Women receiving chemotherapy for breast cancer can experience considerable emotional strain alongside physical side effects. Researchers in Mexico are investigating whether a six-week online mindfulness programme could provide accessible support, with early findings suggesting it may help reduce stress and feelings of sadness.
Dr Fernanda Mesa Chávez, from Centro Médico Zambrano Hellion, wants emotional wellbeing to be recognised as an important part of cancer care.
With funding from our INSPIRE Research Challenge, Dr Mesa Chávez and her team have been investigating whether mindfulness can help women manage the emotional impact of cancer treatment.
“Breast cancer affects patients’ lives in aspects beyond the tumour itself. The diagnosis and its treatments can have a deeply emotional impact related to factors such as side effects, fear, and changes in body image, interpersonal relationships and daily routines,” she says.
How the online mindfulness programme worked
The study was designed to involve 128 women beginning chemotherapy for breast cancer in Mexico. Participants were randomly assigned either to take part in a six-week online mindfulness programme or to a comparison group that would be able to access online videos after the study.
The programme used six pre-recorded online sessions to introduce practices including meditation, body awareness and techniques for managing difficult emotions. Because the sessions were available on demand, women could follow them at home and fit them around treatment, medical appointments and periods of fatigue.
The researchers assessed participants’ stress and related symptoms at the beginning of the study and then again after seven and 11 weeks.
Can mindfulness reduce stress during chemotherapy?
With recruitment complete, Dr Mesa Chávez’s team is now analysing the data and preparing the results for presentation and publication in a peer-reviewed journal.
Early findings have been encouraging, both in terms of participants’ emotional wellbeing and their experience of using the online sessions.
“Overall, the online mindfulness programme helped to reduce patients’ stress levels and feelings of sadness. In addition, patients were highly satisfied with the programme and considered that its online, on-demand format was accessible and easy to use.”
Dr Mesa Chávez adds: “Notably, patients were highly satisfied with the programme, with nearly all of them (97%) confirming that they would recommend it to other patients receiving chemotherapy for breast cancer.”
The full findings have not yet been published or peer reviewed, so further detail will be needed before firm conclusions can be drawn. Nevertheless, the early results offer an encouraging indication that relatively simple, accessible support may make a meaningful difference during an intensely demanding period.
Why online mindfulness could improve access
For Dr Mesa Chávez, one of the programme’s greatest strengths is that it does not require people to travel to another appointment or practice at a particular time: “Being able to watch the videos at home in a familiar environment can offer a layer of comfort and a sense of safety.”
Several participants told the researchers that the online approach made support feel more inclusive because women could access it regardless of where they lived or which medical centre was providing their treatment. Many wanted to continue practicing mindfulness after completing the study.
Caring for the whole person
Mindfulness is not a treatment for cancer and should not replace medical or psychological care. Instead, Dr Mesa Chávez sees it as a form of supportive care that could sit alongside treatment and help people manage difficult emotions with greater calm and self-compassion. She is encouraged by growing recognition that cancer care must support the whole person, not only treat the disease.
“Being able to offer this kind of supportive care to patients throughout the country, receiving their feedback and words of gratitude, and observing the positive impact that the mindfulness programme had on their wellbeing have been the most fulfilling parts of this project.”
What happens next for the research
Dr Mesa Chávez’s team now plans to present the findings at an international scientific meeting and prepare a manuscript for publication. Following the positive feedback from participants, the team has also begun promoting mindfulness at its centre and encouraging oncologists to consider it as an additional supportive-care option for patients experiencing emotional distress.
Reflecting on the people who helped make the research possible, Dr Mesa Chávez says: “Generating scientific evidence is possible thanks to the patients who participate in research, their families, and the generous donors who advocate for science. I would like to express my profound gratitude for your participation and support.”
A cancer diagnosis can affect energy, routines and how easy it feels to stay active. Understanding these everyday changes – and when they may be greatest – could help healthcare professionals offer support that feels realistic and manageable for each person.
The study, published in the Journal of Epidemiology & Community Health, analysed data from 91,352 UK Biobank participants. This included 10,152 people with a history of cancer, as well as healthy adults and people living with other health conditions.
Participants wore a wrist activity monitor for up to 7 days. This allowed researchers to estimate how much of each day they spent doing moderate-to-vigorous activity, light activity, and inactive time (including sedentary behaviour and sleep).
The study, which was part of an international collaboration based at Monash University in Australia, made strong use of wearable technology to record and transmit movement data. Participants wore a wrist activity monitor to provide an objective picture of movement, sitting and sleep across everyday life.
What did the study find?
On average, people with a history of cancer spent about 25 fewer minutes per day being active than the healthy group. That included 11 fewer minutes of moderate-to-vigorous activity and 14 fewer minutes of light activity. They also spent around 11 more minutes sedentary and 14 more minutes in the measured sleep period.
The difference was greatest among people diagnosed less than a year earlier. They recorded about 40 fewer active minutes a day, alongside around 20 more sedentary minutes and 20 more minutes in the sleep period, compared to healthy individuals. The largest differences were seen among people with lung and gastrointestinal cancers, although some cancer groups were small and the results require cautious interpretation.
The monitor’s “sleep period” also included time spent awake in bed and longer periods could include disrupted or inefficient sleep, so measurements should not be read as a precise record of time asleep. As this was an observational study, it cannot prove that cancer caused the differences or demonstrate exactly how an individual’s activity changed before and after diagnosis. The researchers also did not have detailed information about cancer stage or treatment.
Why does this matter?
The findings suggest that gentle, practical support to help people move more may be especially important soon after a cancer diagnosis. This does not have to mean structured exercise. Looking at the whole day could help healthcare professionals find realistic ways to replace some sitting time with safe, manageable movement.
Dr Yue Liao of the Department of Kinesiology at the University of Texas at Arlington, who led the research, explained:
“A cancer diagnosis can reshape everyday life, including how much people move, sit and rest. By using wearable monitors, we found that people with a history of cancer were less active across the day – and that the difference was greatest in the first year after diagnosis. These findings underline the need for practical, personalised support that helps each person move in ways that feel safe, realistic and achievable.”
The work was partly funded by the American Institute for Cancer Research (AICR), as part of its work to build evidence that can improve health and quality of life for people affected by cancer. AICR is part of a network of charities led by World Cancer Research Fund International, alongside World Cancer Research Fund in the UK and Wereld Kanker Onderzoek Fonds in the Netherlands.
World Cancer Research Fund International’s Assistant Director of Research and Policy, Dr Helen Croker, said:
“Wearable monitors are common devices nowadays, but they’re scientifically exciting. They have revolutionised research, giving us far more data than old approaches like self-reported surveys and letting us understand much more accurately how people actually move, sit and sleep.
“We’re delighted that our funding has helped this terrific team use this kind of data to show how behaviour shapes cancer risk and survival, and where support is needed most.”
AICR recommends moving more and sitting less when possible. People receiving or recovering from cancer treatment should ask their healthcare team what is safe and suitable for them.
When Ben Wagenmann walked through a hospital radiation scanner and triggered every alarm in the corridor, it was not a malfunction. For several days after treatment, Ben is radioactive.
The 27-year-old medical AI student is living with metastatic cervical paraganglioma, a form of cancer so rare that only a handful of documented cases exist worldwide.
Ben’s original tumour developed around the fork of his carotid artery located in his neck. It measured around 5-6cm and required complex surgery lasting over ten hours to remove.

