Oncology Rehabilitation: An Untapped Market for Physical Therapists

Over the past three decades, the physical therapy community has grown to include ten board-certified clinical specialties, each of which provides therapists with an opportunity to further their skills, advance their knowledge, and grow their careers. Of these specialties, one in particular has gained steady traction ever since the American Board of Physical Therapy Specialties (ABPTS) approved its board certification in 2016: oncology physical therapy.

To learn more about this field, I spoke with Chris Wilson, PT, DPT, DScPT. In addition to being board-certified in geriatric physical therapy, Chris:

• holds a graduate certificate in oncology rehab from Oakland University (where he is also an assistant professor);
• is the Residency Director for the Beaumont Oncology Residency (the first accredited program of its kind in the US); and
• currently serves as the vice president of the Academy of Oncologic Physical Therapy (formerly the Oncology Section) of the American Physical Therapy Association. 

In this blog post, Wilson lends insight on the direct impact cancer wellness and exercise can have on the recovery and survivorship of cancer patients, as well as the opportunity this growing—albeit largely untapped—market presents to physical therapists from both a business and career perspective. 

Oncology Rehabilitation at a Glance

Cancer is incredibly hard on the body, and treatments like radiation and chemotherapy only exacerbate the trauma this illness invokes. To this end, oncology physical therapy focuses on mitigating pain, restoring strength, increasing endurance, regaining and improving overall function, and restoring normalcy to the lives of patients—during or after cancer treatment. 

To do this, therapists develop individualized cancer wellness and exercise programs aimed to reduce the severity of the effects of a patient’s specific cancer and cancer treatment. As such, oncology physical therapists are an integral part of each patient’s interdisciplinary team. They focus on understanding the minutiae of how the cancer and its subsequent treatments are impacting the patient’s physical, mental, and emotional health.

“Oncology physical therapy is in many ways a specialty composed of different specialties,” said Wilson. “It extends across the entire patient spectrum and body; therefore, care plans vary depending upon the type of cancer each patient has, their age, the cancer treatment they’re prescribed, their symptoms, and their general health.”

What’s neat about this specialty is that beyond getting to work with a unique population in a fulfilling way, oncology PTs can also niche down even further by choosing to work with specific populations like children or older adults. 

A Growing Demand in an Underleveraged Field

Currently, there are only 105 certified oncology physical therapists—which isn’t all that surprising considering the first oncology specialist certification examination was administered in 2019. However, with life-extending treatment options and other advancements in the cancer world, surviving cancer has become more and more common. Thus, there has been an increased demand for rehabilitative care.

This demand is compounded by the growing body of evidence demonstrating the impact of exercise and physical rehab in supporting cancer survivorship. Research shows that this type of treatment:

• mitigates physical and mental side effects of cancer and cancer treatment;
• strengthens cardiovascular, metabolic, and immune function;
• restores proinflammatory and anti-inflammatory homeostasis, which is especially critical after undergoing radiation;
• reduces healthcare costs for providers and patients alike; and
• improves overall quality of life.

Furthermore, there is compelling data indicating that physical activity can help lower the incidence of breast cancer and colorectal cancer. This supports many physical therapists’ mission to establish their services as a pro-health preventive measure in the eyes of the greater healthcare community.

“It’s critical that our profession move beyond our focus as interventionists and advocate for our role as preventionists,” Wilson explained. “This is especially true for oncology physical therapists. Some of the patients we see will need rehab therapy for life after surviving cancer. So, if we can begin prehabilitation with them as soon as they’re diagnosed, we can help build their bodies up to better withstand cancer treatment and optimize their quality of life. It falls to us to effectively use outcomes data to show payers and other healthcare stakeholders what will happen if our services are given to these patients.”

The Path to Becoming an Oncology Physical Therapist

So, how does one become an oncology PT? As with any specialty, there are some standard requirements, including:

• holding a currently valid, permanent and unrestricted license to practice physical therapy in the US (or any of its possessions or territories); 
• paying an application and review fee and meeting the minimum eligibility requirements by the application deadline; 
• submitting an application and review fee for each specialist certification exam you plan to take; and 
• taking (and passing) said certification exam for the desired clinical specialty.

With regard to specializing in oncology physical therapy, applicants must meet the additional requirements for one of the below options:

• Option A: Applicants must submit evidence of 2,000 hours of direct patient care as a licensed US physical therapist in the oncology rehabilitation field. These hours must be accrued within the last 10 years, with 500 of them (or 25%) having occurred in the last three years.
• Option B: Applicants must submit evidence of successful completion of an APTA-accredited post-professional oncology clinical residency within the last 10 years. Applicants who are currently enrolled in an oncology residency accredited by the American Board of Physical Therapy Residency and Fellowship Education (ABPTRFE)—or a residency program that has earned candidacy status—may apply for the oncology specialist certification examination prior to completing the clinical residency. In addition to Beaumont Health’s Oncology Residency, there are five other ABPTRFE-accredited oncology residency programs in the country. 

For more information about oncology specialist certification, check out this page on the ABPTS website, which offers resources to help PTs along every step of the process.

Opportunities for Oncology Rehabilitation Services in Your Practice

With business continuity on the brain of many clinic leaders after the events of last year, revenue diversification has become a popular strategy among therapy providers. Not only does diversifying revenue streams help safeguard a business’s financial health, but it also helps clinicians shake up their caseloads and reach new patient populations. 

So, when asked whether he thought incorporating oncology physical therapy services into an outpatient setting could be a viable option for clinicians, Wilson responded: “Although most cancer physical therapy programs are usually attached to big hospital systems, there are some really successful outpatient oncology rehab therapists. Furthermore, any institution that has an oncology program must have connections in both inpatient and outpatient systems, which has increased the demand for qualified oncology rehab therapists.”

He also served up some insightful tips for PTs who are interested in offering oncology rehab therapy services in their practice or partnering with oncology care teams from larger institutions:

• First, you must have at least one therapist on staff with a passion for oncology rehabilitation who has taken at least a few oncology rehabilitation-specific continuing education courses. Ideally, these therapists have their specialist certification or have completed an ABPTRFE-accredited oncology residency program.
• Next, tell oncologists in your area that your clinic can be of service to them and their patients. Rather than taking the traditional marketing approach, lead with your team’s knowledge and experience in the field. Oncology physicians are typically very protective of their patients, and they need to know that your team fully understands the cancer each patient has and the treatments the patient is undergoing. It’s also important for you to be sensitive to the patient’s emotional and mental state.
• Lastly, make friends with the “nurse navigators.” These individuals are a crucial component to interdisciplinary care teams, as they are with patients every step of the way. They are also responsible for ensuring patients make it to each appointment—including the ones with their oncology PT.

Although this is still a developing field within the physical therapy ecosystem, it is one that holds tremendous promise in:

1. helping cancer survivors live longer, more fulfilling lives; and
2. helping physical therapists assert their value as integral members of highly respected care teams.

“At the end of the day, the actual interventions oncology PTs use aren’t that different from what our profession already does,” said Wilson. “Physical therapists already have a solid clinical foundation—it’s just a matter of taking this area further to demonstrate what we really can do to help people through the most difficult moments of their lives. I truly believe no other professions can do it as well as we do, which is why I hope to get as many people as possible excited about this emerging field.”

Feel free to drop any questions you might have about oncology physical therapy in the comment section below, and we will get back to you as soon as possible.