Rewiring Relief

Dr. Ian Kleckner on Exercise, the Brain, and Chemotherapy Side Effects

What if one of the most powerful ways to ease the side effects of cancer treatment didn’t come from a drug prescription, but from movement? 

That’s the focus of Ian Kleckner, PhD, MPH, associate professor and director of the Cancer Control Mind & Body Lab at the University of Maryland School of Nursing. A physicist-turned-psychologist and neuroscientist with a passion for understanding how the mind and body work together, Kleckner is studying how exercise can reduce the painful, long-lasting nerve symptoms caused by chemotherapy — known as chemotherapy-induced peripheral neuropathy. 

Backed by the National Institutes of Health and American Cancer Society, Kleckner’s lab uses methods from neuroscience, physiology, and behavioral science to examine how walking and resistance exercise can improve not only physical function, but also brain activity, balance, and mood in people with cancer. The lab’s work is grounded in his belief that the key to treating neuropathy lies not only in the nerves in the hands and feet, but in the brain’s ability to adapt and retrain the body.  

At the heart of the Cancer Control Mind & Body Lab is what Kleckner describes as a “tiny but mighty team” who is driving the research forward, including neuroscientist Thushini Manuweera, PhD, whose expertise guides data analysis, study design, and publication efforts; Javier Rosales, an exercise physiologist who serves as lead clinical coordinator; Camille Baechler, BSN, a part-time clinical coordinator and full-time nurse with the University of Maryland Medical System; research intern Kaitlin Chung; and post-baccalaureate research intern Benick Mbaya.

In a new video Q&A, Kleckner explains how his team is rethinking symptom management, why exercise might help prevent neuropathy altogether, and what’s next in the effort to treat mind and body together.  Read on for highlights from the conversation or watch as Kleckner describes his research and its potential to reshape supportive cancer care. 

Questions

What is chemotherapy-induced peripheral neuropathy? 

Chemo-induced peripheral neuropathy, he explained, “refers to nerve damage caused by certain chemotherapy agents that are used to treat cancer. The nerve damage can make the nerves – especially in the fingers and the toes, the hands and feet – dysfunction and activate when they normally wouldn't, and it can cause them to die back and not cause sensations when you would normally feel them. So, for example, normally when we touch something, you feel that when you touch it. But if someone has chemo induced neuropathy, they might not feel anything.”

How often do patients experience chemo-induced peripheral neuropathy, and how does it impact their lives?

“It occurs in about two out of three patients who get chemotherapy agents that are so called neurotoxic, which is many of them,” Kleckner answered. “And for about half of people, it will go away, and for the other half, it might take months or years to go away, if it goes away at all.” 

He continued, “It stops people from doing everyday activities like button and clothes, texting, writing, also walking, and it compromises people's balance, increases risk of falls, causes rehospitalizations and increased medical expenses of upwards of $20,000 for a patient with chemo induced neuropathy compared to a patient with cancer who doesn't have chemo induced neuropathy.”

What role does exercise play in your research? 

Kleckner said his team has conducted several studies suggesting that home-based daily walking and resistance exercise can help partially reduce symptoms of chemo-induced neuropathy. He outlined potential reasons for the findings, saying, “We think that exercise can help reduce brain inflammation, which could reduce nerve sensitivity. Exercise can help by supporting beneficial activity patterns and connectivity patterns within the brain, which we know are altered in chemo induced neuropathy.”