What makes Ben’s case so extraordinary is not only the tumour itself, but where the cancer has metastasised (spread). While cervical paraganglioma is typically benign (non-cancerous), Ben’s has spread throughout his spine, ribs and other bones.
Because no standard treatment exists, specialists across multiple hospitals in Europe worked on an experimental care plan. This included radionuclide treatment, a form of nuclear medicine requiring Ben to enter an underground radiation ward every six weeks.

“It genuinely felt like being in a bunker,” Ben said. “There were no door handles, and I couldn’t shower because it would turn the water radioactive.”
At one point, he triggered a hospital radiation detector simply by walking through the corridor. Ben added:
“That was a surreal moment, realising you’re literally radioactive.”

Following hospital discharge, Ben’s radiation levels were still so high that he could not be around pregnant women or small children safely.
Despite intensive treatment, regular hospital travel across Europe and the fragility of his spine, Ben has refused to give up the hobby he loves most – skiing.

“I’ve had to adapt. I’m more careful now and I notice the pain more, but skiing is one of the most important things in my life. I don’t want cancer to take that away,” he explained.
To raise awareness about cancer in young people, Ben began sharing his journey online through short ‘life recap reels’ on Instagram. Unexpectedly, the project raised hundreds of pounds for World Cancer Research Fund.
“I didn’t complete a marathon or jump out of a plane,” Ben said. “I just shared my life online and people connected with that.”
Rachael Hutson, World Cancer Research Fund CEO, commented:
“Ben’s commitment to sharing his journey is deeply moving, and we are grateful for the way he has turned his experience into hope for others. His fundraising efforts are helping fund life-saving research, and we are truly honoured to have his support.”
Following the success of his Instagram fundraiser, Ben completed a 16-kilometre race in his native Switzerland in May 2026 while on treatment break. He is now exploring a cycle across Norway to combine his love of endurance sport with fundraising.

Now, Ben hopes his story will challenge assumptions about what living with cancer looks like.
“You’re not just your diagnosis. Cancer changes things but it doesn’t automatically end your life.”

