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Welcome to the latest Series of Supportive Care Matters, a podcast hosted by Medical Oncologist and International Cancer Survivorship Expert, Professor Bogda Koczwara AM.

"If it were a pill, we would all want it." This powerful opening statement captures the essence of ground-breaking research that's transforming our understanding of cancer survivorship care. The CHALLENGE Study has delivered what many considered impossible: definitive evidence that structured exercise significantly extends the lives of colorectal cancer survivors.

The results are nothing short of remarkable. Colorectal cancer patients who participated in a structured exercise program for three years after completing surgery and chemotherapy showed an 80% disease-free survival rate at five years, compared to 74% in those who received only health education materials. The results showed that structured exercise provides a significantly longer disease-free survival. Even more impressive, overall survival improved from 83% to 90% - a 37% decrease in risk. To put this in perspective, for every 14 patients who followed the exercise program, one additional life was saved.

What makes this intervention unique is its sophisticated approach to behaviour change. Participants received individualised exercise prescriptions targeting 150 minutes of moderate aerobic activity weekly, combined with regular supervision and motivational support. Exercise physiologists conducted environmental scans to identify accessible opportunities, established accountability through regular check-ins and helped participants overcome barriers to physical activity. This wasn't simply about telling people to exercise - it was about teaching them how to make sustainable lifestyle changes.

The implications for clinical practice are profound. To discuss this ground-breaking paper in detail, Professor Bogda Koczwara is joined by the Australian Principal Investigators - Professor Haryana Dhillon and Professor Janette Vardy.

Visit www.oncologynews.com.au for show notes and more information about Supportive Care Matters.

This conversation is proudly produced by the Podcast Team at The Oncology Podcast, part of the Oncology Media Group Australia.

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Proudly produced by The Oncology Network

When does aggressive cancer treatment shift from beneficial to harmful? This powerful conversation between Professor Nathan Cherny and Professor Christopher Jackson tackles one of oncology's most challenging ethical dilemmas – overtreatment at the end of life.

Drawing on his extensive experience and research, Professor Cherny illuminates the complex factors driving excessive treatment, from departmental culture to cognitive biases.

"Oncologists need to learn not only when to treat, but when not to treat," he emphasises, highlighting how treatment decisions for poor-performance status patients with resistant disease require particular scrutiny.

The discussion reveals eye-opening research showing patients might consider additional treatment worthwhile only if it provided 12-18 months of quality life – far beyond what late-line therapies typically deliver.

Throughout the conversation, both oncologists acknowledge the delicate balance between appropriate intervention and knowing when to step back. Professor Cherny offers practical guidance for reframing hope beyond treatment response and recognising that courage exists not only in pursuing another treatment but also in saying "enough." This nuanced exploration of patient-centred decision-making provides a valuable perspective for clinicians, patients, and families navigating cancer's most difficult moments.

Join our community at oncologynetwork.com.au for more insightful discussions and subscribe to our weekly publication The Oncology Newsletter to stay informed on the latest advancements in cancer care.

The Oncology Podcast - An Australian Oncology Perspective

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Welcome to The Oncology Journal Club Podcast Series 3
Hosted by Professor Craig Underhill, Dr Kate Clarke & Professor Christopher Jackson | Proudly produced by The Oncology Network

Welcome to Episode 6 of The Oncology Journal Club podcast. This is where we take a famously different approach to oncology research.

Has non-operative management finally found its place in treating certain cancers? This episode unpacks compelling new data that might challenge the surgeon's traditional role for some patients with mismatch repair deficient tumours. While rectal cancer patients show remarkable complete response rates to immunotherapy, the story gets more complex across different cancer types – raising fascinating questions about tumour biology, patient selection and the future of organ preservation.

We explore the delicate art of discussing immunotherapy outcomes with patients, navigating that narrow path between hope and realism. When treatments occasionally produce dramatic responses but more commonly offer limited benefits, how do oncologists communicate effectively without creating unrealistic expectations? Our hosts share practical strategies for these challenging conversations, emphasising that truly patient-centred care requires ongoing dialogue about prognosis.

The oncology research world is evolving too, with updated CONSORT and SPIRIT guidelines transforming how clinical trials are designed and reported. These frameworks now mandate greater transparency, clearer safety reporting and increased patient involvement in study design – potentially leading to more trustworthy and applicable research outcomes.

Plus, we examine an intriguing Chinese trial showing remarkable survival benefits from low-dose continuous capecitabine combined with aromatase inhibitors for metastatic breast cancer – a potential game-changer for resource-limited settings.

From this year's AACR meeting, we highlight what might be the first change in standard of care for locally advanced head and neck cancer in two decades, along with promising targeted therapies for specific molecular subtypes of lung cancer.

Join our expert hosts Professor Craig Underhill, Dr. Kate Clarke and Professor Christopher Jackson as they navigate these developments with their trademark blend of critical analysis, clinical wisdom and humour.

Subscribe to The Oncology Newsletter to stay informed about the evolving landscape of oncology care and research.

For links to the abstracts and bios of our hosts, head to the show notes on oncologynetwork.com.au.

The Oncology Podcast - An Australian Oncology Perspective