New findings from an international clinical trial show that a simple prescription of moderate exercise can significantly improve outcomes for colon cancer survivors. Patients who logged about two and a half hours of physical activity each week after treatment lowered their risk of cancer recurrence by 28 percent and reduced their risk of death by 37 percent, according to the study.
The research, known as the CHALLENGE Trial (CO.21), involved patients treated at Niagara Health in Ontario, among other sites worldwide. Dr. Radhika Yelamanchili, a gastrointestinal oncologist at Niagara Health who contributed to the study, said the results give doctors and patients a powerful, drug-free tool for recovery. “This isn't a new drug. It's exercise,” she said. “By studying it scientifically, we were able to quantify the impact and show just how meaningful exercise can be.”
The findings are part of a broader push by the Niagara Health Knowledge Institute (NHKI) to bring clinical research directly into community hospitals. In 2025 alone, the institute supported 58 active clinical trials involving 629 patients across specialties including oncology, critical care, cardiology and stroke care. Most trials run in partnership with universities, research networks and industry sponsors, allowing patients to receive care locally while contributing to national and international studies.
Beyond Exercise, Precision Medicine Advances
Niagara Health has also participated in the DYNAMIC-III Trial, which used circulating tumour DNA, or ctDNA, to guide chemotherapy decisions after colon cancer surgery. The study found that de-escalating chemotherapy in patients who tested negative for ctDNA successfully reduced side effects without compromising survival rates, enabling more personalized treatment plans. More recently, the centre joined the CO.33 BATTMAN Trial, which is testing a novel immunotherapy approach for patients with advanced colorectal cancer whose disease has progressed despite prior treatments.
Cancer research at Niagara Health dates back to 1985, when the oncology research program was first established. Since then, the Walker Family Cancer Centre has participated in nearly 100 studies, with roughly 111 cancer patients currently being followed through active clinical trials. Dr. Yelamanchili recalled one pancreatic cancer patient who enrolled in two separate trials over the course of his illness, extending his life by nearly five years. “For a patient with that type of cancer, that's remarkable,” she said. “Without those clinical trial opportunities, his journey would have been very different.”
Beyond oncology, NHKI is expanding research into critical care and cardiology. One completed study examined whether in-bed cycling for mechanically ventilated patients could improve recovery, and the results were so positive that the equipment remains in use today. Researchers are now preparing to study a similar upper-body cycling intervention. Elaina Orlando, Director of Research Operations at NHKI, said the goal is simple: “When research shows something works, it becomes part of practice.”
Patients in Niagara previously faced long trips to Hamilton or Toronto to participate in research. Now, they can access emerging therapies closer to home while helping answer questions that shape care globally. As Orlando put it, “A research ecosystem has been created. Patients in Niagara can receive leading-edge care close to home while contributing to knowledge that helps people everywhere. That's something we should be proud of.”