Stay Up-to-date with the Oncology Section
The field of Oncology Rehabilitation is moving forward at an unprecedented pace. Check back frequently for the most up-to-date news and information from the Oncology Section.
CSM 2019 Call for Abstracts
The 18 specialty sections of the American Physical Therapy Association invite you to submit an abstract to present research at CSM 2019 – the leading conference and career-building event of the year. We are accepting abstracts for poster and platform presentations from every specialty, in the categories of research, special interest, case studies, and theory reports.
- Poster Presentations: Posted for discussion during an assigned 2-hour time slot.
- Platform Presentations: Oral presentations, assigned to a 5 – 15 minute time slot.
Opens: December 15, 2017
Deadline: June 15, 2018
For more information and to submit your proposal visit http://www.apta.org/CSM/submissions/
CSM 2019 Call for Proposals
The 18 specialty sections of the American Physical Therapy Association invite you to submit a proposal for CSM 2019 – the
leading conference and career-building event of the year. We are accepting proposals from every specialty. Plan to submit soon, proposal submissions will close March 21, 2018.
Proposal submission options:
- Two hour education sessions
- One or two-day preconference courses
Opens: December 15, 2017
Deadline: March 21, 2018
For more information and to submit your proposal visit http://www.apta.org/CSM/submissions
Oncology Section Introduces New Guideline on Diagnosis of Upper Quadrant Lymphedema in Patients With Cancer
While early recognition of upper quadrant lymphedema secondary to cancer can play a crucial role in maintaining quality of life for patients, few clinical practice guidelines (CPGs) exist to help clinicians diagnose the condition. The APTA Oncology Section set out to change that with the publication of “Diagnosis of Upper Quadrant Lymphedema Secondary to Cancer: Clinical Practice Guideline From the Oncology Section of the American Physical Therapy Association” in Physical Therapy (PTJ), APTA’s science journal. An executive summary of the CPG will be published in Rehabilitation Oncology’s July issue.
Authors Kimberly Levenhagen, PT, DPT; Claire Davies, PT, PhD; Marisa Perdomo, PT, DPT; Kathryn Ryans, PT, DPT; and Laura Gilchrist, PT, PhD, evaluated research on current diagnostic and assessment methods, including bioimpedence analysis, circumferential measurement, water displacement, perometry, and ultrasound imaging.
In a podcast summarizing the work group’s recommendations, coauthor Claire Davies reminds clinicians, “We need to be aware that none of the diagnostic criteria are perfect in their diagnostic accuracy, especially [in] patients that fall just under or over a cut point. These [patients] have the potential to be misclassified. Also, the clinical presentation of lymphedema should influence the selection of diagnostic tool, as some measures … are more accurate in the early stage.”
Physical therapists need to tailor the diagnostic approach to each patient. For example, Davies told PT in Motion News, “in some groups with early or subclinical lymphedema, volume measures may not be sensitive enough to diagnose and/or assess extracellular fluid. As tissue changes occur with later stage lymphedema, volume may be increased, yet measures of extracellular tissue fluid may not be as accurate due to fibrotic changes.”
Authors of the CPG “encourage clinicians to cluster findings from their examination,” using the most appropriate tests recommended for each of the clinical presentations, to draw a conclusion on diagnosis.
In her podcast, Davies ends “with a call for research.” Among their recommendations, authors of the CPG urge “further psychometric testing of the tools currently being used to assess and diagnose [secondary upper quadrant lymphedema].” They point out the need for research that examines diagnostic criteria at different stages of this condition. Further research should examine what “combination of history, symptoms, and other measurements” is “most accurate” for diagnosis, they state.
Research-related stories featured in PT in Motion News are intended to highlight a topic of interest only and do not constitute an endorsement by APTA. For synthesized research and evidence-based practice information, visit the association’s PTNow website.
Proposed Bylaw Amendments to Include Name Change
The Oncology Section is putting forth several bylaw amendments to include a name change:
The Academy of Oncologic Physical Therapy of the American Physical Therapy Association, Inc.
The vote will take place at the Oncology Section Business Meeting at CSM on Friday, February, 23, 2018 from 6:30 – 8:00 pm in the New Orleans Marriott.
