington, for example, was told it could expect about $9.5 million, so the Department of Health planned for that amount for the 2026 fiscal year. When the state got its Notice of Award on July 1, however, it was for $7.8 million, an 18% reduction. Massachusetts was told it could expect $7.7 million for the upcoming fiscal year, already a 20% reduction from its 2025 budget. When the award arrived, it was $1 million under the targeted amount, at $6.7 million, which means the department expects to operate with about 30% less funding next year than it has this year. Colorado received almost $500,000 less than it expected, a decrease of about 5% from the amount it budgeted for, according to federal data California, Illinois, Michigan and New York also received lower-than-expected funding awards, according to a CNN analysis of federal data. Sometimes, the delays and errors in funding caused chaos: At least one state, Idaho, furloughed its immunization program staff with no notice after the money didn't arrive when expected. When the award did come through a day later, they were put back to work, but medical providers who reached out in the interim to submit their regular data updates had no one to help them and didn't know when services would be restored. The cuts didn't just affect state health departments. The city of New Haven, Connecticut, had to lay off immunization positions that were supported by subawards it receives from the state grant. When the grant didn't arrive in time, the state directed the city not to incur any more expenses, and when the federal money did come through, it was 20% less than anticipated. Chicago is also preparing to lay off immunization workers, according to multiple sources with knowledge of the city's plans, who asked not to be named because they feared retaliation by the Trump administration. Not all awardees saw reductions, however. About two dozen jurisdictions, including Alabama, Idaho and Wyoming and Montana, got significant funding increases over their award targets for this year. State officials who spoke to CNN for this story say they were given no explanation for why the awards were reduced or increased this cycle. The cuts come on top of the loss of billions in unspent Covid relief funding that was being used by states, in part, to help staff immunization programs. In late March, HHS directed the CDC to roll back about $11.4 billion in Covid-era funding granted to state and local health departments. Another $1 billion was reclaimed from the Substance Abuse and Mental Health Services Administration. A survey conducted by the Association of Immunization Managers found that the Covid money clawback alone has led to the elimination 579 staff positions in state vaccination programs. After the new grant cuts, some jurisdictions said they would probably need to lay off even more workers but were trying to assess the changes that would be needed. Some programs said they hoped state funding could help fill the gaps. In the past, the funding amounts that jurisdictions were told they could expect have been determined by a relatively simple formula that primarily relied on an area's population. This year, however, federal officials deployed a more complicated formula that took into account population levels as well as how much of a state was rural and how many providers participate in the Vaccines for Children program compared with the overall population, according to a public health advocate familiar with the awards who asked not to be named for fear of political retaliation. Immunization programs were told they could expect about $418 million in funding. All told, what they were awarded totaled roughly $398 million. Changes to the funding formula don't appear to account for the reductions, however. The formula was applied to the target amounts that were distributed in January. Instead, changes to the awards came after the HHS review, which in some cases delayed the release of the money and left programs hanging. Hawaii, for example, received authorization to borrow up to $100,000 from the state government to pay salaries and cover operational expenses until its award came through, about two weeks late. Public health advocates blasted the funding decision. 'Stripping 317 waiver funds combined with other losses is starving state and local public health budgets and is not just short-sighted, it's reckless,' said Dr. Brian Castrucci, president and chief executive officer of the nonprofit deBeaumont Foundation, which advocates for the public health workforce. 'We're watching the deliberate dismantling of the public health safety net in real time,' Castrucci said.


CNN
9 hours ago
- CNN
Shark expert details encounter with ‘venomous shark'
Marine biologist and Shark Week expert Forrest Galante sits down with CNN's Fredricka Whitfield to describe his search for "venomous sharks."