USF Health College of Nursing professor first to research exercise program to help cancer patients suffering from CIPN

Dr. Constance Visovsky remembers the time when she was a young instructor and doctoral student teaching at Case Western Reserve University and an undergraduate student of hers conducting physical assessments at the VA hospital came to her with a problem.

The student was embarrassed, explaining that he realized he should know how to obtain a patient’s reflexes, but he was having trouble getting a response from one man in particular. Could she help?

Visovsky readily agreed, but when she arrived at the VA to observe the patient she was stunned. Just the semester before, the man–a cancer patient in his sixties–had been walking independently around the unit. After undergoing chemotherapy treatments for lymphoma, he was experiencing horrible neuropathy. Now he could barely walk.

“The difference was astonishing,” Visovsky recalled. “We saved his life maybe, but we left him with terrible impairment.”

It was a pivotal moment in her career.

“I’m going to study this,” she decided about neuropathy and the neurotoxic and myotoxic effects of chemotherapy. The commitment deepened further a short while later after she graduated from Case Western with her PhD in nursing, and a woman in the community wrote to thank her for her research focus after reading about her in the newspaper.

The woman suffered neuropathy after receiving treatments for breast and lung cancer. She had been an avid gardener and seamstress who made her daughters’ pearl-laced wedding gowns by hand, she wrote, sharing the information with Visovsky as if they were old friends. Now she could no longer do either.

“Whenever I got discouraged, I would re-read that letter,” Visovsky said about the 22 years that have passed since receiving it. The letter helped her “understand the importance of the day-to-day things that we take for granted, and the things we can do, and how important it is to a person’s quality of life.”

In those more than two decades, Visovsky, a faculty member at the USF College of Nursing since 2011, has become a renowned researcher and nurse scientist in the area of oncology and exercise.

She is currently in the middle of a five-year study to help cancer survivors improve balance, gait and strength following chemotherapy treatments – part of a $2.2 million grant awarded in 2019 from the NIH’s National Cancer Institute.

The research is the first to test the effects of a home-based exercise intervention for cancer patients suffering from CIPN – chemotherapy-induced peripheral neuropathy.

“There really are no good evidence-based treatments for this problem,” she said. One small past study addressed pain, but not function.

“So we believe that with our interventions, using exercise we are bringing blood flow to the peripheral nerves and oxygen to the peripheral nerves,” she said – in the process, preventing further impairment of the neurons.

The research includes very sophisticated measurements using sensors on a mat as well as on a person’s knees and ankles to record aspects of gait, balance and muscle strength.

While the pandemic slowed the recruitment of participants for the study, Visovsky said, so far more than 50 people had been enrolled by this fall for the 16-week regiment, with the end goal of 312 people. Materials are being translated into Spanish to help recruit non-English speakers as well.

While it’s too soon to draw conclusions, she said, anecdotally patients have told her team that they are enjoying the program and feeling benefits from it.

Visovsky is also working on a study with previous COVID-19 patients, to research people with long-term respiratory effects such as shortness of breath. Her team is designing a pulmonary rehabilitation program that consists of external muscle exercises and pursed-lipped breathing to help expand chests and bring up mucus with the goal of preventing reinfection.

For Visovsky, it’s important to practice what she researches – developing a regular exercise routine for herself later in life – from cycling to kayaking to running.

“To stay moving, you have to move,” she said. “I like to do a lot of things, so I want to have the energy to do them.”

To learn more about Visovsky, click here.

If you are a breast cancer survivor with CIPN and would like to participate in Visovsky’s study, please email cvisovk@usf.edu or call 402-639-9966. You may be eligible if you are female, at least 21-years-old, completed treatment that included taxane-based chemotherapy and suffer from peripheral neuropathy. Participants will receive a $25 Publix gift card for each completed study, a total of $125. 

Story by Saundra Amrhein