Short workouts may improve the effectiveness of some cancer treatments
Last reviewed: 14.06.2024
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A new study led by researchers from the Universities of Birmingham and Bath in the UK shows that intense exercise can improve the effectiveness of treatment with rituximab, an antibody often used to treat chronic lymphocytic leukemia (CLL). The results were published in the journal Brain, Behavior, and Immunity.
Description of the study
The study involved 20 people with chronic lymphocytic leukemia who had not previously received any treatment for cancer. In the study, participants cycled for 20-30 minutes at moderate to vigorous intensity.
Main conclusions
Researchers found that this type of exercise increased the number of anti-cancer immune cells, or natural killer cells, by 254%. When combined with rituximab, which binds to a protein on cancer cells to help natural killer cells identify and destroy them, the anti-cancer cells were twice as effective in blood samples taken immediately after exercise.
"This study is the first to show that acute cycling training improves ADCC [antibody-dependent cellular cytotoxicity] mediated by rituximab against self chronic lymphocytic leukemia cells ex vivo," write the authors.
Expert opinion
Dr. Katherine S. Diefenbach, director of the Clinical Lymphoma Program at NYU Langone Health's Perlmutter Cancer Center, who was not involved in the study, said the results are interesting but questions remain due to the small sample size.
"This is a small pilot study of 20 patients in a controlled setting—with limited exercise in a prescribed form—with intriguing biological findings about NK cell activation and rituximab-induced CLL cell killing," she explained.
“However, these data need to be confirmed in larger studies with a more heterogeneous patient population,” Diefenbach cautioned. "It is also unclear how this finding affected clinical outcome or whether it had any implications for response to therapy or disease stability."
Dr. Wael Harb, a board-certified hematologist and oncologist at MemorialCare Cancer Center in Orange County, California, also noted that it is difficult to draw broad conclusions from this study.
"Patients who are capable of vigorous exercise may have different immunity compared to those who cannot. How can we generalize these findings to others, given exercise opportunity and sample size?" asked Dr. Harb, adding that because the study is based on ex vivo blood samples, it is difficult to determine what is happening inside the body.
"The most important thing is how does this affect outcome, right? We need to have long-term results to see if this actually has an effect on treatment response, leukemia remission? We would require a more structured trial to find out and randomize it." patients to different regimens with the same treatment - rituximab - or rituximab-containing treatments and add different exercise programs to this," he added.
Effects of exercise on cancer
Although many cancer treatments, especially chemotherapy or surgery, can cause severe fatigue that interferes with physical activity, there is growing evidence that exercise can stimulate immune cells.
Dr. Harb explained that physical activity is well documented as a way to boost the body's immune system to fight cancer cells. He cited several studies in recent years that have examined the effects of short-term intense exercise and more regular activity patterns.
"We encourage staying active and exercising - we believe there is a wealth of evidence that exercise during cancer treatment can help the immune system, and now more than ever we understand the role of the immune system in fighting cancer." " he said, speaking about the doctors' recommendations.
"In fact, many of the new cancer treatments rely on immunotherapy, which helps activate the immune system to fight cancer," Harb added, although he also expressed caution about exercise as an adjunct to cancer therapy.
"Intense exercise is a little more difficult. It depends on the person's ability to exercise, age, comorbidities that make it more difficult. So there may be practical problems when we talk about intense exercise; it limits patient participation," noted he.