Researcher:
Ian Kleckner, PhD, MPH, associate professor
Director, SYNAPSE Center
Read Combatting Chemotherapy Symptoms with Exercise by Dan Mezibov
(from the fall 2024 issue of Nursing For/um magazine)
Areas of Expertise:
Kleckner researches how cancer chemotherapy causes side effects such as neuropathy, pain, and distress and how to treat these symptoms using exercise and healthy eating. These treatments are assessed via randomized clinical trials in Baltimore and across the United States. He uses methods from psychophysiology, such as measuring heartbeats and skin conductance during symptoms; brain imaging; exercise science; and psychological and behavioral science. While not a nurse, Kleckner draws upon his background in physics and biophysics in his research of ways to prevent, treat, and predict symptoms – all core elements of nursing.
The BIG Idea:
Chemotherapy-induced peripheral neurotoxicity (CIPN) is a common, tough-to-treat, and poorly understood side effect of chemotherapy agents used to treat many cancers including breast, gastrointestinal, prostate, lung, testicular, ovarian, myeloma, lymphoma, leukemia, and others. CIPN can present as a combination of numbness, tingling, and pain in the hands and feet, causing discomfort and interfering with daily activities such as writing, texting, buttoning clothes, and maintaining balance, and it can limit the number of doses of chemotherapy that a patient might receive. Kleckner is investigating two aspects of CIPN: first, how CIPN develops and persists by measuring how people perceive bodily sensations and how the brain processes them (“interoception”); and second, if and how regular exercise can treat or prevent CIPN, with current studies focusing on home-based walking and resistance exercises.
Kleckner is currently leading a National Cancer Institute-funded nationwide randomized clinical trial testing if exercise can treat CIPN. His preliminary work suggests that these exercises may reduce CIPN symptoms. This study is conducted with collaborators at the University of Rochester Medical Center in New York and is co-led by close collaborator Po-Ju Lin, PhD. The study is open at more than 30 sites across the United States as part of the National Cancer Institute’s Community Oncology Research Program. The study is the first nationwide clinical trial of exercise for CIPN that also studies the role of the brain in CIPN. Learn more about the study.
Why does the research matter?
Forty percent of individuals worldwide will develop cancer at some point, and many will receive chemotherapy as part of their treatment. “If we can better prevent, treat, and predict toxicities from cancer and its treatment, we can reduce the burden of cancer for tens of millions of people per year, including patients, care partners, and the health care system,” Kleckner says.
Who does the research matter to?
This research matters to everyone because nearly every person is affected by cancer, through either a diagnosis for themselves or a diagnosis of a loved one.
What are the clinical applications of the research?
“Our work investigating exercise can improve standard of care by identifying the extent of possible benefits, who will benefit most, and what dose of exercise is minimally effective and maximally effective,” Kleckner says. “Our work studying the role of interoception and the brain in chemotherapy toxicities can inform new biomarkers to predict toxicity risk to inform treatment decisions and can inform and optimize brain-based interventions to prevent and treat toxicities. All our work is in collaboration with doctors, nurses, other clinical professionals, and patient advocates to ground our work in clinical application.”
For more information, follow Kleckner on X (formerly known as Twitter).