Researchers wanted to know if a special program teaching colorectal cancer survivors to eat healthier and exercise more could help them feel less tired. They worked with 161 cancer survivors who completed treatment and were experiencing fatigue. Half of them got help from a lifestyle coach for six months, while the other half didn’t. The good news: the people who worked with the coach did make better choices about food and exercise. The surprising news: these healthier habits didn’t actually reduce their tiredness or improve how they felt overall. This suggests that cancer-related fatigue might need different types of help beyond just lifestyle changes.

The Quick Take

  • What they studied: Whether a program that helps cancer survivors eat better and exercise more can reduce the extreme tiredness that many feel after cancer treatment
  • Who participated: 161 colorectal cancer survivors (average age 64 years, 55% women) who had finished treatment between 6 months and 5 years ago and were experiencing significant fatigue
  • Key finding: While the lifestyle program successfully helped people improve their eating habits and physical activity, it did not significantly reduce cancer-related fatigue or improve overall quality of life compared to the control group
  • What it means for you: If you’re a cancer survivor feeling tired, eating better and exercising more are still good for your health, but you may need additional support specifically designed to address cancer fatigue, such as talking to your doctor about other treatment options

The Research Details

This was a randomized controlled trial, which is considered one of the strongest types of research studies. Researchers randomly divided 161 colorectal cancer survivors into two groups: one group received help from a lifestyle coach for six months (12 sessions total), while the other group received no coaching. The coaching group worked on gradually improving their diet and physical activity based on cancer prevention guidelines. Both groups answered questions about their fatigue and quality of life at the beginning and after six months to see if there were any differences.

The researchers used a specific tool called the FACIT-Fatigue Scale to measure tiredness, which is a well-established way to assess cancer-related fatigue. They also measured quality of life to see if people felt better overall. This approach allowed them to compare whether the lifestyle coaching made a real difference compared to no coaching.

This study design is important because it helps prove whether lifestyle changes actually cause improvements in fatigue, rather than just showing that people who exercise happen to feel less tired. By randomly assigning people to groups, researchers can be more confident that any differences are due to the program itself, not other factors. This type of evidence is what doctors use to decide what treatments to recommend.

This study has several strengths: it was randomized (which reduces bias), it had a reasonable number of participants (161), and it measured fatigue using a validated tool that’s recognized by cancer researchers. However, the study was relatively short (only six months), and the researchers found that the lifestyle improvements didn’t translate to reduced fatigue, which suggests the program may have had limitations in its design or that cancer fatigue requires different approaches. The study was published in a reputable nutrition journal, which adds credibility.

What the Results Show

The main finding was surprising: even though the lifestyle coaching program worked well at helping people eat better and exercise more, it did not significantly reduce cancer-related fatigue. The fatigue scores improved slightly in both groups, but the difference between the coached group and the non-coached group was very small (0.8 points on the fatigue scale) and could have easily happened by chance.

Similarly, quality of life improved slightly in both groups, but again, there was no meaningful difference between those who received coaching and those who didn’t (1.3 points difference). This means that the lifestyle changes alone were not enough to tackle the tiredness that cancer survivors experience.

The positive side of the results was that the intervention group did successfully make real improvements in their eating habits and physical activity levels. They ate more fruits and vegetables, reduced unhealthy foods, and increased their exercise. The control group, by comparison, didn’t make these changes. So the program was effective at changing behavior, just not at reducing fatigue.

While the study focused on fatigue and quality of life, the behavioral improvements are worth noting. The fact that people could successfully adopt healthier habits with coaching suggests that lifestyle coaching works for behavior change. This is important because even if it didn’t reduce fatigue in this study, eating better and exercising more have many other proven health benefits for cancer survivors, including reducing the risk of cancer returning and improving overall health.

Previous research has suggested that exercise and healthy eating might help with cancer fatigue, which is why researchers designed this study. However, this study’s results suggest that the connection may not be as straightforward as once thought. Cancer-related fatigue appears to be a complex problem that might involve factors beyond just lifestyle, such as changes in the body’s metabolism, hormones, or the nervous system from cancer treatment. This finding aligns with growing recognition in cancer research that fatigue may require more targeted medical interventions in addition to lifestyle changes.

Several limitations should be considered: First, the study only lasted six months, which may not be long enough to see changes in fatigue. Second, the study only included colorectal cancer survivors, so results may not apply to other cancer types. Third, the fatigue improvements in both groups (even without coaching) suggest that time itself may help with fatigue, making it harder to see the true effect of the program. Finally, 161 participants is a moderate sample size; a larger study might have found different results. The study also didn’t measure whether people stuck with their healthy habits after the coaching ended.

The Bottom Line

If you’re a colorectal cancer survivor experiencing fatigue: (1) Continue pursuing healthy eating and exercise because they have many proven health benefits, even if they may not directly reduce fatigue (moderate confidence); (2) Talk to your cancer care team about fatigue specifically—there may be other treatments or strategies designed to address it, such as cognitive behavioral therapy, energy management programs, or medical evaluation for other causes (high confidence); (3) Don’t rely solely on lifestyle changes to fix cancer fatigue without also exploring other options with your healthcare provider (high confidence).

This research is most relevant to colorectal cancer survivors who have completed treatment and are experiencing ongoing fatigue. It’s also important for oncologists and healthcare providers who work with cancer survivors. People with other types of cancer should be cautious about applying these results, as different cancers and treatments may affect fatigue differently. This study is less relevant to people who don’t experience cancer-related fatigue or those still undergoing treatment.

Based on this study, lifestyle changes alone may not reduce fatigue within a six-month timeframe. If you’re considering lifestyle coaching or changes, you should discuss realistic timelines with your healthcare provider. Some people may see improvements in energy over months to years, but this study suggests you shouldn’t expect fatigue to disappear just from eating better and exercising more. Improvements in other health markers (like weight, strength, or disease prevention) may happen faster than fatigue reduction.

Want to Apply This Research?

  • Track both lifestyle behaviors AND fatigue separately: Log daily physical activity (minutes and type), meals with fruit/vegetable servings, and daily fatigue level (1-10 scale). This helps you see if lifestyle improvements are happening even if fatigue doesn’t change, and provides data to discuss with your healthcare provider about whether additional fatigue-specific interventions are needed.
  • Use the app to set gradual goals for healthy eating and exercise (like adding one extra vegetable serving per day or a 10-minute walk three times weekly), celebrate these wins separately from fatigue improvements, and track which activities make you feel most energized versus most drained. This helps identify personal patterns that might differ from general recommendations.
  • Create a long-term dashboard showing: (1) Lifestyle habit adherence (diet quality, exercise frequency), (2) Fatigue levels over time, (3) Quality of life indicators, and (4) Notes about other factors that might affect fatigue (sleep, stress, medical appointments). Share this data with your healthcare provider every 3 months to help identify whether additional fatigue-specific treatments might help beyond lifestyle changes.

This research shows that a lifestyle program alone did not reduce cancer-related fatigue in this study. If you are a cancer survivor experiencing fatigue, this does not mean you should ignore healthy eating and exercise—these remain important for overall health. However, you should not rely on lifestyle changes alone to treat cancer fatigue. Please discuss your fatigue with your oncologist or healthcare provider, as there may be other treatments or interventions specifically designed to address cancer-related fatigue. This information is for educational purposes and should not replace professional medical advice. Always consult with your healthcare team before making significant changes to your treatment or lifestyle plan.