Exercise is "better than a drug" at cutting the chance of cancer returning, a landmark study has revealed.
A brisk walk several times a week could also cut the risk of death by a third, the global study found.
The findings were unveiled at the American Society of Clinical Oncology annual meeting in Chicago, the world's largest cancer conference.
Scientists studied the effect that a structured exercise programme would have on the survival of patients after treatment for advanced colon cancer, the most common bowel cancer.
Exercise of any kind helps keep the heart healthyGETTY
Oncologists are calling for rollouts of personal trainers and health coaches to extend thousands of lives.
What's more, the research revealed that just telling people to exercise more did not work.
The world-first trial, published in the New England Journal of Medicine, tracked 889 colon cancer patients across six countries, including the UK, in a study taking place from 2009 to 2023.
Led by the Canadian Cancer Trials Group, researchers compared the effect of a "structured" exercise programme with just being given standard health advice.
All participants had colon cancer, mostly at stage three and had completed surgery and chemotherapy. None were meeting recommended physical activity levels at the start.
Prescribed personal trainers had fortnightly sessions, involving motivational advice and exercise supervision, with the patients for the first year, which then dropped to a monthly basis.
The trial aimed to increase exercise by at least 10 "metabolic equivalent task hours" per week, roughly 45 to 60 minutes of brisk walking three to four times a week, or 25 to 30 minutes of jogging three to four times a week.
Most opted to boost their exercise by walking. After five years, those with health coaching had a 28 per cent lower risk of cancer recurrence or the appearance of new cancer. After eight years, they had a 37 per cent lower risk of death compared to those given health advice only.
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Survival among those with personal trainers was 90 per cent
GETTYSurvival among those with personal trainers was 90 per cent, compared with 83 per cent in the group who only received advice.
For every 14 people on the "structured" programme, exercise prevented one person from dying.
Dr Julie Gralow, ASCO's chief medical officer, said the study provided the "highest level of evidence" that doctors should prescribe exercise to cancer patients.
"We titled the session 'As Good as a Drug'. I would have retitled it 'Better Than a Drug', because you don't have all the side effects," she said. "It's the same magnitude of benefit as many drugs that get approved 28 per cent decreased risk of recurrence, 37 per cent decreased risk of death. Drugs get approved for less than that, and they're expensive and toxic."
The costs of health coaching were "remarkably affordable" at £2,000 to £3,000 for three years.
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