Nicholas Phillips, MD, PhD

As we try to predict health outcomes in survivors of childhood cancer, understanding how therapies affect neurologic and neurocognitive function is vital. My research within the Department Psychology and Biobehavioral Sciences uses imaging, biologic and behavioral data to generate a range of models that estimate how therapies may alter the neurologic and neurocognitive outcomes in survivors. In a collaborative effort, my colleagues and I collect data on the incidence of both common and unusual late effects in survivors and validate this information in large cohorts of survivors—St. Jude LIFE and the Childhood Cancer Survivor Study (CCSS). Our goal is to develop interventions that improve health outcomes. 

In our characterization research, we examine the physical performance of survivors, specifically in regard to how their health performance impacts their neurologic and neurocognitive outcomes. Although it is generally understood that physical exercise has a positive impact on mobility, cognition, and reduces the risk of dementia and chronic illnesses, it is important to explore how the benefits of exercise extend to cancer survivors. We investigate the potential benefit of exercise on cognition in survivors of acute lymphoblastic leukemia (ALL) and aim to expand this study to survivors of Hodgkin lymphoma and those who received therapy that targeted their cardiopulmonary system. 

Another area of our characterization research explores multiple aspects of the body’s response to chemotherapy and other treatments. We examine cerebral spinal fluid (CSF) biomarker and proteomic changes in response to chemotherapy and the impact chronic neuroinflammation has on children receiving cancer treatments. An interesting element of this research involves neuroimaging studies to show the connection between CSF biomarkers and the resultant changes to white or gray matter in the brain as observed via magnetic resonance imaging (MRI). 

In addition to this characterization work, we explore non-traditional interventions to improve the neurocognitive outcomes of long-term cancer survivors. Using evidence observed from our functional and structural connectivity research, we target regions of the brain that are maldeveloped because of cancer treatment and employ transcranial electrical stimulation to suppress overconnected parts of the brain’s network. 

Other intervention research involves the use of photobiomodulation, or light therapy, to transmit a near-infrared light to improve mitochondrial function in the cortex of the brain. 

All aspects of our work seek to advance our knowledge of how treatment affects neurological and neurocognitive outcomes, so we can develop interventions to improve overall quality of life for childhood cancer survivors.