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Physical activity may increase the effectiveness of an anti-cancer drug
Last reviewed: 02.07.2025
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Periods of moderate to intense exercise may improve the effectiveness of antibody therapy used to treat chronic lymphocytic leukemia (CLL), a new study has found.
Researchers from the Universities of Birmingham and Bath have found that exercise increases the number of cancer-fighting immune cells called natural killer cells, and that these cells are almost twice as effective at killing cancer cells in "ex vivo" tests carried out on blood samples from patients.
In addition, the researchers found that the number of cancer cells in blood samples temporarily increased immediately after exercise, making them more vulnerable to attack by natural killer cells and antibody therapy.
The study could open up new possibilities for antibody treatments for some forms of cancer, although more studies are needed to determine the effects "in vivo" in patients undergoing treatment.
Dr James Turner, co-author of the study from the University of Birmingham, said: "These findings show potential benefits for patients undergoing a certain type of treatment and could open up new avenues of research to see if exercise can improve the effectiveness of other cancer treatments."
In a study published in the journal Brain, Behavior, and Immunity, researchers wanted to test the effects of exercise on an antibody therapy called Rituximab. It is a common treatment for chronic lymphocytic leukemia, which is a cancer of white blood cells and the second most common adult blood cancer in the UK. The therapy works by attaching to a specific protein on the surface of cancer cells that natural killer cells can recognise and attack.
The researchers worked with 20 people aged 45 to 82 who had been diagnosed with chronic lymphocytic leukemia but had not yet started treatment. The participants were asked to do 30 minutes of moderate-intensity cycling. Blood samples were taken before and immediately after the exercise, and then another sample was taken an hour later.
In ex vivo blood samples, the researchers measured the number of natural killer cells in each sample and tested their ability to kill cancer cells with and without Rituximab.
They found that natural killer cell counts increased by 254% after exercise, and that blood samples taken after exercise had 67% more cancer cells than samples taken before exercise.
The team then isolated the natural killer cells and placed them in direct contact with cancer cells for two hours "ex vivo" with and without the antibody therapy Rituximab. When Rituximab was also present in the blood sample, the natural killer cells were more than twice as effective at killing cancer cells in samples collected immediately after exercise compared to samples collected before exercise.
Dr John Campbell, senior author of the study from the University of Bath, said: "Cancer cells often try to 'hide' in the body, but exercise seems to help move them into the bloodstream where they become vulnerable to antibody therapy and killer cells."
The study's findings may also be useful for patients who have completed treatment for leukemia and are being monitored for the return of cancer cells.
Dr Harrison Collier-Bain, first author of the study from the University of Bath, said: "Monitoring patients after treatment is difficult because if cancer cells remain or come back they are sometimes too small to detect, but a period of exercise followed by a blood sample taken immediately afterwards may help 'find' them if they are 'hiding' in the body."
Although these results are promising, larger trials in a cohort of patients treated with Rituximab will be needed to form treatment recommendations.
Caroline Geraghty, senior information officer at Cancer Research UK, said: "This study adds to a growing body of evidence showing that exercise can be beneficial before, during and after cancer treatment.
"We know that being physically active before and after treatment can help patients cope better with treatment, aid recovery and improve mental wellbeing. It is interesting to see that exercise can also improve the effectiveness of treatment for some types of blood cancer, although more research is needed in a larger group of patients.
"Everyone has different needs and abilities, so it's important to discuss with your doctor what forms of exercise will be best for you. We encourage all cancer patients to seek advice from their doctor before starting an exercise program before or after treatment to ensure the types of activity suggested are suitable for them."