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The Waterloo Regional Health Network (WRHN) Cancer Centre is proud to announce its contribution to the landmark findings recently published in the New England Journal of Medicine on the results of the CO.21 (CHALLENGE) study. The study, led by the Canadian Cancer Trials Group, found that structured exercise significantly improves survival in colon cancer patients.
WRHN’s Cancer Centre assisted 33 cancer patients from Waterloo Region since 2009 to contribute to the research findings. A total of 889 patients across 55 clinical sites comprised the study’s findings that determined integrating exercise into survivorship care positively transforms outcomes for patients.
WRHN’s contribution to the study was made possible through a partnership with the University of Waterloo’s Centre for Community, Clinical and Applied Research Excellence (CCCARE) and the UW WELL-FIT program. This unique collaboration enabled patients to access supervised, evidence-based exercise interventions tailored specifically to individuals recovering from cancer treatment.
“This is a model of how regional hospitals can shape international research and how local partnerships, like ours with CCCARE, can deliver global impact. We are proud to be part of the solution,” said Carla Girolametto, Director of Research Operations at WRHN.
Patients in the structured exercise program experienced a 37 per cent lower risk of death and a 28 per cent reduction in recurrence or development of new cancers compared to those who received only health education materials, the study found.
“This is a transformative moment in oncology and we’re proud to have played a key role in this global research,” said Dr. Stacey Hubay, Medical Oncologist and Principal Investigator at WRHN, who led WRHN’s contribution to the global study.
“This is a transformative moment in oncology and we’re proud to have played a key role in this global research.”
“We’ve long known anecdotally that exercise benefits cancer patients, but to see such clear improvements in disease-free and overall survival, confirmed by rigorous data, is extraordinary. These results suggest that exercise should be incorporated into cancer care, not just as a recommendation, but as an integral part of the treatment plan from diagnosis through survivorship.”
WRHN’s participation in the CO.21 study would not have been possible without the collaboration with CCCARE and the UW WELL-FIT program. What began as an initiative to support individuals undergoing cancer treatment over two decades ago, UW WELL-FIT has expanded to serve a broader patient population and offer ongoing exercise options, with clear evidence that exercise supports physical and mental well-being across the cancer experience.
Following the CO.21 study’s results, additional work is being done at CCCARE and in partnership with EXE-COPP led by Principal Investigator Dr. Anupam Batra who is currently examining how exercise can offset physical and cognitive decline in men with metastatic prostate cancer.
“It’s the natural evolution of what CO.21 helped to prove: exercise is medicine,” said Julia Fraser, Ph.D. candidate, co-investigator and Research and Operations Manager with CCCARE.
For patients, the impact is deeply personal and transformative.
“I was diagnosed with cancer in 2016, and Dr. Hubay introduced me to the CO.21 study while I was undergoing chemotherapy. At the time, I was still quite active, running and exercising, but I waited to formally join the study until I had completed treatment,” said Russel Espiritu, one of WRHN’s CO.21 study participants.
“I truly hope these study results will encourage physicians to prescribe exercise as part of standard cancer care.”
“The exercise program at the University of Waterloo gave me the motivation and energy I needed to recover from the harsh effects of chemotherapy. It also connected me with other cancer patients who truly understood the journey. After the study, I was able to return to practicing karate. Staying active during and after treatment helped me manage the side effects, physically and mentally. I truly hope these study results will encourage physicians to prescribe exercise as part of standard cancer care.”
Nicole Thomson, Ph. D., Vice President of Quality, Research and Patient Experience at WRHN, reflected on the broader impact: “The CO.21 study is a powerful example of how community hospitals can meaningfully contribute to high-impact research. Our participation demonstrates that with the right partnerships and infrastructure, community-based cancer programs can drive innovation, improve outcomes, and help shape the future of care, not just locally, but nationally and beyond.”
