Nurse Scientist Collaborating to Combat Confounding Cancer Complications

Mei Fu is teaming up with faculty and students on her groundbreaking lymphedema research

When nursing researcher Mei Fu, Ph.D., uses the Human Motion Lab at the UMKC School of Science and Engineering, the small room can get pretty tight with the impressive research team she has put together. As the associate dean for research and an endowed professor in the UMKC School of Nursing and Health Studies, Fu leads a group of six faculty and students from the School of Science and Engineering in her groundbreaking research into cancer pain, also known as lymphedema.

On a typical day for Fu in the motion lab, she performs a series of exercises so a research participant can mimic her movement while two students from the School of Science and Engineering use a cell phone to record the participant. Behind the scenes, Greg King, associate professor in mechanical engineering, makes sure the motion capture system gets all the data Fu is looking for. The research participants wear a special jacket with reflective markers placed on different body landmarks. The lab uses technology often seen in behind-the-scenes footage of movie or video game production, where actors are moving in front of green screens.

According to King, the lab analyzes the movement of the exercises as well as the corresponding electromyography, known as EMG, data, which measures muscle function. The collaboration with Fu is fulfilling for King.

"It's always fun for me to work with researchers from other disciplines," King said. "It broadens my horizons and is the most rewarding part of my work."

Fu has spent the past two decades studying lymphedema and trying to find answers for hundreds of millions of people worldwide suffering from lymphedema and lymphatic diseases, painful swelling caused by a buildup of fluid in the body.

Her passion for this research began when she was an oncology nurse in 1998 at the Ellis Fischel Cancer Center in Columbia, Missouri. She would celebrate with her patients when they received the good news that they were cancer-free. But when it came to breast cancer patients suffering from lymphedema doctors had little advice to offer.

"The oncologist would say to these women, 'Remember, you survived cancer, you should be grateful,'" Fu said. "After the doctor would leave, my patient would say, 'Mei, I wish there was something that could help with the pain I'm in.'"

Lymphedema can occur anywhere in the body, but it most commonly affects arms and legs. The lymph fluid that causes swelling is part of the lymph system, which helps the body's ability to fight infection and disease. Cancer or cancer treatment can disrupt the flow of lymph fluid and cause lymphedema, which in addition to pain, can cause chest tightness, impaired range of motion and long-term complications such as discoloration and hardening of the skin.

In addition to King, Fu is also working Science and Engineering faculty Bowen Liu and Yugyung Lee, Ph.D. Liu as well as doctoral student Ahmed Alanazi and master's student Abhinav Kochar. It's an interdisciplinary collaboration that involves researchers from nursing science, computer science, engineering and statistics.

"It's a huge team of people," King said. "Now that we've got it running pretty smoothly, it's fun."

Fu came to UMKC from Rutgers University in 2023, where she was a professor and the senior associate dean of research in its nursing school. It's that wealth of knowledge and experience that excites UMKC Nursing and Health Studies Dean Joy Roberts, J.D., RN, FNP-BC. Roberts said the school has seen an uptick in research activity since Fu joined the faculty at UMKC.

"Since Dr. Fu's arrival, our faculty research and grant writing has increased dramatically," Roberts said. "She encourages and inspires all nurses to delve into research for the betterment of science and our profession. We are very lucky to have her at UMKC."

According to Fu, her time at UMKC has enabled her to establish a strong team that is helping her extend and enhance her research. Fu is now focusing that research on building a multi-modal, artificial intelligence (AI)-assisted training tool that enables patients to learn the exercises that are part of the intervention.

Fu's research is narrowing in on a standard of care that optimizes symptom management. Through her research, she's developed an innovative intervention called The Optimal Lymph Flow, which focuses on activating the lymphatic system to promote lymph flow. The program emphasizes three components: deep breathing, exercises that provide muscle contraction and eating a healthy diet in combination with quality sleep.

The optimal blood flow exercises came from her Ph.D. dissertation study in 2003 at the University of Missouri, where she interviewed patients to find out what interventions helped provide them with some relief from the condition. Since then, she's performed six clinical trials that have shown the efficacy of The Optimal Lymph Flow intervention.

Being a participant in Mei's research has been incredibly meaningful for Jeannine Midgett, a National Board-Certified Health and Wellness Coach (NBC-HWC). In 2013, she had a bilateral mastectomy and reconstruction in 2014. Throughout that time, Midgett dealt with a lot of healing and a lot of pain. Now 10 years cancer free, she is still dealing with the pain from lymphedema. That is why being a participant in Fu's research is so important to her.

"Being involved with this study means that I bring value," Midgett said. "When you're in pain, you have absolutely no control and you're very reactive. It's so important to be able to participate and have my voice heard, that there is someone like Mei trying to understand my pain while also offering some kind of change."

For computer scientist Lee, who is helping with the AI aspects of the training tool, the collaboration has broadened her research abilities.

"Collaborating with Mei has allowed us to push the boundaries of research and create technologies that have the potential to transform patient care," Lee said. "It is exciting to see how these efforts bring together multiple disciplines to develop intelligent, impactful and accessible solutions."

The AI assistant will walk patients through the recommended exercises. To gather data for the AI functionality, Fu recruits participants, both individuals with lymphedema as well as healthy adults, and guides them through the exercises while they wear sensors that provide data for her team to utilize in creating the training tool.

Liu is providing his expertise in statistical analysis to help analyze the data coming out of the motion lab. He will lead the statistical analysis of participant data. Once the app is in a prototype stage, he will also lead the feasibility and usability of it, under Fu's guidance. Beyond that, he will oversee the clinical trial to determine the effectiveness of the system.

"Working with a renowned healthcare researcher like Mei has been an incredible experience," Liu said. "This project is deeply meaningful to me, especially as I think about my grandfather's struggle with cancer. I am truly grateful for the chance to contribute to research that aims to develop interventions that not only alleviate pain and discomfort for cancer patients but also extend their lives."