Specialization Updates at CSM
Stop by the Section Booth for information about the Oncology Specialist Examination and learn about the timelines for applications and examination prep materials. Applications will open in Spring 2018 and we want you to be prepared. Members of the Oncology Specialty Council will be at the booth to answer your questions.
On Thursday, February 22, 2018, Strategies for the Oncologic Physical Therapist Certification Exam will be held from 3:00 to 5:00 pm (check the location onsite). The Specialty Council members will take you through everything you need to know about requirements, applications and materials to get ready for the exam.
The Specialty Council will be seeking volunteers to serve as reviewers for the Case Reflection portion of the exam application. More information will be available at the CSM booth.
Clinical Research Grant Application Deadline (May 1, 2018)
Purpose and Deadlines
One clinical research grant award of $5,000 is available to Oncology Section members to assist with a 1-year research study that investigates a question or questions of importance to adult or pediatric oncology physical therapy. The purpose of the award is to provide funding to assist primarily new physical therapists investigators and to encourage research that will add to the body of knowledge related to improvement of oncology physical therapy. This award can be given to support post-professional dissertation research or a clinical researcher who is working with colleagues who have a post-professional degree. Details regarding the specific required contents, format and review procedures of a proposal can be found on the attached sheets.
The DUE DATE FOR SUBMISSION IS MAY 1, 2018. Proposals must be emailed by the due date to be eligible for review. Download a copy of the guidelines.
Please contact Melissa Eden if you have any questions.
Ask Your Legislators to Follow Through on Repealing the Medicare Therapy Cap
In less than a month, if Congress does nothing, a hard Medicare therapy cap returns on Medicare beneficiaries. In 1997, Congress passed the Balanced Budget Act, which created an annual financial limit on physical therapy and speech-language pathology services, and a separate “cap” on occupational therapy, for all outpatient settings.
Ask Your Legislators to Follow Through on Repealing the Medicare Therapy Cap
In less than a month, if Congress does nothing, a hard Medicare therapy cap returns on Medicare beneficiaries. In 1997, Congress passed the Balanced Budget Act, which created an annual financial limit on physical therapy and speech-language pathology services, and a separate “cap” on occupational therapy, for all outpatient settings. Since 1997, Congress has acted 16 times to prevent implementation of the cap, including the 2006 creation of an exceptions process allowing patients to receive medically necessary services exceeding the annual cap amount. Historically, Congress has passed short-term extensions of the therapy cap exceptions process along with the sustainable growth rate (SGR) extension. In 2015 the therapy cap exceptions process received an extension through December 31, 2017.
Recently the Congressional Committees that handle healthcare agreed to a bipartisan, bicameral policy that would permanently repeal the hard cap on therapy services. This policy will protect patients, provide better care, and allow physical therapists to treat their patients at a higher level. If this is not passed, a hard cap on therapy services goes into effect on January 1, 2018. We need to get this across the finish line and must remind Congress of the importance of this issue. Without repealing the therapy cap, Medicare beneficiaries are at risk of not receiving the needed physical therapy services that our profession provides.
Ask the Tax Legislation Conference Committee to Preserve Student Loan Interest Deductions and Tax Exemptions for Tuition Assistance and Waivers
The House passed H.R. 1, the Tax Cuts and Jobs Act that include the repeal of the current Student Loan Interest Deduction and would convert tuition assistance and waivers to taxable status. The Senate does not have either provision in their version of the bill. However, the tax legislation conference committee has started, and there is a likelihood that both can be included in a final bill through negotiation; your representative has been chosen as a member of this committee.
As passed by the House, Section 1204 would repeal the current Student Loan Interest Deduction (SLID). Under current law, any individual with income up to $80,000 (or $160,000 on a joint return) repaying student loans can deduct up to $2,500 in student loan interest paid. Eliminating this provision would mean that the cost of student loans for borrowers would increase at a time when affordable college education is increasingly becoming out of reach for many Americans.
In addition, the House legislation would also convert tuition assistance and waivers to taxable status; subsection D of U.S. Tax Code section 117 states tuition reductions and waivers for graduate teaching and research assistants are tax exempt. Elimination of tuition reductions and waivers for graduate teaching and research assistantships would have a negative effect on the physical therapy profession, especially for those who are considering pursuing post-professional graduate degrees.