Ben shares his journey as part of our Every step tells a story campaign.
Feeling inspired? Why not sign up to one of our exciting events and challenges today.
Our Cancer and Nutrition Helpline is staffed by oncology dietitians who help people living with cancer and their loved ones find their way through the maze of misinformation about nutrition after a diagnosis.
Our dietitians are asked about cancer and nutrition myths more than any other subject. Here are a few of the questions they answer most often.
“I’ve just been diagnosed with cancer. What can I do to help myself before my treatment starts?” – Dave
Receiving a cancer diagnosis can feel overwhelming. It can also feel like you’re losing some of your independence as your calendar fills with hospital appointments. But there are steps you can take yourself to look after your health before treatment begins.
Healthy changes will stand you in good stead as you go through treatment so it’s helpful to make a start as soon as you can. That means following a healthy, balanced diet, being physically active and looking after your mental health. Ask your cancer care team for advice and let them know about any changes you’re making.
Some cancer centres run prehabilitation programmes designed to help you prepare for treatment in the days or weeks before it starts. Prehab programmes typically focus on your general health, including your diet and how active you are, and your emotional wellbeing. Their goal is to get you in the best state possible for treatment.
There’s increasing evidence of the benefits of prehab for people living with cancer. It can reduce your side effects or help you cope better with side effects linked to your treatment. It can shorten the time you need to spend recovering in hospital. And, sometimes, being fitter can mean you’re offered treatments you wouldn’t otherwise be suitable for.
You don’t need to take part in an official hospital prehab programme to benefit from making healthy changes and looking after your general health, but make sure you’re using information from a robust, evidence backed source like World Cancer Research Fund, the NHS website or other trusted information creators showing the PIF TICK symbol.
See it as taking steps to invest in your health which will not only bolster you to cope better with treatment, but also help with your recovery and lay foundations for healthy habits in the future.
“I’ve seen cancer-fighting diets advertised online. What’s your advice?” – Bernice
You may come across ‘fad diets’ which claim they can fight cancer and, with claims like that, it’s not surprising if they grab your attention. That’s exactly what they are designed to do, but there’s no scientific evidence that following any particular diet can cure cancer or replace cancer treatments.
Cancer and cancer treatment can be tough on your body so it’s really important that you give your body the energy (calories) and nutrients it needs. Some ‘fad diets’ suggest you restrict yourself to particular foods or cut out whole food groups like carbohydrates or dairy. These diets might stop you getting what your body needs and they aren’t backed by reliable scientific evidence.
It’s much safer to stick to a healthy, balanced diet before, during and after cancer treatment. If you have questions about healthy eating, ask your cancer care team or contact our Cancer and Nutrition Helpline – you can pick up the phone or drop them a line.
“Is a vegan diet a good idea during cancer treatment?” – Becky
There’s no evidence to suggest that a vegan or plant-based diet gives you any advantages during cancer treatment compared to a diet that includes animal products.
We do know that eating plenty of plant-based foods like fruit, veg, pulses (like beans, chickpeas or lentils) and wholegrains (like brown rice, bread and pasta) can help give your body essential nutrients like vitamins, minerals and fibre.
So a vegan diet isn’t something you need to avoid as long as there’s enough variety in what you eat so your body can fight infection, cope with treatment side effects and minimise weight loss. That means you need to make sure you get enough energy (calories), protein, vitamins and minerals.
Going vegan sometimes means you can struggle to get everything your body needs and to keep to a healthy weight, especially as cancer and cancer treatments can make you feel sick or affect your appetite. But a vegan diet which includes a variety of different foods can be a good substitute for an animal-based diet if it gives you enough energy and you don’t miss out on any essential nutrients.
If you’re following a vegan diet or want to swap to one, it’s a good idea to speak to a dietitian to check you’re still getting all the nutrients your body needs.
“Will taking supplements help me during my cancer treatment?” – Ian
Most people don’t need to take dietary supplements as long as they’re following a healthy balanced diet, and that includes people who are living with cancer. Some supplements can be harmful, increasing tumour growth, and some can interfere with how chemotherapy and radiotherapy work.
Let your cancer care team know about any supplements you’re taking, including the doses. That includes homeopathic, natural or herbal remedies. Even if a supplement is made from plants and seems natural, that doesn’t mean it’s safe. You should only take supplements that your doctor or dietitian has said are ok for you.
Even multivitamin supplements which include a wide range of nutrients will not give you all the benefits of substances naturally found in foods like fibre.
If you can’t manage to eat very much or you can’t eat a healthy balanced diet because of your cancer or the side effects of treatment, you might need advice from your doctor or a dietitian.
They can check if you’re missing out on essential nutrients like vitamins and minerals like iron and give you advice on how to top up on the nutrients you need. That may be through a small change to your diet or they may prescribe a supplement that’s safe to take during treatment.
Examples are calcium and vitamin D to support your bone health or protein-rich drinks or powder to give your body enough protein to repair itself when you are unwell.
“I heard that sugar makes cancer grow more quickly so should I try and cut it out completely?” – Kam
There’s no strong evidence to show that avoiding sugar can stop cancer cells growing or that sugar directly causes cancer. So the answer’s no, you don’t need to avoid sugar entirely.
Sugar comes into our diet from different sources. You don’t only find sugar in foods like cakes and biscuits, in soft drinks or added to savoury foods like soups and ready meals. It’s also found naturally in foods like fruit and milk.
If you decided to restrict all the sugar you have, of all types, that could mean limiting how much fruit and veg you eat. We know that having a mix of fruit and veg is important to give you the vitamins and minerals you need to help with your recovery.
Instead, for a healthy balanced diet, we recommend that you limit how much added sugar you have. That’s the sugar in sugar-sweetened syrups, cakes, biscuits, chocolate and full-sugar soft drinks. It’s also the sugar you often find in ready-made soups, sauces, ketchup and ready meals. You’ll see if these foods have had sugar added on the ingredients list on the packaging.
You don’t need to cut down on the sugars in fruit and milk because they are digested slower than added sugar and also come with other nutrients like fibre, vitamins and minerals.
It’s a good idea to try to limit the added sugar in your diet because over time the excess calories can affect your weight. We know that living with overweight or obesity increases your risk of cancer.
There can be exceptions to this. If your appetite is poor or you’re having cancer treatment and are losing weight without intending to, foods with added sugar can be useful to help you get enough calories to regain a healthy weight. A dietitian can advise if this would help you and can give you tips on which foods to choose.
Cancer and Nutrition Helpline
Looking for trusted nutrition advice after a cancer diagnosis? Our FREE Cancer and Nutrition Helpline offers expert answers and practical support for people living with cancer and those who care for them.
When Sharron Moffatt was diagnosed with triple positive breast cancer in January 2024, her world was turned upside down. But alongside the physical and emotional toll of cancer, she faced another challenge: a flood of cancer misinformation.
The mental health first aid (MFHA) trainer and speaker, from Buckinghamshire, was working in the corporate wellbeing industry when she noticed her right breast growing in December 2023.

