What is oncology physical therapy?

In some ways, it’s very similar to other physical therapy, but there are some unique problems that many cancer patients experience related to the disease, and we help with that. Treatment fatigue is a huge problem for 90% of patients going through chemotherapy and radiation therapy. We run an exercise program to specifically address the fatigue. And there’s a whole host of other side effects we help with that are common for patients being treated for cancer—­like lymphedema [the buildup of fluid in soft tissue], pelvic floor dysfunction, nerve injuries, radiation side effects, like fibrosis [tissue scarring], and effects of hormonal treatments for different types of cancer.

How does physical therapy help with fatigue?

Lots of good research indicates that the best nondrug intervention for cancer-related fatigue is moderate-intensity exercise. So we teach people how to do moderate-intensity cardiovascular fitness training as well as strength training and flexibility work. Studies indicate that people doing this tolerate treatment better. Exercise is helpful, but it also needs to be dosed properly, so there’s some instruction for patients. The biggest thing that patients give us feedback on is the personal connection. People really appreciate being in the gym with other cancer patients.

How can people with cancer know whether they could benefit from physical therapy?

Close to 70% of people who go through cancer treatment have some type of functional deficit that would be amenable to therapy. If they’re having fatigue, weakness, pain issues—any of these really common side effects of cancer treatment—they can ask their physician to refer them to a physical therapist, even if they’re not in a region with an oncology-specific practice like mine. There are lots of therapists out there who treat cancer patients for things like lymphedema, pelvic floor problems and general fatigue and deconditioning. Even patients with very advanced cancers can get stronger and improve their quality of life and function. Even though they may have, in some cases, a non-treatable cancer, I can still help them. A huge part of the process is figuring out what’s important to them and working toward that.

What inspires you in your work?

My oncology patients are amazing. They’re some of the most motivated people. I can make a really significant impact on quality of life and function for people whose cancer is treatable. But I also have particular interest in patients with advanced cancers and those receiving end-of-life care because I’ve also been able to make a significant difference for them. I’ve had people in my gym working out two or three weeks before they’ve passed away because they like coming in. I’ve been surprised over and over again by patients who are at the end of life and can come in and work out and feel better.