Archive: CSM 2013: Oncology Programming

  • This is archived programming for CSM 2013. See current programming.

    Browse Oncology sessions by day. Return to the main topic menu 

    Monday, January 21 | Tuesday, January 22 | Wednesday, January 23 | Thursday, January 24 

    * Should you choose to preselect regular (not preconference) Tuesday-Thursday sessions during the registration process, please be advised that preselection is not a guarantee of a seat. Attendees are asked to preselect to better determine room size and all efforts will be made to accommodate sessions in the largest rooms possible. All attendees are encouraged to show up to sessions early. Attendees are also encouraged to select alternative sessions in the event their first choice is full. 

    Monday, January 21 (Preconference)

    Developing an Oncology Rehabilitation Program Through the Integration of Physical Therapy Intervention

    Location: Hilton Bayfront | Sapphire 410

    Time: 8:00 am - 5:30 pm

    Speakers: Nancy Roberge, PT, DPT, MEd; Linda Boyle, PT, DPT, OCS, CLT-LANA; Linda T. Miller, PT, DPT, CLT; Barb Nicholson, PT, MSPT, CLT-LANA

    Level: Beginner - Intermediate

    CEUs: 0.8 (8.0 contact hours/CCUs)

    Preconference Pricing: Standard (1A)

    The IOM (Institute of Medicine) defined a cancer survivor as being one who has been diagnosed with cancer, throughout treatment, into survivorship. The IOM's recommendation to the medical community was to define "survivorship" as a "distinct" phase of the oncology patient, from diagnosis onward. Cancer is now being treated as a chronic disease, and cancer treatment can be a grueling journey of surgery, chemotherapy, and radiation therapy—leaving patients with significant musculoskeletal (and other) issues, which can be successfully addressed by physical therapy intervention. Historically, MDs have only sent patients to physical therapy if they have a problem; we need to foster a paradigm shift where the physical therapist is there at the initial diagnosis of cancer. PTs should be part of the multidisciplinary team that works with the individual diagnosed with cancer. This preconference session will help those who have seen this need for a paradigm shift by providing a template for moving their oncology program forward.

    Upon completion of this course, you'll be able to:

    • Recognize the musculoskeletal, neurological, psychological, integumentary, and genitourinary (including pelvic floor) issues related to cancer treatment.
    • Develop an "action plan" template for forming an oncology rehabilitation program.
    • Appreciate the need for physical therapy intervention in the oncology patient to improve quality of life, from diagnosis to survivorship.
    • Describe how to both integrate the oncology rehabilitation program into existing facilities and market it successfully.

    Exercise Training Guidelines for Cancer Survivors: Endurance and Strength

    Location: Hilton Bayfront | Sapphire 411

    Time: 8:00 am - 5:30 pm

    Speakers: Steve Morris, PT, PhD, FACS; Alison T. DeLeo, PT, DPT, NREMT-B

    Level: Basic

    CEUs: 0.9 (9.0 contact hours/CCUs)

    Preconference Pricing: Standard (1A)

    Exercise reconditioning has become a widely utilized treatment intervention for treating the oncology survivor. However, these survivors present with unique needs, comorbiditites, and impairments. The purpose of this course is to teach the attendees how to apply currently existing knowledge of exercise and fitness training to the unique needs of the oncology patient.

    Upon completion of this course, you'll be able to:

    • Describe the basic constructs of exercise physiology and oncology.
    • Write an exercise prescription for a cancer survivor.
    • Recognize the safety issues connected with exercising cancer survivors.
    • Identify helpful clinically useful methods of exercise testing and outcome assessments.

    Tuesday, January 22

    Design and Implementation of a Hospital-based Oncology Rehabilitation and Survivorship Program

    Time: 8:00 am–10:00 am (See Program for Room)

    Speakers: Reyna Colombo, PT, MA; Deborah J. Doherty, PT, PhD

    Level: Intermediate

    This intermediate-level course is designed to prepare participants to successfully develop a comprehensive oncology rehabilitation and survivorship program (CORSP). The presentation will focus on the 3 tenets of a successful CORSP: (1) efficient management and administration, (2) rehabilitation team members with advanced specialty training and education, and (3) informed stakeholders for appropriate and timely referrals. Strategies and discussions will cover methods for ensuring sound business practices, meeting the demands of the population served, and aligning institutional missions with insurance requirements and governmental regulations. Participants will be provided with tools to begin implementation of the various aspects of a CORSP in their facility.

