Becoming an Oncology Physical Therapist: The Ultimate Guide
March 15, 2021
Board-certified since 2019, oncology physical therapists are among the latest additions to the cancer-treatment medical world. Their work helps patients not merely to survive cancer but rather to overcome it.
For most people, the term oncology evokes invasive, traumatic treatments: chemotherapy and surgery, to name two. Indeed, these interventions are critical tools in the fight to suppress and remove patients' cancers.
They are not the beginning and end of cancer treatment, however. In fact, their detrimental (even when successful) impact on patients has given rise to a relatively new regimen: oncology physical therapy. Oncology PTs assist patients with the weakness, deconditioning, peripheral neuropathy, and lymphedema associated with cancer therapies. By helping cancer patients regain function, mitigate pain, and restore normalcy to their lives, oncology physical therapists encourage and empower clients.
This is a relatively new practice, one that was only recognized by the American Physical Therapy Association (APTA) in 1983. Today there are nearly 1,400 oncology physical therapists practicing in the United States, and the field is reportedly growing. Some experts assert that there's a need for many, many more.
"Physical therapists are underutilized, especially during the cancer journey, as we provide great value in a cost-effective manner," says Sharlynn Tuohy, who was the director of Rehabilitation at Memorial Sloan Kettering Cancer Center (MSKCC) in 2014. "Surviving cancer requires attention to optimizing function and quality of life, and physical therapists are primed to do just that."
Oncology physical therapy is coming into its own—the American Board of Physical Therapy Specialties approved board certification for the practice in 2019, with the first certification exams administered in 2019. With the profession's profile on the rise and its ranks growing, now is a good time to consider becoming an oncology physical therapist.
In this article, we'll cover:
- The pros and cons of becoming an oncology physical therapist
- The educational commitment to become an oncology physical therapist
- Licensure and accreditation for becoming an oncology physical therapist
- Resources for becoming an oncology physical therapist
Pros and cons of becoming an oncology physical therapist
Pros of becoming an oncology physical therapist
- You'll be well-compensated: The median pay for general physical therapists is $87,930 per year, according to the Bureau of Labor Statistics. The field is projected to grow at a 28 percent rate through 2028. That's nearly five times the growth rate of the job market as a whole. According to the job search website Salary, oncology physical therapists earn between $72,612 and $85,523 annually, on average.
- You'll help survivors adjust to life after cancer treatment: A cancer survivor is defined by the National Cancer Institute (NCI) as "one who remains alive and continues to function during and after overcoming a serious hardship or life-threatening disease." The NCI projects there will be over 20 million cancer survivors in the US by 2026. Studies indicate the structured movement and massage oncology PTs provide increase mobility, confidence, and energy levels among patients.
- You'll help all patients manage the invisible side effects of treatments: For those with "brain fog" (a sense of confusion), cancer-related fatigue, or other mental side effects of oncology, a PT can design exercise programs that sharpen the mind and memory.
- You'll help terminal patients maximize their remaining time: "One of the most rewarding things for me is the privilege of helping people who will not survive their cancer to complete their 'bucket list,'" says Chris Wilson, vice president of APTA's Academy of Oncologic Physical Therapy (AOPT). "I've worked with patients who've said, 'I want to get strong enough to walk my daughter down the aisle,' or 'I'd love one more Thanksgiving dinner with my family'... I've helped make those things happen."
Cons of becoming an oncology physical therapist
- The field is still developing and, by some accounts, still has room to improve: Nicole Stout, spokesperson for the APTA, states in PT in Motion that when she was in PT school in the 1990s, "We'd hear, 'Don't do ultrasound in a person who has cancer.' 'Don't do massage.' 'Restrict mobility in someone who has bone metastasis.' Even now, we don't sufficiently teach students what physical therapy can do for people who have cancer."
- Cancer patients are dealing with trauma, which can pose challenges to working with them effectively: Understandably, some cancer patients experience depression from loss of agency, resulting in additional challenges to providing therapy. "Participation restrictions occur when activity limitations cannot be sufficiently overcome to maintain role functions in the person's normal environment," according to researchers in a Physical Therapy study. The study provides the example of a firefighter whose cancer limits mobility, preventing them from returning to the work they love.
- Grief is real: It can be tough to deal with, especially for new physical therapists.
Educational commitment to become an oncology physical therapist
To become a physical therapist, you must first earn a bachelor's degree, preferably in a related field (although the APTA does not require a specific undergraduate major or coursework). Some top majors for physical therapists include:
- Exercise science
Your next step is to earn a Doctor of Physical Therapy (DPT) degree, which takes about three years for most full-time students. The DPT replaces the Master of Physical Therapy (MPT) and Master of Science in Physical Therapy (MSPT) degrees, which are no longer offered to new students in the United States. Those who hold a physical therapy master's degree will be able to continue practicing without earning the DPT.
Top physical therapy programs include:
- Emory University: A top-five physical therapy program, Emory University is home to a Division of Physical Therapy that houses a cancer rehabilitation practice.
- University of Delaware: University of Delaware is rated one of the top physical therapy schools, according to U.S. News and World Report. The UD program offers students to complete clinical hours in five different physical therapy clinics.
- _University of Southern California_ Division of Biokinesiology and Physical Therapy: Like Emory, USC's Division of Biokinesiology and Physical Therapy hosts a cancer care center.
Once you've earned your DPT, you can apply to your state's licensing authority to take the National Physical Therapy Exam (NPTE) through the Federation of State Boards of Physical Therapy (FSBPT).
