Bowel cancer survivors are hampered by persistent fatigue issues, sometimes lasting years, yet many don’t undertake exercise programs which is well known to overcome this debilitating problem – so Flinders University researchers are investigating a solution.  

This specific issue has been noticed by Dr Matthew Wallen, Deputy Lead of the Cancer Survivorship Program at Flinders University’s Caring Futures Institute, who is about to start a new type of physical activity trial for bowel cancer patients. 

With funding from The Hospital Research Foundation, the I-FIT (Improving Fatigue Through digital physical activity interventions) study will work with bowel cancer survivors and clinicians to design and test a new 12-week trial designed to improve physical activity that will combat post-treatment fatigue. 

As a leading expert in clinical exercise physiology and cancer survivorship, Dr Wallen has spent the last 14 years working closely with cancer survivors – taking specific interest in how exercise can get people best prepared for treatment and overcome many side-effects.  

Through his clinical work, he has noticed that fatigue is a lasting but under-addressed problem – but also found that the prospect of maintaining a regular exercise regime can be met with some hesitation from many cancer survivors. 

“Of the many unmet supportive care needs reported by bowel cancer survivors, self-managing cancer-related fatigue is among the most common, which limits their participation in work and many other activities,” says Dr Wallen.

“Overwhelming evidence demonstrates the effectiveness of physical activity for improving fatigue in cancer survivors, particularly after treatment completion, but despite this evidence, an estimated 83% of bowel cancer survivors do not achieve guideline activity recommendations.  

“When I explain that the recommended amount of moderate physical activity is at least 150 minutes a week, this can be met with some resistance. And this is understandable, as many people who have just come out of surgery or completed treatments, that target can be quite overwhelming. 

“It shows that we need to innovate how we prescribe physical activity – and that we need to think about breaking down these physical activity guidelines into smaller, more manageable targets.” 

Dr Wallen explains that several prohibitive factors are cited by bowel cancer survivors; the amount of time required, the costs attached to exercise equipment or gyms, or having access to hospital facilities to perform exercises. He believes there are simple ways to overcome these perceived obstacles, and engaging with technology is a very appealing solution. 

“The modern exercise industry overcomplicates the simplicity of movement. In truth, you don’t need much to get physically active – it needs to be simple and accessible. Most people will have access to a smart phone, and our plan is to use this technology to get bowel cancer survivors moving more and sitting less” 

The I-FIT trial will involve three components, starting with the design of a 12-week digital physical activity intervention to address fatigue with bowel cancer survivors. This process will involve input from bowel cancer survivors, clinicians, health service providers, non-for-profit organisations and academics. 

To implement the physical activity intervention, a national cohort of recruits will have 25 bowel cancer survivors to participate in the intervention, along with a control group of 25 people in usual care, to evaluate the feasibility, acceptability, appropriateness and efficacy of the I-FIT intervention. 

If this proves successful, researchers will then co-design a translation strategy so that the intervention project could be scaled up and implemented into a larger trial. 

It marks the continuation of significant cancer survivor health programs by Dr Wallen, who has also been instrumental in establishing the Cancer Exercise and Physical Activity Service, a student-run clinic that provides assistance for up to 15 cancer survivors a week, supported through the Flinders Foundation. 

This work has seen Dr Wallen shortlisted as a finalist for the 2025 40-Under-40 Awards, recognising young leaders and entrepreneurs aged under 40 who are making significant contributions to their communities. “This is important work, because it’s providing solutions to address many unmet needs experienced by cancer survivors in the community.”