    Upon completion of this course, you'll be able to:

    • Explain and critique the components of a comprehensive oncology rehabilitation and survivorship program (CORSP) that include the team members, the settings, and the stakeholders.
    • Evaluate the challenges and barriers for developing a CORSP related to administrative initiatives, space, hospital mission, staffing, funding, patient diversity, patient payment, and economic issues secondary to insurance and governmental regulations.
    • Discuss unique opportunities that can be incorporated into your existing oncology rehabilitation program.
    • Describe and discuss metrics essential for sustainability of a CORSP in the participants existing program.
    • Compare and contrast the differences between program development in a large corporate hospital system versus a small suburban hospital system.

    An Evidence-based Approach to Strength Training in Breast Cancer Survivors

    Joint Program: Orthopaedics

    Time: 8:00 am–10:00 am (See Program for Room)

    Speakers: Andrea R. Branas, PT, MPT, MSE, CLT; Joy Cohn, PT, CLT-LANA; Kathryn Schmitz, PhD, MPH, FACSM

    Level: Intermediate

    In order to provide the best care for patients, it is important for physical therapists to understand the current evidence in exercise for breast cancer survivors. Therapists must be able to translate that evidence into a clinical program applicable to each individual patient in their office. Common concerns surround lymphedema, use of compression garments, osteoporosis, cancer-related fatigue, and patients on active treatment. We will address the evidence and programmatic issues surrounding these concerns. For many years, health care providers cautioned breast cancer survivors to avoid exercise, for fear of developing lymphedema. The Physical Activity and Lymphedema (PAL) trial made a valuable clinical contribution to the collective knowledge by demonstrating the safety and effectiveness of a weight-training intervention in breast cancer survivors with and at risk for lymphedema. A physical therapy-based strength-training program for breast cancer survivors was created based on the results of this trial. Translating the PAL research into clinical practice has been a lesson in organizational dynamics, health care policy, planning, and implementation.

    Upon completion of this course, you'll be able to:

    • Describe the current evidence for strength training in breast cancer survivors.
    • Make evidence-based recommendations on the exercise guidelines for the following special situations: lymphedema, use of compression garments while exercising, fatigue, and bone loss.
    • Evaluate the strengths and limitations of a physical therapist-led strength-training program for breast cancer survivors.
    • Design and implement an evidence-based exercise program for breast cancer survivors.
    • Identify key players in their health care community who should be involved in creating a strength-training program.

    A Prospective Surveillance Model for Rehabilitation for Women With Breast Cancer: An Emerging, Evidence-based Standard of Care

    Joint Program: Women's Health

    Time: 11:00 am–1:00 pm (See Program for Room)

    Speakers: Nicole Stout, PT, MPT; Jill Binkley, PT, OCS

    Level: Multiple Level

    The current model of care for individuals with breast cancer focuses on treatment of the disease, followed by ongoing surveillance to detect recurrence. This approach lacks attention to patients' physical and functional well-being. Patients experience common impairments including pain, fatigue, upper-extremity dysfunction, lymphedema, weakness, joint arthralgia, neuropathy, weight gain, cardiovascular effects, and osteoporosis. Published evidence confirms that even when these impairments lead to functional limitation, rehabilitation referral is lacking. Evidence supports that a prospective surveillance model (PSM) for early identification and treatment of physical impairments may prevent or mitigate many of these functional concerns. The PSM identifies time points during breast cancer care for assessment of and education about physical impairments. The model seeks to optimize function during and following treatment and positively influence a growing survivorship community. This system could also provide a venue for patient activation towards exercise and other health promoting activities. Ultimately, implementation of the model may influence incidence and severity of breast cancer treatment-related physical impairments.

    This presentation will provide an overview of the PSM for physical rehabilitation and exercise. The goals of the model are to promote surveillance for common breast cancer-related physical impairments and functional limitations, to provide education to facilitate early identification of impairments, to introduce rehabilitation and exercise intervention when physical impairments are identified, and to promote and support physical activity and exercise behaviors through the trajectory of disease treatment and survivorship. The PSM is ultimately coordinated with disease treatment from diagnosis through follow-up to create a more comprehensive approach to survivorship care.