Just eighteen months earlier, Sharron’s mother died from metastatic breast cancer after facing the disease three times. It was this heartbreaking loss that prompted Sharron to always check her breasts.
“I miss my mum terribly, but I’m grateful to her because I learned so much about how to navigate cancer from watching her take it in her stride,” Sharron said.
Following tests at her local breast cancer clinic, Sharron was officially diagnosed with triple positive breast cancer on 7 January 2024.

Further investigations, including an ultrasound and biopsy, revealed three large tumours in her right breast which measured 12 centimetres combined.
“I broke down in tears wondering how I would tell my family, if anyone would ever work with me again and how I would walk the senior dog I adopted just one week prior.”

Her treatment included seven rounds of chemotherapy, a single mastectomy and radiotherapy followed by further chemotherapy – spanning twenty months in total. Sharron explained:
“Cancer takes so much from you, I was even on the cusp of having to stop treatment because I lost so much weight. During my first round of chemotherapy, I was really sick for around three days. When I finally recovered, it was time for my next infusion.”
Despite the gruelling effects of her treatment, which included fatigue, hair loss, nausea and even liver cirrhosis – the hardest part of Sharron’s experience wasn’t the cancer itself. It was the misinformation that preyed on her through one of the most vulnerable moments of her life.
“During chemotherapy, I became so ill I didn’t recognise myself. That was hard. But the hardest thing for me, which still makes me uncomfortable to this day, was the misinformation I received.”
After sharing her cancer diagnosis on social media, Sharron was inundated with messages and claims about apricot kernels – the seeds found inside apricot stones – which were positioned to her as a “natural” cancer cure.

The claims centre on a plant compound called amygdalin, which is found in apricot kernels, but there is no evidence that it treats cancer in humans. In fact, consuming apricot kernels can be dangerous because amygdalin releases cyanide in the body.
But the misleading claims didn’t end there. More recently, Sharron was contacted by someone on Instagram who claimed to have cured themselves of stage four melanoma by “healing their trauma”.
When Sharron asked for evidence to support the claim, she was met with defensiveness and hostility.
“Many of those on social media will deliberately target vulnerable people. I can understand why someone living with stage four cancer may be persuaded to try things like apricot kernels. However, they deserve access to reliable, evidence-based information that enables them to make informed choices about their treatment.”
After completing her extended treatment plan in October 2025, Sharron continues long-term treatment (aromatase inhibitors). Following a meeting with her oncologist in May 2026, it was confirmed she currently has “no measurable evidence of disease” – marking an important milestone in her journey.

Today, she dedicates herself to raising awareness about the dangers of misinformation and providing expert-led training on understanding cancer in the workplace.
“When you’re diagnosed with cancer, you’re dealing with fear and uncertainty. The last thing you need is misinformation adding to that. That’s why I’m passionate about encouraging people to know where to find trustworthy information and training employers on how to support people affected by cancer, including carers. No-one should have to face cancer and misinformation at the same time.”

Isobel Booth, World Cancer Research Fund’s Head of Health Information, said:
“Unfortunately, Sharron’s story is not unique. Misinformation is seeping into more and more lives every day. This is why we are drawing attention to this important issue during Cancer Prevention Action Week. While we recognise there is valuable information out there, the science is often taken out of context, twisted or manipulated. For anyone affected by cancer who has questions on nutrition or supplements, please contact our Cancer and Nutrition Helpline, which is staffed by specialist oncology dieticians who can help filter through the noise.”
Sharron shared her story as part of World Cancer Research Fund’s Cancer Prevention Action Week campaign, which ran from 15-21 June 2026.
New evidence, published today, shows that sticking to five lifestyle recommendations improves survival after a later cancer diagnosis.
The findings provide encouraging evidence that simple, achievable habits established before a cancer diagnosis can play a role in improving long-term health and the health of those following a cancer diagnosis.
The Cancer Prevention Recommendations analysed in the study include:
- Be a healthy weight
- Be physically active
- Eat wholegrains, vegetables, fruit and beans
- Limit red and processed meat
- Limit alcohol consumption
The latest research led by Newcastle University, UK, published in Cancer was funded by Wereld Kanker Onderzoek Fonds, (WKOF) – the Netherlands-based charity within theWorld Cancer Research Fund International network of charities that also includes World Cancer Research Fund and the American Institute for Cancer Research.
The Recommendations were developed in 2018 by World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) as evidence-based lifestyle guidance which aim to reduce cancer risk.
Although previous research in cancer survivors has indicated some positive effects, this new study provides the most comprehensive evidence to date of their association with improved survival for people living with and beyond cancer.
Professor John Mathers, Emeritus Professor of Human Nutrition at Newcastle University, who led the study, said:
“This research is incredibly exciting because, for the first time, we have shown that higher adherence to the WCRF/AICR 2018 Recommendations may reduce the risk of mortality for people diagnosed with cancer in a UK cohort.
The results of this paper add to an existing body of evidence on the WCRF/AICR Recommendations and cancer survivors and could be informative for those developing policies and clinical guidelines to improve health and longevity following a cancer diagnosis.”
Breaking down the results
The research team assessed the dietary and lifestyle data of 28,550 individuals who were assigned score points from 0-5 in relation to how closely the Recommendations were followed at the time of recruitment to the Biobank, prior to a cancer diagnosis. The UK Biobank is a large, population-based database, established to allow detailed investigations of the genetic and nongenetic determinants of the diseases of middle and old age.
Based on decades of research, the key WCRF/AICR Recommendations were developed in 2018.