LOG INTO THE LEGISLATIVE ACTION CENTER AND TAKE ACTION!
Study Aims to Improve Breast Cancer Survivors’ Outcomes with Physical Therapy
By Yaman Shalabi
The journey to overcome breast cancer is a difficult one, and the road to full recovery can be taxing. The National Cancer Institute estimates over 250,000 new cases of breast cancer will be diagnosed in 2017 alone. Despite it being the most common form of cancer and having a relatively high survival rate, a patient’s quality of life is often compromised as a result of grueling treatments. This is where a physical therapist (PT) comes into play. Breast cancer survivors undergo various physical changes and debilitating side effects. These include fatigue, pain, musculoskeletal impairments, anatomical changes, chemotherapy induced peripheral neuropathy, cognitive changes, weight changes, and lymphedema. Such factors indicate the importance of including a PT on the health care team, which is why in late 2016, the Foundation for Physical Therapy awarded the first-ever $40,000 Moffat Geriatric Research Grant to a PT working to improve the lives of breast cancer survivors.
“Being the first to receive this prestigious award, established by and named for 1 of the most influential people in our field, is an honor that has truly humbled me,” says Ann Marie Flores, PT, PhD. “It comes at a time when our medical oncology colleagues begin to acknowledge cancer rehabilitation in a way that we have never seen before.”
In her study titled “Breast Cancer Impairment Knowledge Study,” Flores aims to compare health beliefs about breast cancer-related impairments and to demonstrate the role physical therapy plays to treat such impairments. “My goal is to translate population-based research into patient-centered, physical therapy based interventions that will improve physical and functional impairments, abilities, and self-efficacy for cancer survivors,” Flores says.
A recent 2016 study published in Cancer Epidemiology, Biomarkers & Prevention found that the percentage of breast cancer survivors age 65 years and older is expected to increase from 62% to 73% by 2040. Therefore, it becomes necessary to assess their needs beyond treatment and generate an interdisciplinary recovery plan.
“These results,” explains Flores, “point to the need to systematically examine beliefs of breast cancer survivors and oncology specialists about breast cancer-related impairments and the role of physical therapy in the treatment.”
While the implications of avoiding exercise in cancer survivors have been widely studied, Flores explains that “physical therapy and self-management of impairments remain absent.” Through her research of over 600 breast cancer survivors, she has found that about 80% reported having 1 or more related impairment and lacked pre-surgical self-management education. Her study also found that despite exhibiting extreme physical impairments, less than 20% of breast cancer survivors are referred to a physical therapist.
Flores explains that the combination of aging with persistent impairments and comorbidity make the people who are elderly more susceptible to the erosion of function and disability. This, she says, can only be prevented through early detection and prevention of impairments.
“I hope this project will help shed light on understanding the barriers to physical therapy utilization on the referring provider side. The Moffat grant will help unpack the reasons for this and provide important clues on how to overcome these barriers to care so our patients won’t have to spend their elderly years still dealing with cancer-related impairments.”
Flores is excited to be working on what she describes as the first study of its kind to be conducted among oncology specialists and breast cancer survivors that will use the health belief model to measure breast cancer-related impairments and the role of physical therapy in addressing them.
“I have devoted my career to the reduction of physical and functional impairments from chronic disease, particularly for those who bear the greatest burden of side effects,” says Flores. “My ultimate goal is to see my research findings translated into an intervention and referral model that includes physical therapy to improve the standard of treatment planning and management for breast cancer survivors.” She will follow through with this study by applying for an R01 grant from the National Institutes of Health.
Ann Marie Flores is an associate professor of physical therapy and human movement sciences and medical social sciences at Northwestern University’s Feinberg School of Medicine. She is the Director of the Cancer Rehabilitation Studies (CARES) Laboratory, and a full member of the Robert H. Lurie Comprehensive Cancer Center and the Cancer Survivorship Institute at Northwestern University.
This grant is made possible by the Marilyn Moffat Fund for Geriatric Research.
The Oncology Section, APTA has several course offerings looking for partners to host. The host facility will be chosen based on the guarantee that they can draw a minimum of 20 registrants.