Effects of Prehabilitation by Physical Activity on Fatigue After Surgery for Colorectal Cancer. Results From Secondary Analyses in the Randomized Controlled Trial PHYSSURG-C
In brief
Unsupervised moderate exercise cut postoperative fatigue scores by about four points
In a secondary analysis of 518 colorectal cancer patients, adding WHO-guideline exercise before and after surgery lowered self-reported fatigue by roughly four points at both four weeks and twelve months compared with usual care. The regimen did not change quality of life, pain, or mental recovery, and the authors call for larger trials to confirm the modest benefit.
- Journal
- Cancer medicine (Q1)
- Published
- 1 August 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Kevin Afshari, Aron Onerup, Ying Li, Eva Angenete, Carolina Ehrencrona, Anette Wedin, et al.
- PMID
- 42568293
- DOI
- 10.1002/cam4.72142
Why clinicians should know about it
- Picked for Gastroenterology (paper of the day, 11 August 2026): Prehabilitation reduces postoperative fatigue in colorectal cancer
Abstract
OBJECTIVE: The objective of this study is to explore effects on self-reported fatigue at 4 weeks and 12 months after surgery in patients with colorectal cancer undergoing a pre- and postoperative exercise intervention compared to standard care in a randomized trial. BACKGROUND: Fatigue after cancer surgery is common and evidence suggests it could be alleviated by physical activity. In this post hoc exploratory study, we analyzed fatigue and other secondary outcomes from a randomized trial aimed at exploring if prehabilitation by additional physical activity could improve postoperative recovery. METHOD: PHYSSURG C was a multicenter, controlled, randomized trial. Patients diagnosed with colorectal cancer were randomized to additional unsupervised moderate physical exercise in accordance with WHO guidelines or usual care two weeks before and four weeks after surgery. Trial-specific questionnaires were used at baseline, at 4 weeks and 12 months. Outcomes were self-reported fatigue as well as quality of life, pain, and mental recovery at both postoperative follow-up times. RESULTS: A total of 518 patients were included in this analysis. At 4 weeks after surgery, the mean difference in fatigue was 3.75 ((CI 0.01;7.49), p = 0.05) with intention to treat approach, and in a per protocol analysis at 4 weeks the mean difference was 4.04 ((CI 0.14;7.93), p = 0.04), and at 12 months it was 4.29 ((CI 0.44; 8.14), p = 0.03). There were no differences between the intervention and control groups regarding quality of life, pain, or mental recovery. CONCLUSION: This exploratory study found a suggestion of less postoperative fatigue in the intervention group. Further studies are needed to define the role of unsupervised moderate exercise, if any, before and after surgery in regard to postoperative fatigue in patients with colorectal cancer. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02299596.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.