cancer rehabilitation: what is it and how can it help your
TRANSCRIPT
Cancer Rehabilitation: What Is It and How Can It Help Your PatientsAudrey Stockwell, PT, DPT, OCS, CLTDirector of Cancer Rehabilitation-KORT Physical TherapyReVital-Certified Oncology Rehab SpecialistCertified Lymphedema Specialist
Business Development
• Decrease function and quality of life
• Hinder compliance
• Ripple affect on general health
• Increase cost of cancer
Less than 2% of cancer patients’
physical impairments are treated*
*With the exception of lymphedema
Cheville AL, Troxel AB, Basford JR, KornblithAB. Prevalence and treatment patterns of physical impairments in patients with metastatic breast cancer. Journal of Clinical Oncology. 2008;26:2621-2629.
NEW NORMAL
THE CANCER
CARE TEAMPhysicians
providing oncology
care
Rehabilitation
clinicians
Clinicians providing
psychological
support and
spiritual workers
Palliative care
clinicians (including
hospice at end-of-
life)
Pharmacists
Physician
Assistants
Patient – clinician
interactions
Nurses
PATIENTS
Institute of Medicine’s 2013 report, ‘Delivering High-
Quality Cancer Care: Charting a New Course for a
System in Crisis’
CANCER REHABILITATION
Improves quality of life
GOALS FOR CANCER
REHABILITATION
Achieve maximal possible physical, social,
psychological and vocational functioning
1
GOALS FOR CANCER
REHABILITATION
Achieve maximal possible physical, social,
psychological and vocational functioning
1
CANCER REHABILITATION
Decreases the burden placed
on oncology teams
GOALS FOR CANCER
REHABILITATION
Help oncology teams maintain focus on
saving lives
2.
Save time by reducing call backs
• “Patients who have started with therapy have felt
much more confident going into surgery,
understanding what to expect and have tools to
handle what may come their way.”Dr. Novasad (Colorectal Surgeon)
GOALS FOR CANCER
REHABILITATION
Help oncology teams maintain focus on
saving lives
2.
Improve outcomes by improving compliance
• “The first visit with a ReVital therapist both educates
and empowers the patients prior to surgery. Patients
come away with hope and empowerment. The ReVital
program is an important part of the net of support that
we put around patients being treated for breast
cancer.” C. Reidey Nurse Navigator
GOALS FOR CANCER
REHABILITATION
Help oncology teams maintain focus on
saving lives
2.
Save money by reducing ED visits
• Therapy center in Fort Worth:
• 87 evaluations from December – April
• No admits to hospital
• 1 confirmed fall that went to ER
• 100% treatment compliance
ACHIEVE YOUR
PRACTICE GOALS
Adult Cancer Pain Cancer-Related
Fatigue
Survivorship
Eligibility Requirement 11 - Rehabilitation Services
Policies and procedures are in
place to ensure patient access to
rehabilitation services either on-
site or by referral
Lymphedema program, Pain
management, Physical
impairments and disabilities
EFFECTIVENESS
“early detection…and timely referral to rehabilitation services is important...to learn compensatory strategies that preserve function and prevent disability and falls. ”
“Cancer rehabilitation can significantly
improve physical and psychological
health outcomes in survivors as well as
reduce direct and indirect health care
costs”
Julie K. Silver, MD; Jennifer Baima, MD; R. Samuel Mayer, MD, “Impairment-Driven Cancer Rehabilitation: An Essential
Component of Quality Care and Survivorship”, CA A Cancer Journal for Clinicians, volume 63, no. 5, September/October 2013
EFFECTIVENESS
DEFINING THE NEW NORM FOR
THE PATIENT WITH CANCER
PrehabAcute Cancer
CareCancer
Rehabilitation
Exercise Class or Other
Fitness Options
NOT
Acute Cancer Care
Exercise Class or Other Fitness
OptionsNothing
WHAT CONSTITUTES A
QUALITY CANCER
REHABILITATON
PROGRAM?
COMPREHENSIVE SERVICES
Impairments we treat:
Physical
therapy Physical therapyOccupational
therapy Physical therapyLymphedema
therapy Physical therapy
• Cancer related fatigue
• Pain
• Neuropathy
• Range of motion issues
• Lymphedema
Neuro
psychology
• Pelvic floor dysfunction
• ADL impairments
• Balance dysfunction
• Mild cognitive impairments
Pelvic Floor
Therapy
Speech
Therapy
PAIN
SHOULDER DYSFUNCTION
ARTHRALGIAS
PLEXOPATHY
BALANCE DYSFUNCTION
PERIPHERAL NEUROPATHY
GAIT DYSFUNCTION
ADL IMPAIRMENT
MILD COGNITIVE IMPAIRMENT
FATIGUE
INCONTINENCE
SEXUAL DYSFUNCTION
DYSPHAGIA/ DYSARTHIA
TRISMUS
Education Quality Protocol
Continuing Education Requirement
SETTING INDUSTRY
STANDARDS FOR QUALITY
Certification Program
Specialist Physical therapyAdvanced
SpecialistPhysical therapyEducator
SIMPLICITY
1. Screen 2. Refer
• When is the best time to refer for cancer
rehab?
• Who would benefit from cancer rehab?
• What is cost?
• How many appointments does it take?
• How does the process work?
Questions….THANK YOU!Contact info:Audrey [email protected]