October 15, 2026 | Erin Bluvas, bluvase@sc.edu

Thanks to the efforts of exercise oncologists like Ciaran Fairman, physical activity, particularly strength training, is now a standard part of the treatment plan for cancer survivors. But given the uphill battle of maintaining muscle mass while fighting cancer, receiving treatment, and aging, do patients need additional support to realize the benefits of exercise after a cancer diagnosis?

In a recent pilot study published in PLOS One, the exercise science assistant professor and his team looked at whether creatine supplementation could help optimize the outcomes of resistance training for individuals being treated for colorectal cancer. While they did not find a significant difference between the group that received creatine and the one that did not, supplementation was well tolerated and accepted. Further, the participants evaluated the format positively and both groups modestly improved their strength and physical function. These findings lay the foundation for larger studies in the future that may be able to identify the right blend of exercise and supplementation.

“The effects of cancer and its treatment both contribute to accelerated aging, including the progressive loss of muscle mass and the functional ability to engage in daily activities,” Fairman says. “Resistance exercise training is a widely recommended strategy for addressing musculoskeletal declines among oncology patients, however, our recent meta-analysis of research in this area revealed minimal gains in whole-body lean mass among cancer patients, suggesting that exercise alone may not be enough to combat the exacerbated muscle loss that accompanies cancer and its therapies.”

With this study, the researchers evaluated the feasibility and effects of combining a 10-week resistance exercise training program with creatine supplementation. As one of the most extensively studied nutritional supplements, creatine is known to be safe and effective across the lifespan – including among older adult populations who face accelerated muscle loss. Building on a small number of studies looking at the dual effects of resistance exercise training and creatine, this project was the first to pilot a randomized control trial in this area.

Partnering with Prisma Health, Fairman and his team recruited 27 colorectal cancer patients, with 13 of them taking the supplement (20g/day for a week followed by 5g/day for the remainder of the study) and 14 taking a placebo in this double-blind study. They all participated in the same resistance exercise training program, which met three times per week through in-person and virtual sessions at a 1:1 participant-to-instructor ratio to ensure individual supervision.

The researchers’ primary goal of determining feasibility and acceptability of the intervention was supported with a high retention rate (89% completed the study), adherence (91.5% for exercise; 94-95% for supplementation), and satisfaction (overall: 4.6/5; willingness to enroll again: 4.5/5). With no reported adverse effects, the program appeared to be safe for both groups. When looking at the secondary outcomes (e.g., muscle strength, body composition/muscle mass, physical function, quality of life), they found that both groups saw modest improvements in strength and physical function.

“While we were hoping to see creatine amplify the effects of the resistance training, it’s important to remember that this was a small pilot study,” Fairman says. “What we have learned is that the supplements were well tolerated, and the participants favorably reviewed the program format overall, finding it to be practical, safe, and supportive, and suggesting that a larger trial is the best path forward to determine the true potential of creatine in this context.”

The experience also opened new avenues of investigation for Fairman and his collaborators. In addition to examining whether creatine can support muscle health and physical function, the team is now exploring whether its potential benefits may extend to other common side effects of cancer treatment.

Fairman is currently collaborating with USC faculty Chris Rorden and Leo Bonilla on a new pilot trial examining creatine supplementation in individuals with breast cancer experiencing cancer-related cognitive impairment (CRCI), sometimes described as “chemo brain.” The study will investigate whether creatine can help address changes in memory, attention and other aspects of cognitive function that can persist following cancer treatment.

“One of the valuable things about doing an early trial like this is that it helps you identify the next questions,” Fairman says. “Our initial focus was largely on muscle and physical function, but the experience has led us to think more broadly about how creatine might help manage some of the wider effects of cancer treatment. Cognitive impairment is a major concern for many individuals after cancer treatment, and we’re excited to investigate whether creatine may have a role there as well. We’re still at the very beginning of understanding whether, and to what extent, creatine supplementation might help lessen some of the burden associated with cancer and its treatment, but we’re excited to see where this work leads.”