The word to the primary oncologists

Dear Director,

I appreciated the article about the study published on June 1st in the NEJM on the role of physical activity in patients with operated colon cancer.

It is known that physical exercise, through a reduction of inflammatory processes, an increase in blood pressure on the vascular wall and insulin sensitivity, an increase in the immune response, and an action on the proliferation of tumor cells linked to metabolic growth factors, can represent an effective treatment in the evolutionary control of oncological disease.

However, I believe it is useful to reiterate that the study in question has demonstrated how well-structured physical activity can be considered as an adjuvant to chemotherapy treatment indicated in patients in this disease setting and not as a substitute. It is important, in fact, to specify that 100% of the patients enrolled in the study had already completed the planned chemotherapy treatment. This is to avoid misinterpretations, especially by readers accustomed to superficial readings.

Finally, I believe that these data are relevant not only from a clinical perspective but also from a pharmaco-economic perspective, considering that the promotion of physical activity as a therapeutic act during the patient's follow-up after chemotherapy treatment would allow for an evident economic containment given the high cost of the oncological active ingredients that would be indicated in the event that the disease relapses. It is no coincidence that the promotion of physical activity and, more generally, of lifestyles represents a significant challenge for the NHS.