The research team found that each 1-point increment in score, equivalent to fully meeting one Recommendation, was associated with an 8% lower chance of dying from any cause over time. Overall, having a score in the highest third of the study population was associated with a 16% lower chance of all-cause mortality, compared with those in the lowest third.
This association was consistent regardless of whether the individual smoked and also held true for multiple cancer types such as breast and liver cancers, suggesting broad survival benefits.
Calls for interventions for healthy living
The findings show that following a healthy lifestyle is not only important for cancer prevention but may also have implications for long-term health after a cancer diagnosis.
Dr Fiona Malcomson, researcher at Newcastle University and co-author of the paper said:
“The take home message is that the 2018 WCRF/AICR Cancer Prevention Recommendations apply to cancer survivors too. Having a healthier eating pattern, being more physically active and avoiding being too heavy, as described in the Recommendations, is associated with better long-term outcomes for those living with and beyond cancer.
The scientists behind the research suggest that these findings support prioritising the development of interventions to enhance adherence to the WCRF/AICR Recommendations– including after diagnosis – that may potentially lower mortality risk among people diagnosed with cancer. This means that cancer survivors can take action to improve their health and should be encouraged to do so by healthcare providers.”
Nadia Ameyah, Director of WKOF, the Netherland-based charity within WCRF International said:
“This tremendously exciting study further cements the status of our evidence-based Recommendations as one of the best ways of maintaining your health when living with and beyond cancer. We have always prided ourselves on the scientific grounding of our Recommendations for primary prevention, and this is the first time we have had such robust evidence for survivorship. Cancer survivorship and quality of life after cancer diagnosis are key priorities of WKOF.
We look forward to seeing how these findings will inform health policy and the design of healthcare interventions to help those living with and beyond cancer to live happier, healthier lives.”
We spoke to Dr Renate Winkels (pictured) and Dr Laura Winkens, at Wageningen University & Research, to discover more about their studies in bowel (also known as colorectal) cancer.
Your team looked at what influences people’s health behaviours after they’ve been treated for bowel cancer. What do you mean by health behaviours and what did you find out?
Health behaviours are the everyday choices people make that affect their health. In this study, we focused on 2 things:
- healthy eating (more fruit, vegetables, whole grains and beans; and less fast food, red meat, processed meat, sugary drinks and alcohol)
- physical activity
For people who’ve had bowel cancer, healthy behaviour may be associated with living longer, feeling better and having fewer problems like fatigue.
However, in previous studies, we found that many bowel cancer survivors don’t make big changes after treatment. Survivors are dealing with side-effects from the cancer or its treatment (such as gastrointestinal problems, fatigue or body image distress), which can make it hard to eat well and stay active.
Our study looked at what helps or gets in the way of healthy behaviour for people who have finished treatment for bowel cancer. We found:
Personal factors matter
How much time people have, their motivation, what they believe about healthy habits, what they know, and the skills they have can all influence whether they eat well and stay active.
Support helps
Encouragement and support from family and friends, or feeling like healthy habits are normal in their social circle, can make a big difference.
Environment plays a role
Access to gyms, parks, or even just good weather can affect how easy it is to be active.
Cancer symptoms can get in the way
Ongoing physical issues after cancer treatment, like fatigue or bowel problems, often make it harder for people to stick to healthy habits. But if someone is feeling physically well, they’re more likely to eat better and stay active.
Mental health may be important
Depression or being unhappy with one’s body seem to be linked with less healthy behaviour.
In short, to help people with bowel cancer lead healthier lives after treatment, we need to focus on motivation, knowledge, support, and overcoming the challenges they face physically and emotionally.
Towards a more complete picture
Your team conducted a “systematic review”. What is that and why is it important?
We wanted to find out what other scientists had studied, so we could build our study on the latest evidence. Moreover, we wanted to provide an overview of the topic. We looked at 21 papers, but we started with around 800 publications, and had to sift through them to identify the relevant ones.
You divided the studies into quantitative or qualitative. Why did you choose to look at both?
Quantitative studies collected a lot of numbers and measurements. The studies used standardised questionnaires to collect data on dietary intake and other aspects of lifestyle. Those studies answer questions like “how many” or “how much”.
Qualitative studies focus more on experiences. Such studies are mostly interviews to better understand why people do what they do, or how people behave.
Together, they provide a richer, more complete picture of the challenges and motivations colorectal cancer survivors face.
Were you surprised that people find it hard to change their behaviour?
Not really. Most people will recognise how challenging it can be to always make healthy choices. After cancer, when you’re rebuilding your life, that can be even harder.
How important is mental health for people living with and beyond bowel cancer?
