“I survived leukemia, but no one told me how to live again.”
That’s what one of my patients said after completing chemotherapy. The treatment saved her life but left her weak, anxious, and wondering what came next. Her story isn’t unique. While oncology has made remarkable strides in survival, too many patients emerge from treatment with bodies battered and guidance reduced to a faded survivorship brochure.
Yet, a growing body of evidence shows that structured lifestyle interventions such as physical activity, nutrition, and stress management aren’t just helpful; they also reduce cancer recurrence, improve quality of life, lower mortality, and even decrease healthcare costs.
It’s time to treat these interventions not as extras, but as essentials.
The evidence is strong and growing
Cancer care is entering a new phase – one in which evidence-based lifestyle interventions are emerging as critical components of comprehensive oncology treatment. A growing body of clinical research demonstrates that targeted changes in diet, physical activity, and stress management can significantly reduce cancer recurrence and mortality.
A 2023 New England Journal of Medicine study followed 962 colorectal cancer patients for three years. Those in a supervised, moderate-intensity exercise program had a 37% reduction in mortality. That’s a bigger benefit than many chemotherapy agents provide – and with fewer side effects.
In breast cancer patients, regular physical activity was linked to a 30–50% reduction in death and up to 40% lower recurrence risk.
Beyond survival, structured lifestyle programs improve how patients feel. A meta-analysis of 110 randomized trials found that cancer survivors in lifestyle programs experienced significantly better physical, emotional, and social well-being. Exercise alone consistently reduced cancer-related fatigue, one of the most debilitating effects of treatment.
Strengthening patients before treatment
Lifestyle medicine is not only vital for recovery. It’s increasingly essential even before treatment begins.
A 2022 systematic review and meta-analysis in Supportive Care in Cancer found that prehabilitation lowered the rate of postoperative complications and reduced the average length of hospital stay in frail cancer patients. In 2023, a review in Critical Reviews in Oncology/Hematology linked prehabilitation to better treatment tolerance and fewer post-treatment complications.
We don’t send patients into surgery without preparation. We shouldn’t send them into radiation therapy, chemotherapy, or immunotherapy without it either.
None of these facts, though, are secrets to oncologists. We’ve long known that “exercise is medicine” when used in tandem with standard oncology care. In fact, a 2024 American Society of Oncology (ASCO)-Society for Integrative Oncology (SIO) guideline explicitly recommends exercise, mindfulness, cognitive behavioral therapy, yoga, relaxation, and other practices to ease anxiety, depression, and fatigue in cancer patients.
Why aren’t lifestyle interventions standard?
Despite compelling evidence, most cancer patients still receive minimal support for lifestyle change. A handout. A few words of encouragement. Maybe a referral, if one even exists.
There are well-known barriers:
- Low adherence to generic or one-off advice. One study showed only 5% of patients fully adhered without structured support.
- Limited coverage by payers for non-pharmacologic services.
- Fragmented care, especially after hospital discharge or treatment completion.
But it’s not the patients who are the problem. When given consistent, personalized support, they engage.
Cancer patients receiving daily coaching on diet, movement, and stress-reduction goals are much more likely to adhere to lifestyle modification sessions, which in turn leads to a drop in total medical costs, driven by fewer hospitalizations and complications. These are real savings for providers and better outcomes for patients.
Embedding lifestyle care into oncology
The evidence is now too strong to ignore. Exercise, nutrition, and mental health support are not “nice to have” extras. They are evidence-based therapies that should stand alongside chemotherapy, immunotherapy, radiation, and surgery.
What needs to change?
- Cancer centers must embed lifestyle services into standard care pathways, not bolted on as afterthoughts.
- Payers must recognize the value by covering credentialed, outcomes-driven lifestyle programs.
- We must track lifestyle intervention metrics the same way we track chemotherapy adherence or surgical outcomes. Are we helping patients move, eat, and cope? If not, we’re missing a critical part of care.
Beyond survival: Helping patients thrive
Patients like my leukemia survivor aren’t just looking for survival. They’re seeking strength, purpose, and a way forward. They want to thrive, not just endure.
With lifestyle programs that improve adherence rates and reduce complications and costs, we have a model that works. What’s missing is the will to scale it.
Lifestyle interventions don’t just improve quality of life. They extend life, prevent suffering, and reduce the financial burden on patients and systems alike. It’s time to make them the standard, not the exception, in oncology care.
Photo Credit: Saimon Sailent, Getty Images
Christopher R. Cogle, M.D. is a nationally recognized oncologist, physician-scientist, and Chief Medical Officer at Complement 1– a clinically validated platform delivering one-on-one lifestyle coaching to cancer patients and survivors to improve health outcomes. He is the inventor on multiple U.S. patents, author of more than 140 peer-reviewed medical publications, and professor of medicine at the University of Florida.
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