The incidence but also survival rates of cancer are at an all-time high. The use of increasingly aggressive treatment methods however are leaving survivors with a range of adverse side effects long after treatment completion. Exercise has been proven to be a safe and effective method of intervention to decrease mortality and improve health outcomes. The physiological and psychological benefits of exercise for cancer survivors in ameliorating these aversive effects are well documented; however, health care policies have still not implemented any widespread opportunities for exercise referral programmes. One area of research that has recently gained much interest is determining the underlying biological mechanism of effect behind the benefits of exercise in order to provide clear and objective evidence to clinicians and policy makes alike. As most of the research in this area has only been published since 2009 (Ballard-Barbash, et al., 2012), a systematic review of the current available research was conducted. Fifteen relevant articles were identified (12 RCTs). It was shown that randomized controlled trials of exercise for cancer survivors posttreatment may results in changes to circulating levels of insulin, insulin related pathways (insulin like growth factor II [IGF II], IGF binding protein 3), high density lipoprotein, total cholesterol, leptin, and osteocalcin. Due to small sample sizes, the evidence is still preliminary and therefore more research is warranted in this area in the form of larger, statistically powered for cancer survivors. The results gathered from the systematic review informed the biological marker analysis of the ‘EXACT - EXercise And Colorectal cancer Trial’ small-scale feasibility RCT study. Twenty-three stage I-IIIb CRC patients (65.7%) consented to this study. Preliminary results showed trends for significant decreases in hip and waist circumference. Other favourable findings were a larger decrease in weight and BMI within the intervention group compared to the control. Both groups demonstrated clinical improvements in cardiovascular fitness in the 6MWT and increases in lower body muscular strength. Further research in the form of large-scale RCTs is warranted in order to test the efficacy of the intervention.