Mental health is a very broad topic. People who have had bowel cancer may have a stoma, or be suffering from fatigue, or from bowel functioning problems. These can have a real impact on your life, and it’s important to address them. Some care teams really have an eye on this, but it’s not always the case. One patient told me that she did not dare to discuss her feelings of severe fatigue with her oncologist, as the oncologist told her that “fatigue was not a thing” for people with bowel cancer. We need more awareness and integrated care that addresses both mental and physical health to truly support survivors’ wellbeing.
You’ve also looked at whether following our Cancer Prevention Recommendations can reduce fatigue for people with bowel cancer.
We set up a study to assess whether following the Recommendations would help people to feel less fatigue. Cancer-related fatigue is a symptom that many bowel cancer patients experience during treatment and after completion. What is disturbing is that this type of persistent, overwhelming sense of physical, emotional or mental fatigue is not proportional to activity nor relieved by resting or sleeping.
We recruited participants for the trial who were experiencing cancer-related fatigue. In a randomised study, half of the group received lifestyle coaching to improve their adherence to the Recommendations, while the control group did not.
The coaching really helped the participants to adopt a healthier lifestyle: over time, this group reported eating more fruit and vegetables, and less processed meat and sugar-sweetened beverages. Also, physical activity levels went up more in the group that received coaching than in the control group.
Nevertheless, those changes didn’t result in less fatigue. This suggests that while these changes have many benefits, managing fatigue may require additional, targeted interventions.
This grant was funded by Wereld Kanker Onderzoek Fonds based in the Netherlands, as part of the World Cancer Research Fund International network.
Key takeaways:
- The CO21 CHALLENGE Trial found that a structured exercise programme after chemotherapy led to a 28% lower risk of cancer recurrence in colon cancer survivors compared with usual care.
- This is the first randomised controlled trial (RCT) to show that exercise directly improves survival in colon cancer patients. It confirms what observational studies have long suggested.
- The results were presented at a recent conference and made headline news. Experts say the CHALLENGE Trial marks a shift from viewing exercise as a “nice to have” to a “need to have” in cancer care.
Colon (part of the large bowel) cancer survivors who took part in a 3-year structured exercise programme had a 28% lower risk of cancer recurrence or a 2nd cancer. They also had a 37% lower risk of death compared with usual care.
These findings were shared at the 2025 Association of Clinical Oncology (ASCO) Annual Meeting. They were also published in the New England Journal of Medicine.
The ASCO Annual Meeting is the world’s largest oncology conference. It attracts more than 40,000 attendees from around the world. Every year, ASCO highlights the latest advancement in treatments. It also shares the directions that have the greatest potential for progress and patient impact.
Spotlight on exercise
The CO21 CHALLENGE Trial pulled back the curtain on a weapon that has been hiding in plain sight: physical activity. The results of the trial showed improvement in disease-free survival and overall survival in colon cancer survivors in the aerobic exercise intervention group. This trial is the first gold standard RCT to show what has long been indicated from observational studies. This is a big deal!
The impact of exercise on cancer outcomes has been a topic of great debate. Observational research has shown improvements in survival and quality of life linked to higher levels of physical activity. However, observational study designs are limited. They do not show cause and effect.
Plus, they are hard to implement in clinical settings due to concerns that the reported effects may not truly reflect the impact of exercise (and may be due to something else).
Our research
Over the past few years, World Cancer Research Fund International has done extensive reviews through its flagship Global Cancer Update Programme (CUP Global).
CUP Global includes partnerships with American Institute for Cancer Research, World Cancer Research Fund in the UK and Wereld Kanker Onderzoek Fonds in the Netherlands.
Our CUP Global reviews look at the extent to which diet, nutrition and physical activity impact people after a diagnosis of breast and colorectal cancers with regard to:
- cancer-specific mortality
- all-cause mortality
- risk of cancer recurrence
- health-related quality of life
An expert panel judged the strength of this CUP Global evidence. There were some limitations. Still, detailed recommendations were made to strengthen future research. One of the key recommendations was for well-conducted trials to look at the impact of nutrition or physical activity. The CHALLENGE trial is therefore very timely.
The CUP Global analysis was published in the International Journal of Cancer. It was cited several times in the CHALLENGE trial manuscript.
The CUP Global analysis compared highest with lowest levels of activity. We found that all-cause mortality was reduced by 23–40% depending on physical activity exposure.
Prof Anne May, University Medical Centre, Utrecht
During our review of the literature concerning the impact of post-diagnosis physical activity on colorectal cancer prognosis for the Global Cancer Update Programme (CUP Global), we were unable to draw strong conclusions due to lacking evidence from randomized controlled trials. The Challenge trial provides exactly the evidence we were waiting for.
The summary estimate for studies that assessed activity dose was measured in MET hours per week.
- A 10 MET hour per week increase in activity was linked to a 24% reduction in all-cause mortality.
- A change of 10 MET hours per week was also the intervention goal in the CHALLENGE trial.
The effect sizes in this first, gold-standard RCT are remarkably well-aligned with the CUP Global analyses of observational studies.
During the presentation of the trial results at ASCO, the authors shared this chart. It includes the treatment benefits from approved therapies for colon, lung and breast cancer.

