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Can exercise fight cancer in leukaemia patients?

This research will evaluate the safety and acceptability of a progressive exercise programme for chronic lymphocytic leukaemia using a randomised controlled pilot trial

Researcher: Campbell, John
Grant type: Regular Grant Programme
Countries: UK
Cancer types: Haematological
Exposures: Body composition, Immune function, Physical activity
Status: Completed
Area: Cancer survivorship

We are delighted to be awarded funding by World Cancer Research Fund for this pilot project which will evaluate whether exercise is safe in watch and wait Chronic Lymphocytic Leukaemia. Importantly, this funding will allow us to preliminarily determine whether exercise has an impact on disease activity in this population

– John Campbell

Background

It is widely thought that regular exercise can help reduce the risk of cancer, leading to reductions in the number of new cancer cases, as well as the number of cases of cancer relapse, among people who are physically active. Animal studies support this idea, and show that if you give mice different types of cancer, exercise reverses cancer growth.

Despite these important findings from animals, it remains unknown in humans whether exercise can work in the same way and suppress cancer. This problem exists mainly because most people diagnosed with cancer require treatment for their cancer, and so it is not possible to look at the effects of an exercise training programme on its own against cancer.

In other cancer patients who do not need urgent treatment – for example, in types of early prostate cancer – it is not easy to accurately measure cancer cells without doing surgery, or other complex and expensive procedures.

Another opportunity could be in patients with an advanced and untreatable form of the disease, but these patients have serious health problems and thus prescribing exercise has numerous challenges.

Our study aims to overcome these problems by investigating the effects of exercise in people with ‘watch-and-wait’ chronic lymphocytic leukaemia (CLL). CLL is a type of blood cancer, and it is the most common adult leukaemia in the UK.

Most patients are diagnosed by chance, and have no disease symptoms, and as such do not need urgent treatment and have no major health problems caused by their cancer. This means we can look at how exercise affects their cancer, without having to worry about cancer treatment or cancer-related health problems.

Moreover, CLL is characterised by the presence of lots of tumour cells in the blood. This means we can easily take blood samples to see how the cancer is affected by exercise and importantly, we can store cancer cells to study the mechanisms.

Aims and objectives

As this type of study has not been done before, the main aim of this pilot study is to see if exercise is safe and feasible for people with CLL. Another important aim of the study is to see what the exercise programme does to cancer cells so that we can determine if a larger study is worth pursuing, and how large it should be.

How it will be done

Forty physically inactive patients will be recruited into this study. Twenty will be randomly allocated into a 16-week exercise programme and 20 into a control group (where they will do no exercise). We will then determine if the exercise programme is safe and feasible for patients.

We will also see what happens to their tumour cell count, fitness, strength, and body composition, and we will monitor changes to other things, such as diet.

Potential impact

The data will inform the design of a larger study that can be used as an investigative model to assess, for the first time, the tumour-suppressing effects and mechanisms of exercise in humans, thus fulfilling a major 2018–19 objective of WCRF.

Grant publication

Frankie F Brown, Rebecca Oliver, Adam J Causer, Harrison D Collier-Bain, Annabelle Emery, Rachel Eddy, David Dutton, Josephine Crowe, Daniel Augustine, John Graby, Dan Rees, Daniela Rothschild Rodriguez, Oliver Peacock, Sally Moore, James Murray, James E Turner, John P Campbell; Safety and Feasibility of a 16-Week Progressive Exercise Intervention in Treatment Naïve Chronic Lymphocytic Leukaemia. Blood 2023; 142 (Supplement 1): 6533.