    Upon completion of this course, you'll be able to:

    • Implement the prospective surveillance model of care.
    • Identify the evidence for specific tests and measures used in the model for detection of impairment and functional issues.
    • Identify specific time points during and after treatment when patients should interface with the physical therapist for examination and reexamination.
    • Recognize the common impairments associated with breast cancer treatment and identify when rehabilitation intervention is warranted.

    Why Is Cancer Such a Pain?

    Time: 11:00 am–1:00 pm (See Program for Room)

    Speakers: Shana Harrington, PT, PhD, SCS, MTC; Kathleen Sluka, PT, PhD; Meryl Alappattu, PT, DPT

    Level: Basic

    The rehabilitation of individuals with cancer both during and after cancer treatments is a growing specialty practice area of physical therapy. To provide the highest quality of care to individuals with cancer, physical therapists must be able to recognize, assess, and manage one of the most common symptoms of cancer and its related treatments: cancer pain. The prevalence of chronic pain is estimated at over 75% in patients with cancer, yet approximately 43% of these patients fail to receive appropriate care for their pain. The purpose of this education session is to provide an overview of cancer pain and provide the physical therapist clinician with the tools to appropriate assess, evaluate, and managed the pain experienced by individuals with cancer. The speakers will review the neurobiology of cancer pain, including the role of peripheral and central sensitization. This session will also evaluate appropriate clinical pain assessment tools for individuals with cancer and provide recommendations of specific physical therapy interventions for individuals with cancer.

    Upon completion of this course, you'll be able to:

    • Describe the neurobiology of pain.
    • Compare and contrast musculoskeletal and cancer pain.
    • Discuss the relationship between cancer pain, fatigue, and pain-related psychosocial factors.
    • Review assessment tools for cancer pain from a physical therapy perspective.
    • Evaluate evidence-based treatment options utilizing physical therapy for cancer pain.

    Balance Screenings for Cancer Survivors: Development and Progress of an Onsite Program

    Joint Program: Neurology

    Time: 3:00 pm–5:00 pm (See Program for Room)

    Speakers: Elizabeth S. Hile, PT, PhD, NCS; Kathleen Brandfass, PT, MS; Hallie Zeleznik, PT, NCS

    Level: Multiple Level

    This course will describe the development and current progress of a balance screening program for cancer survivors led by neurologic physical therapists on site in an outpatient medical oncology clinic. Topics will include: an evidence-based overview of balance impairment across the spectrum of cancer survivorship, with emphasis on the multifactorial nature of the problem; identification of specific cancer treatments known to disrupt postural control; and common co-occurring conditions that heighten concern for fall-related injury; all in the context of current literature supporting increased risk for fall and fracture in cancer survivors. Consideration will be given to the potential advantages of applying a prospective surveillance model to the management of balance concerns in this population. Also included will be a discussion of barriers and facilitators to the integration of neurologic PT services into a medical oncology setting and a description of balance screening measures used, including discussion of selection considerations during program development, and a review of psychometric properties and protocols. Two clinical cases will be presented to demonstrate interpretation of specific screening results with discussion of how these results can be used to direct further physical therapy intervention. Emphasis will be placed on audience participation with solicitation of questions or feedback on both the screening program and the sample cases. Attendees will have the opportunity to seek guidance on management of their own clinical case examples.

    Upon completion of this course, you'll be able to:

    • Discuss the multifactorial nature of balance impairments in cancer survivors and reasons behind a heightened concern for falls (and injury in the event of a fall).
    • Recognize specific cancer treatments known to interfere with postural control.
    • Recognize the potential for a prospective surveillance model to improve the management of balance concerns starting at the point of cancer diagnosis.
    • Identify potential barriers and facilitators to establishing a balance screening program in your own affiliated cancer center.
    • Select appropriate self-report and performance-based screening tools for balance impairment and/or decline in cancer survivors.
    • Describe how to use balance screening results to direct further physical therapy intervention in this population with unique considerations.

    Wellness Coaching: How Well Do We Define Sustainability in Clinical Practice for the Patient and Physical Therapist?