With 7–8% gains, you can see that exercise compares very favourably with other approved therapies in terms of absolute overall survival gain.
Collecting clinical trial evidence
The CHALLENGE trial confirms the clinical benefits that had been reported from observational studies. However, previous RCTs have also hinted at the accuracy of the results from observational studies. For example:
- The LEANer trial was published in 2023. It showed that triple negative breast cancer patients randomised to a diet and physical activity intervention before chemotherapy had a 53% higher rate of treatment success (eliminated cancer cells).
- A trial published in June 2025 showed that an exercise programme during and after chemotherapy increased the immune system responses in oesophageal cancer patients.
World Cancer Research Fund will fund the Optimus trial in the UK. Dr David Bartlett and Prof Adam Frampton at the University of Surrey will lead this study. It was proposed due to these findings.
Next steps
Dr Kerry Courneya co-led the CHALLENGE trial. At ASCO, he said these results could change practice for high-risk stage 2 and stage 3 colon cancer.
He expressed reservation that these results could be generalised to other sites and cancer stages. But he was optimistic that similar trials could be done more quickly than the CHALLENGE trial by taking advantage of newer methods. This could include using remote exercise assessments or activity trackers.
Dr Courneya noted that “support from funding agencies like WCRF/AICR is critical to moving this field forward because of limited access to funding for lifestyle research”.
AICR recently funded a project linked to the CHALLENGE Trial. It is led by Dr Kristin Campbell at the University of British Columbia in Canada. It will look at how muscle and fat tissue respond to exercise and how that may contribute to the observed survival benefits.
The response to the CHALLENGE Trial has made media headlines. Cancer researchers, doctors and patients are also excited by the news. This suggests that adding exercise as an additional part of treatment will gain further momentum.
While more trial data will be needed to support broader implementation, we are likely leaving the “nice to have” approach to exercise oncology and entering the “need to have” phase!
Research grants on physical activity
A selection of some of the grants we have funded that focus on the impact of physical activity on people living with and beyond a cancer diagnosis.
Research funded by World Cancer Research Fund has shown that people living with cancer who closely follow a sustainable and nutritious diet – the EAT-Lancet reference diet – have a lower risk of dying from cancer and from all causes.
This is the first study to look at the impact of the EAT-Lancet diet on people living with or beyond cancer – as opposed to the general population. Prof Sabine Rohrmann and her team at the University of Zurich, in collaboration with colleagues from another Swiss university, the UK and Austria, used UK Biobank data to see if closely following this diet – with its emphasis on eating a rich variety of plant foods – affected the risk of death for people with a cancer diagnosis at the time they were recruited for the study.
Studying more than 25,000 people with an average age of 60 years at recruitment, the researchers used dietary information collected in the UK Biobank to develop a score that reflected how closely participants followed the EAT-Lancet diet.
More support needed for people facing cancer
Of the 25,348 cancer survivors in the group studied, 4,781 people died during the study follow-up. Prof Rohrmann’s results showed modest links between closely following the diet and a lower risk of dying from cancer, and of dying from all causes. The researchers didn’t observe a link between the diet and dying from heart disease.
Almost 64% of the participants were female, and participants who followed the EAT-Lancet diet more closely were more likely to be female. However, this study confirmed previous evidence showing that people living with and beyond cancer do not tend to follow healthy diets after their diagnosis. This emphasises the need to help people form healthier habits and overcome the barriers to eating well, such as treatment side-effects affecting appetite and taste.
These findings highlight the importance of greater nutrition support and guidance for people facing cancer. Guidelines aimed at the general population are unlikely to consider the needs of people living with and beyond cancer. With a lack of evidence-based recommendations for this population, the gap can sometimes be filled by practices not supported by the science – such as excessive use of dietary supplements.
This evidence showing the benefits of the EAT-Lancet diet follows recent research by our Global Cancer Update Programme, which provided guidance for people with a breast or a bowel cancer diagnosis.
Prof Sabine Rohrmann
We specifically put the focus of our study on cancer survivors because we believe that it is important to encourage them to follow a healthy lifestyle. For this, we need more evidence and so far, research on lifestyle changes in cancer survivors is still scarce.
Dr Julia Panina, Head of Research Funding
This study provides important new evidence that following the EAT-Lancet reference diet may reduce the risk of mortality in people living with and beyond cancer. The focus on the consumption of plant-based foods reflects our Cancer Prevention Recommendations to eat more wholegrains, vegetables, fruit and beans, and to limit red and processed meat. Importantly, these findings also show that diets supporting cancer survivorship can promote more sustainable eating and help protect the environment.
The EAT-Lancet reference diet was created by a team of scientists (The EAT-Lancet Commission on Food, Planet, Health) in 2019. It is a mainly plant-based diet that, according to the Commission, addresses the environmental impact of food production and consumption better than most national dietary guidelines.
> Read the paper: Higher adherence to the EAT-Lancet reference diet is inversely associated with mortality in a UK population of cancer survivors
> On the blog: Plant-based diets: eating for our health and the planet
When John Steventon began competing in HYROX fitness events, he never imagined he’d become a fundraising superhero. But following a skin cancer diagnosis, he found a new motivation for taking on the gruelling challenges.
Dressed as Wolverine, John has been raising money for World Cancer Research Fund (WCRF) while encouraging conversations about cancer prevention. His experiences have also changed how he thinks about his own health, inspiring him to share the importance of healthy lifestyle choices with others.
John is WCRF’s very own supporter superhero. He completed a HYROX in December dressed as comic book character Wolverine, alongside a friend who dressed as Deadpool – and he isn’t stopping there.
HYROX is an indoor fitness race enhanced by workout stations along the route, so competitors run 1km, then do a workout – eight times! The workouts include rowing, pulling and pushing a sled, and lunges while carrying a sandbag, making it an exhausting but fun challenge.
“Everything I’ve done in life, I’ve wanted to share with others. As a DJ, I taught aspiring musicians and even wrote DJing for Dummies. In my TV career, I mentor new editors. When I was racing in indoor rowing, I launched the RowAlong YouTube channel to help home rowers stay motivated. So, when I started competing in HYROX, I wondered how I could use this platform to make a difference.”
He continues:
“I knew I’d never be a podium finisher, but after my skin cancer diagnosis, I found a purpose: racing as Wolverine to raise money for WCRF. The response from the HYROX community has been incredible – not just in donations, but in the conversations I’ve had. Nearly everyone I meet has been touched by cancer in some way, whether personally or through friends and family.”
“I thought I was invincible”
“Even though the doctor said, ‘Don’t worry’, when I heard the words ‘That’s skin cancer’ the last hope that I was indestructible fizzled away. I’d always thought I was invincible – after all, I like to dress up as Wolverine – but skin cancer reminded me that none of us are.”
John’s diagnosis helped him become more aware of the importance of cancer prevention.
“I remember being seven years old, resisting my Mum’s attempts to put sun cream on me. I often opted for the lowest SPF possible, thinking sunburn was just a fast track to a tan. Coming from Scotland, where sunshine is a rarity, I’ve always craved the sun’s warmth. But now, I never go without factor 30 or 50. If only I had learned that lesson earlier.
“The guidance from the WCRF has been invaluable in helping me understand the importance of proper nutrition and lifestyle choices in cancer prevention and overall health. Exercise alone isn’t enough – we need to fuel ourselves properly and protect ourselves from preventable risks like excessive sun exposure.”
John continues to take on HYROX challenges to raise money for us. He’s completed three, including one in Frankfurt, and is running The Grid competition again in September, as well as more HYROX events this year. So far, he’s raised nearly £2,000 towards cancer prevention – thank you, John!
Science and football – while they may not seem like they have much in common, the disciplines meet in the person of Dr Frankie Brown. Frankie is an immunologist and former member of Scotland’s women’s team who has represented her country 96 times on the international stage.
Our funding helped Frankie realise her other dream of researching ways exercise can benefit those living with and beyond cancer.
Helping people with blood cancer

