A Franciscan Health physical therapist who specializes in treating cancer patients is one of the first professionals in the country to earn board certification as a specialist in oncologic physical therapy.
Paula Stout, PT, DPT, CLT-LANA, who treats patients at Franciscan Point Rehabilitation in Crown Point, was part of the first class of certified oncology specialists in 2019. Today, just over 100 nationwide have the board certification, which was approved by the American Physical Therapy Association in 2016.
“It’s a very rigorous exam. You prepare for it for a year or two on your own,” Dr. Stout said. The specialist certification program was established to provide some formal recognition for therapists with these specialized skills, but even more importantly, it lets cancer patients and providers know this treatment is available, she added.
“Cancer patients sometimes fall through the cracks in terms of needing physical therapy to help them improve their quality of life, to get back to what they were doing before and maybe even more,” Dr. Stout said.
Dr. Stout says her journey toward oncologic therapy began about a year out of physical therapy school when she learned about treating lymphedema. This is swelling that usually occurs in arms or legs, often after removal of or injury to lymph nodes due to cancer surgery and radiation.
“Not all lymphedema patients are cancer patients, but the majority of what I was seeing was cancer patients and I started to realize the deficits in our cancer care continuum,” Dr. Stout said. “They wouldn’t normally be referred until the lymphedema was a big problem. So, I might see them a year out of chemo and radiation.”
These patients would tell her they still have trouble with basic tasks like going up and down stairs or getting in and out of cars, problems that could have been addressed earlier through physical therapy.
Physicians often only think of lymphedema in terms of physical therapy for cancer patients, but cancer-related fatigue is the number one side effect experienced by patients and exercise is the number one treatment, Dr. Stout said. “We are the movement specialists. What they need is an exercise prescription.”
“Most importantly, physical therapy is about function, and cancer patients will show functional decline,” Dr. Stout said. “We should be involved from time of diagnosis throughout survival, because the treatment for cancer and how these patients are doing functionally is a very dynamic process.”
Patients going through chemotherapy can experience chemo-induced peripheral neuropathy, tingling and numbness that can cause balance issues, which can be treated through physical therapy. Chemo drugs can also cause cardiac issues and core weakness that physical therapists can address.
For all these issues, the oncologic certification assures cancer patients that the treatment being provided is evidence based and following best practices. In Dr. Stout’s capable hands, they can also know they’re being treated by someone who speaks at continuing education courses and is now helping to write the exam that therapists will take to receive certification.
Dr. Stout received her Bachelor of Health Science in Physical Therapy from the University of Missouri in Columbia, and her Doctorate in Physical Therapy from A.T. Still University in Mesa, Ariz. She has over 21 years of experience in the treatment of cancer patients and has developed cancer rehabilitation programs in Missouri and now in Indiana since coming to Crown Point and Franciscan Point Rehabilitation five years ago. Dr. Stout also serves on the Specialization Academy of Content Experts (SACE) for the Oncologic Specialty Council and is an Item Writer for the American Board of Physical Therapy Specialties (oncology). She also serves as the Oncology representative/board member for the American Board of Physical Therapy Specialties.
Dr. Stout’s hope is that as the ranks of oncologic physical therapists grow, more cancer patients can connect with the treatment to help them live their best lives. “There are over 17 million cancer survivors in the United States today. Therefore, if you are a physical therapist, you are going to see patients who either have cancer or have had cancer.”