    Time: 3:00 pm–5:00 pm (See Program for Room)

    Speakers: Mary Lou Galantino, PT, PhD, MSCE

    Level: Intermediate

    This course is intended for the therapist who wishes to re-evaluate clinical examination, management, and long-term follow-up for patients with chronic disease management. Differential diagnosis and underscoring the psychological aspect of this group is a key feature of small-group discussions. This session will use various clinical cases and identify specific screening tools and surveys to determine life stressors and psychological considerations that impact physical well-being from the point of diagnosis, through treatment and various episodes of care. Evidence for the use of wellness coaches will be accompanied by case studies. Clinicians are encouraged to bring various caseload experiences for discussion. The speaker will engage attendees in an interactive dialogue and explore therapist self-care as the underpinning to managing individuals with chronic disease across the lifespan.

    Upon completion of this course, you'll be able to:

    • Recognize the impact of Healthy People 2020 on populations treated and our health care profession.
    • Define principles of wellness coaching and the scope of practice for rehabilitation specialists.
    • Use various strategies to increase self-efficacy and sustainability with SMART goals established in partnership with patients.
    • Appreciate the evidence for the integration of wellness coaching in rehabilitation for chronic diseases.

    Wednesday, January 23

    Oncology Section EDGE Task Force on Breast Cancer Outcomes: Clinical Measures of Pain, Fatigue, and Lymphedema in Individuals Treated for Breast Cancer

    Joint Program: Research

    Time: 8:00 am–10:00 am (See Program for Room)

    Speakers: Laura Gilchrist, PT, PhD; Marisa Perdomo, PT, DPT; Kathryn A. Ryans, PT, DPT; Shanna Harrington, PT, PhD, SCS, MTC; Deborah J. Doherty, PT, PhD

    Level: Intermediate

    As an outgrowth of the EDGE (Evaluation Database to Guide Effectiveness) Task Force of the Section on Research, the Oncology Section formed a task force to examine and categorize the utility of available clinical tests and measures to identify possible deficits (or assess changes) in body structure, activities, or participation in individuals treated for breast cancer. In this presentation the evidence for outcomes of pain, fatigue, and lymphedema will be reported. Measurement characteristics including psychometric properties as well as limitations as reported in the literature will be discussed. At the end of the session, you will identify which outcomes in these domains are recommended as a routine part of an examination for a patient treated for breast cancer.

    Upon completion of this course, you'll be able to:

    • Describe the most common impairments of body structure and activity limitations in individuals treated for breast cancer.
    • Identify selected assessment techniques and outcome measures that can be used appropriately for individuals with pain, fatigue, and lymphedema following treatment for breast cancer.
    • Recognize the role of consistency in outcome measures to monitor patient status and demonstrate intervention effectiveness in individual and patient groups.
    • Discuss the relative merits of presented outcome tools based on psychometric properties and limitations.

    Physical Therapy Across the Continuum of Care in Pediatric Oncology

    Joint Program: Pediatrics

    Time: 8:00 am–10:00 am (See Program for Room)

    Speakers: Denise Cortes, PT, MBA; Megan L. Freeland, PT, DPT

    Level: Intermediate

    According to the National Cancer Institute, the overall survival rate of children with cancer is nearly 80%. Physical therapists play a vital role in improving function and quality of life for children and young adults throughout the continuum of cancer care. From diagnosis to survivorship and palliative care, physical therapists are an integral part of the multidisciplinary team. Through case presentations and discussion of the current literature in pediatric oncology rehabilitation, participants will gain practical knowledge that can be readily applied to clinical practice at any stage of cancer treatment.

    Upon completion of this course, you'll be able to:

    • Describe the role of physical therapy during all stages of treatment for pediatric hematologic cancers.
    • Identify standardized assessment tools used in the physical therapy management of pediatric cancer patients.
    • Implement at least 2 physical therapy interventions during each stage of pediatric hematological cancer treatment.

    Impairments Associated With Pediatric Brain Tumors and Implications for Physical Therapy

    Time: 11:00 am–1:00 pm (See Program for Room)

    Level: Multiple Level

    This is a joint program. See full description at Neurology programming.

    Physical Therapy Considerations for the Patient Post Prostatectomy

    Time: 11:00 am–1:00 pm (See Program for Room)

    Level: Intermediate

    This is a joint program. See full description at Women's Health programming.