Frankie Brown with her Scotland team-mates
Under Dr Campbell from the University of Bath, Frankie worked in a team on a project funded by us investigating the effects of exercise on the health of patients with chronic lymphocytic leukaemia, a form of blood cancer that affects around 4,000 new people every year in the UK.
The team evaluated the safety and feasibility of a progressive exercise programme for these patients – many who were over 60. Essentially, they tested a “recipe for how to run a big study” more effectively, and even adapted it to continue successfully during the COVID pandemic.
She was inspired by her own background as a professional footballer, as well as her personal experience with cancer:
“When I was finishing up my PhD, my mum died of breast cancer. That was a real trigger moment for me to look more into oncology. I just couldn’t get my head around it – she had been so healthy. I would wonder, what’s going on here?
“I already knew a lot about health and monitoring my body for football. I started playing football very young, playing with my little brother, and I haven’t stopped since. I was in the Scotland under 17s, then the under 19s, and got into the full squad when I was 21 and was there for 10 years.
“Having spent my whole life in a high-performance environment, with everything being tested and monitored, I became more aware of how my body reacts to even very small shifts in circumstances and situations. It wasn’t hard for me to see how those tiny changes that are so important to athletes can be important for everybody.”
This inspired Frankie to become a researcher, where she found herself on the team led by Dr Campbell and funded by us. There were, however, some setbacks along the way – the biggest being the COVID-19 pandemic. Thanks to the flexibility of our funding programme, Frankie says she and the rest of the team were able to pivot from designing the programme to be in-person, to buying the participants exercise bikes and running a group session over Zoom.
“We had to shift the whole design of the exercise sessions to be home-based and World Cancer Research Fund allowed us to deliver exercise bikes to the participants’ homes. Without that, the trial would have fallen apart.“
‘The more muscle mass you have as you get older, the more independent you will be’
The data showed a 2% increase in lean mass in the exercise group compared with a 0.4% decrease in the control group. This is a significant benefit, as Frankie explains: “The data we have now and the study we’ve done shows that any gain a patient can make with their performance can make a huge difference to their own wellbeing.
“An increase in lean mass – in other words, in muscle mass – in these patients is a huge thing, especially in people over 60. The more muscle mass you have as you get older the more independent you will be. One of our participants lived up some stairs, and whenever I think about the study, I think about them and hope that my work has made it easier for them to get the shopping up and down to their home.”
These results have informed the design of a larger study where Frankie and her team will assess the tumour-suppressing effects and mechanisms of exercise in humans.
Frankie is very vocal about the impact of our support on her work: “In my experience, World Cancer Research Fund has been incredibly supportive of me as a young academic. They’ve provided amazing flexibility at a very uncertain time. I wouldn’t have been able to achieve any of this without you.”