September is childhood cancer awareness month. While the survival rate has improved dramatically in recent decades, a different set of concerns has gripped the survivor community, including the physical side effects of cancer and cancer treatments1.Late effects of treatments include stunted bone growth, neuropathy, stiffness, fatigue, and an overall decrease in quality of life. These side effects, coupled with an inactive lifestyle and increased likelihood of heart disease2 can lead to other chronic conditions. In fact the Childhood Cancer Survivor study found that 62% of survivors had at least one chronic condition and 27.5% had a severe, life-threatening, or disabling condition.1
To help mitigate these concerns, one researcher and past Foundation for Physical Therapy funding recipient has dedicated her entire professional career to helping combat the physical limitations faced by the cancer survivor community. Her name is Kirsten K. Ness, PT, PhD, FAPTA.
As a faculty research member at St. Jude Children’s Research Hospital, Ness fights to improve quality of life for these patients.
Ness was drawn to oncology research as a physical therapist at the University of Minnesota Children’s Hospital. There she found that there was a lack of information in the literature to guide her treatment of children diagnosed with cancer and decided to pursue her MPH and PhD in epidemiology. Since joining St. Jude, Ness began focusing her research on cancer survivors, working with children, young adults, and adults into their mid-40, many of whom have chronic diseases as a result of the cancer or its treatment.
Ness is currently participating in several studies as principal investigator that explore the effects of exercise in conjunction with cancer treatment and the long term health of childhood survivor cancers. In 2016, she was awarded a $ 1.8 million R01 grant from the National Cancer Institute (NCI) for her study titled, “Web-based Physical Activity Intervention for Children with Acute Lymphoblastic Leukemia (ALL).” During this 5-year study, Ness would work to evaluate the effects of an interactive web-based physical activity intervention on fitness, markers of cardiometabolic health, physical activity, quality of life, fatigue, and school attendance among children and adolescents following treatment for ALL. The goal, Ness, explains is “to determine whether the effects of an interactive web-based physical activity intervention on markers of cardiometabolic health are mediated by changes in fitness among children and adolescents following treatment.”
She has been simultaneously working on another longitudinal project also funded by the NCI, assessing frailty in young adult survivors of childhood cancer. This $2.25 million project, which culminates in 2019, is looking at survivors of childhood cancer treated at St. Jude Children’s Hospital over a 5-year period to assess the increased risk of premature aging and the early development or worsening of chronic health conditions. Due to the stressful treatments of cancer therapies, many survivors often begin exhibiting fatigue, shortness of breath, and reduced capacity to participate in physical activity, all precursors of frailty or premature aging. Because frailty leads to nearly two thirds of childhood cancer survivors to develop at least one severe chronic health condition years prior to diagnosis, hospitalization and eventual mortality, Ness is hopeful that” by using a frailty phenotype as an early predictor of later chronic disease onset will allow identification of childhood and adolescent cancer survivors at greatest risk for adverse health.” This in turn will allow for specified interventions that will prevent or delay the onset of chronic health conditions.
Ness acknowledges that St. Jude is a special place to work. “Our mission is to find cures and save lives. All of the research is focused on making things better for the children,” she said. “There is this overarching feeling every day that this is what we are here for.”
Ness’s research shows that physical therapists need to focus on getting cancer survivors to exercise. She hopes that her research will give clinicians the tools they need to treat patients who have survived cancer and raise awareness of the unique health challenges that cancer survivors face.
Ness was the recipient of a Promotion of Doctoral Studies award in 2003, which she appreciated, noting how valuable the Foundation is for emerging researchers.
- Vina, C. C., Wurz, A.J., & Culos-Reed, S.N. (2013). Promoting Physical Activity in Pediatric Oncology. Where Do We Go from Here? Frontiers in Oncology, 3. doi: 10.3389/fonc.2013.00173.