After treatment for colorectal cancer (CRC), it’s natural to wonder what steps you can take to reduce the risk of recurrence. While no lifestyle change can eliminate that risk entirely, new research is providing clearer, evidence-based guidance.
According to Dr. Scott Kopetz of MD Anderson Cancer Center, this area has historically been difficult to study with certainty. Much of what we knew came from observational research, where patterns could be identified but not fully explained. Now, newer randomized studies are helping to clarify which lifestyle changes truly make a difference.
Exercise can’t be underestimated
Among all lifestyle factors, exercise is emerging as one of the most powerful tools for reducing recurrence risk.
In a recent study, some patients were simply advised to exercise, while others were given structured support with ongoing accountability. The difference was striking. Dr. Kopetz explains, “The amazing thing was that exercise worked in a really compelling way with benefits comparable to standard treatments.
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But the key isn’t just exercising, it’s how you approach it.
Rather than casually recommending activity, Dr. Kopetz now encourages patients to build in accountability. Instead of hearing general advice at occasional appointments, patients in the study had regular check-ins and support to stay on track. That shift made a measurable difference, reinforcing his current approach. “If you can find someone who will hold you accountable, that’s where we see real benefit,” he shares.
It’s also important to focus on the right type of movement. Aerobic exercise, like walking, cycling, or swimming, appears to drive this benefit. Strength training has its own advantages, but as Dr. Kopetz notes, it “did not appear to drive this effect” when it comes to recurrence risk.
Based on these findings, structured exercise is now entering new guidelines as a part of treatment for CRC.
Diet: A consistent but evolving piece of the puzzle
Diet remains an important part of the conversation, even though the evidence is still evolving.
Recent data suggests that dietary patterns matter, particularly when it comes to fat intake. Dr. Kopetz points out that “a low-fat, low–saturated fat diet is associated with a reduced risk of CRC recurrence.” While this doesn’t prove causation, it aligns with broader recommendations for overall health.
In practice, this means focusing on balanced, nutrient-dense foods while limiting saturated fats and heavily processed foods.
Aspirin: Growing evidence for a preventive role
Another area where the science has become clearer is aspirin use.
What was once considered a possible association is now supported by randomized trials. Dr. Kopetz explains, “Aspirin really does appear to work. Some patients, particularly those with specific tumor characteristics, may see greater benefit, but the overall findings are encouraging.”
Because aspirin is relatively low risk for many people, it may be a reasonable option to discuss with your care team. Still, it’s not a one-size-fits-all solution, and medical guidance is essential before starting.
Vitamin D: Still worth paying attention to
Vitamin D continues to be an area of interest, though the data is less definitive.
There is evidence suggesting that avoiding deficiency may be helpful, and Dr. Kopetz notes that maintaining adequate levels “may also be associated with a lower risk.” While more research is needed, monitoring and correcting low vitamin D levels is a simple step that supports overall health.
What this means for you
While not every lifestyle factor has a definitive answer yet, the overall picture is becoming clearer. Some strategies are strongly supported by evidence, while others are still guided by association and clinical experience.
The most important step is to find an approach that works for you. One that is realistic, supported, and sustainable. And as always, your care team can help you tailor these strategies to your individual needs and medical history.
Interested in hearing more from Dr. Kopetz? Watch the full webinar recording here.
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