Researchers in Focus: Dr Tejaswi Kandula

Dr Tejaswi Kandula is paediatric neurologist at Sydney Children’s Hospital, Randwick, with a special interest in researching peripheral neuropathy in childhood cancer survivors.

Dr Kandula recently published her fourth paper on the subject in the American Medical Association’s top-ranking neurology journal, JAMA Neurology, which generated worldwide interest and has been viewed more than 4000 times since its publication last month.

Now in the final year of her PhD at the School of Women’s and Children’s Health at UNSW Sydney, she has big plans to further her research long into the future.

“This is a really exciting time to be working in neurology.   So many discoveries are being made but there is still so much to be uncovered” she said.

Her most recent paper showcased the findings of a cross-sectional study exploring peripheral nerve injury and its impact in childhood cancer survivors treated with chemotherapy. 

Participants were recruited through the follow-up clinic at Kids Cancer Centre at Sydney Children’s Hospital, Randwick, with some participants still attending nearly 30 years after treatment.  These survivors provide unique insight into long-term side effects that can be studied to limit these in future generations.

To measure nerve function in the cohort, Dr Kandula and her colleagues used a combination of clinical, electrophysiological and functional tests as part of a comprehensive multimodal assessment. The unique assessment package provides more meaningful results than when using one standard alone.

The studies were conducted at the Department of Neurology at Sydney Children’s Hospital, Randwick, under the supervision of Dr Kandula’s PhD supervisor and expert in neurophysiology, Dr Michelle Farrar. Her other supervisor, Dr Susanna Park, specialises in assessing chemotherapy-induced neuropathy at the Brain and Mind Centre, University of Sydney.

Using these assessment techniques, the group showed that childhood cancer survivors had decreased nerve function which persisted later in life and could decrease physical function. 

In future studies, Dr Kandula aims to use age-appropriate assessment techniques as a way to monitor nerve function in children from the time of cancer diagnosis, throughout chemotherapy and in the years following treatment. 

One of these techniques involves nerve excitability studies, which provide sensitive and detailed information about nerve function through skin sensors.  Dr Kandula, Dr Farrar and neurology colleagues at Sydney Children’s Hospital, Randwick, are the only group in Australia to conduct these studies in children.

Dr Kandula hopes that the results will shine a light on the mechanism by which chemotherapy damages peripheral nerves, which is currently poorly understood.  Understanding the mechanism is crucially important to innovating solutions to predict, repair and prevent it, while maintaining the full effectiveness of the cancer treatment for these children.

Neurogenetics is another area of interest for Dr Kandula, which she has already seen directly benefit kids in her care. Emerging discoveries in this fast moving field mean that very sick children with epileptic encephalopathy will be able to be diagnosed and managed according to their diagnosis, which previously was not the case.

“In the coming years, we will be able to treat patients much more effectively than before, and that is thanks to research and the wealth of recent discoveries in neurology.”

Pictured (L to R): Dr Tejaswi Kandula with fellow research-active paediatric neurologists Dr Kerrie-Anne Chen and Dr Hooi Ling Teoh