After you are fully licensed, you can pursue a specialist certification in oncology physical therapy. One option is to acquire 2,000 hours of patient care as a licensed physical therapist within the oncology population. You'll also need to write a one-case reflection demonstrating specialty practice in oncologic physical therapy. This case study must be based on a patient/client seen within the last three years.
A second option is to apply for a residency program.The Academy for Oncologic Physical Therapy maintains a list of residency programs on its website. The Memorial Sloan Kettering Cancer Center in New York City offers an 18-month residency: nine months at the acute care setting at Memorial Hospital, followed by nine months of outpatient treatment a the Sillerman Center for Rehabilitation.
Licensure and accreditation for becoming an oncology physical therapist
Physical therapists are professionals who help all populations manage pain and more easeful movement after an accident or illness. Often, they work in clinics, private offices, and hospitals, where they are part of a rehabilitation team that may include physicians, surgeons, and physical therapy aids.
Licensure is essential for both entry-level PTs and specialty PTs, including those who pursue oncology rehabilitation. The difference between the NPTE for general physical therapists and the oncology board exam through the ABPT is specificity. For example, test questions for the oncology PT board exam include mention of the Six Minute Walk Test (6MWT) and the Short Performance Physical Battery (SPPB) and how they apply to cancer patients.
Below are two types of licensure and accreditation that prove professional competency in the United States:
Licensure for physical therapists and physical therapy assistants (PTAs) is regulated by individual state boards. The Federation of State Boards of Physical Therapy (FSBPT) administers the licensure exam, called the NPTE. All 50 states recognize the NPTE, and most also require future PTs and PTAs to take a jurisprudence examination. States differ in their NPTE renewal requirements. For example, California PTs must take the test every two years, while PTs in Oregon must take it every year.
The NPTE is a multiple-choice exam with 250 questions regarding nine body systems—including musculoskeletal and lymphatic systems—and how they apply to PT examination, evaluations, and interventions. Offered only on specific dates throughout the year (in January, April, July, and October), the test takes up to five hours to complete and costs $485. Prior to the test, you can take the Practice Exam and Assessment Tool (PEAT), which follows the same format as the NPTE.
Oncology physical therapists
To become board-certified as a physical therapist with an oncology specialty, you can presently take a new exam through the American Board of Physical Therapists (ABPT). This exam covers the following areas of clinical practice:
- Knowledge areas
- Professional roles
- Patient/clinic management model
Upon completion of either 2,000 hours of patient care as a licensed physical therapist within the oncology population (Option A) or completion of a residency program with a cancer population (Option B), you can apply to take the computerized 200-question exam.
The review fee for the test is $870 for APTA non-members and $525 for APTA members. The examination fee is $1,535 for non-members and $810 for members.
Resources for becoming an oncology physical therapist
Throughout this article, we've mentioned the ABPTS, FSBPT, and APTA. All host websites (linked above) that offer a wealth of information on oncology physical therapy. There are other helpful resources for current and aspiring oncology physical therapists.
Here are four:
_American Cancer Society_
The American Cancer Society was founded in 1913 in New York City, at a time when a cancer diagnosis meant certain death. Its efforts to understand and control the disease contributed to the passage of the National Cancer Act in 1971, which guaranteed more money and authority to expand the reach of the National Cancer Institute (NCI). Today, the society's work has helped reduce America's overall cancer death rate by 25 percent. That means 2.1 million fewer cancer deaths between 1991 and 2014. With its mission to "save lives, celebrate lives, and lead the fight for a world without cancer," the organization supports a network of volunteers, researchers, and political advocates as well as patients and loved ones.
_Academy of Oncologic Physical Therapy_ (AOPT)
AOPT, a national professional organization, represents more than 100,000 members throughout the United States. "Oncology" is the most recent specialty recognized by the ABPTS as a unique skill set required for rehabilitation for people with cancer. As a member, you receive discounts on services like the oncology specialist certification exam. This important group organizes regional one-day courses to keep your education current. Example titles include "Walk, Run, Jump and Thrive: Physical Therapy for Children with Cancer." It publishes the peer-reviewed publication Rehabilitation Oncology.
_International Classification of Functioning, Disability and Health_ (ICF)
With a framework designed by the World Health Organization, the ICF is an assessment tool that measures health and disability for individuals and populations. Developed in 2001 during the World Health Assembly, the ICF complements the International Classification of Diseases and Related Health Problems (ICD), which is a "standard diagnostic tool" for epidemiology, health management, and clinical purposes.
_National Cancer Institute_ (NCI)
Established in 1937 as a provision of the National Cancer Act of 1937, NCI is the US government's primary agency dedicated to cancer treatment, research, training, and diagnosis. With its library of cancer types and news, the NCI website is a valuable resource that can guide you toward training and grant opportunities. NCI has a deep commitment toward improving new and more established types of treatments as well as researching ways patients can deal with toxic effects.
When Mathias Giordano, an 11-year-old soccer lover in Loudoun County, Virginia, developed osteosarcoma—cancer of the bone—in his lower right leg and lungs, he began seeing Mike Reing, an oncology physical therapist. Reing helped Giordano prepare for the surgery, recover, and regain his edge on the soccer field with a prosthetic limb.
"I can't save anyone's life, that's not my role," Reing says in Move Forward, a website run by the American Physical Therapy Association (APTA). "But my job for Mathias is, 'All right, let's do everything we can to preserve his quality of life.' And my definition doesn't really matter. What matters is his."
As an oncology physical therapist, you'll work with the Mathias Giordanos of the world every day. You may not be able to preserve every patient's quality of life, but you will enable each and every one of them to take their best shot at rehabilitation and recovery.
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