    Palliative Care Physical Therapy: Improving Quality of Life at the End of Life

    Joint Program: Home Health

    Time: 3:00 pm–5:00 pm (See Program for Room)

    Speakers: Daniel W. Ovitt, PT, MS, MHA; Heidi J. Engel, PT, DPT

    Level: Basic

    The physical therapist often is not recognized as a valuable member of the palliative care team in the acute care setting. This session, then, will emphasize the importance of providing palliative care physical therapy when treating patients throughout the continuum of care for chronic disease management. The presenters will outline a contextual approach you can use in providing palliative care rehabilitation to help you determine the fine balance between intervening and stepping back. They will describe the essential aspects of palliative care rehabilitation intervention and the impact of palliative care rehabilitation on overall health and quality of life.

    Upon completion of this course, you'll be able to:

    • Explain the importance of providing palliative care rehabilitation in the acute care setting.
    • Reinforce and define the role of the physical therapist in providing palliative care rehabilitation in the acute care setting.
    • Outline a contextual approach to providing palliative care rehabilitation in the acute care setting.
    • Describe several possible palliative interventions in the acute care setting that physical therapists can provide to patients to improve their overall health and quality of life.

    Thursday, January 24

    Red Flags of Lymphedema

    Joint Program: Hand Rehabilitation

    Time: 8:00 am–10:00 am (See Program for Room)

    Speakers: Rebecca Golden, PT, DPT; Joy Cohn, PT, CLT-LANA; Jenna Fried, PT, DPT

    Level: Intermediate

    Lymphedema is a common misdiagnosis for patients presenting with various other forms of edema. Nearly 12 million people with a history of cancer were alive as of January 2008, and nearly 1.7 million new cases will be diagnosed this year. Lymphedema and edema also may be the first sign of an undiagnosed new cancer, a reoccurrence, or another undiagnosed medical condition. Very often in the clinic, patients are referred by physicians who conclude the diagnosis of lymphedema without extensive testing or examination, even in light of a history of cancer. In the age of direct access, it is increasingly important that physical therapists are able to differentiate between treatable lymphedema and those edemas that are suspicious in nature. It also is important that PTs have the ability to discuss and educate the referring and involved health care providers about the many presentations of malignant lymphedema.

    Upon completion of this course, you'll be able to:

    • Discuss multiple causes and presentations of various forms of edema commonly mistaken for lymphedema, including case presentations.
    • Discuss various tests required to properly rule out malignant lymphedema.
    • Discuss strategies for educating referring physicians and other health care providers.

    Patient-Centered Care: Bringing Quality Toward End of Life

    Time: 8:00 am–10:00 am (See Program for Room)

    Level: Multiple Level

    This is a joint program. See full description at Home Health programming.

    Significant Findings From the Recent Oncology Rehabilitation and the Importance of Case Studies in Generating Such Studies

    Time: 11:00 am–1:00 pm (See Program for Room)

    Speakers: Margaret E. Rinehart Ayres, PT, PhD; Julie A. Hobbs, PT, DPT, PhD, CHES; Kristen Ness, PT, PhD; Cindy Pfalzer, PT, PhD; Anne Marie Flores, PT, PhD, CLT

    Level: Basic

    In each of our busy worlds, keeping up with the expanding literature in oncology rehabilitation is an important responsibility but can be challenging if not overwhelming. This problem is further exacerbated by the need to recognize which literature is most significant. Clinicians often turn to experts in the field to provide them with insight into the literature. As such, the first hour portion of the course will be taught by 2 highly respected, nationally funded, and well published members of the oncology Section (Ness and Pfalzer). At the same time, insights gleaned from clinicians treating unique and challenging patients are equally valuable contributions to the literature and are presented in the form of case studies. Such publications often lay the groundwork for a larger clinical study. With this in mind, the second purpose of this presentation is to share information about how to write a case report using PTJ guidelines. This section of the course will be taught by a published clinician (Hobbs and a member of the editorial board for Oncology Rehabilitation [Rinehart Ayres]).

    Upon completion of this course, you'll be able to:

    • Identify high quality manuscripts of clinical significance from the recent oncology literature.
    • Describe the key components of each of the selected manuscripts.
    • Understand why and how these manuscripts make a significant contribution to the field of Rehabilitation Oncology.
    • Describe the importance of writing and publishing case reports.
    • List the required components of a case report.
    • Understand how writing a case report can enhance clinical reasoning and practice.
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