Impact of exercise interventions in people with colon and colorectal cancer on quality of life, physical function and fatigue

Colon and colorectal cancer treatments are frequently associated with cancer-related fatigue, physical deconditioning, and reduced health-related quality of life (HRQoL). Exercise has been proposed as a supportive care strategy, but evidence remains heterogeneous. This systematic review aimed to evaluate the effects of exercise interventions on cancer-related fatigue, physical function, HRQoL, and selected biological outcomes in adults with colon or colorectal cancer. Searches were conducted in PubMed, PEDro, and Scopus following PRISMA 2020 guidelines. Randomized and controlled clinical trials assessing structured exercise interventions were included. Methodological quality was evaluated using the McMaster Critical Review Form and the PEDro scale. Due to heterogeneity, results were synthesized qualitatively, with limited quantitative synthesis based on single-study effect estimates. Five studies met the inclusion criteria. Exercise interventions delivered during chemotherapy or survivorship consistently reduced cancer-related fatigue, showing moderate-to-large effect. Small-to-moderate improvements in physical function and muscular strength were observed. HRQoL outcomes were generally favorable, particularly in physical and functional domains. Evidence regarding biological outcomes was limited but suggested potential benefits for gastrointestinal function, sleep quality, and selected biomarkers. Overall, structured exercise appears to be a feasible and clinically relevant supportive care intervention for patients with colon and colorectal cancer. Further high-quality trials with standardized protocols are required.