How Physical Therapists Can Support Patients on Immunotherapy

WEBVTT

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You're listening to the PT Pinecast,

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where smart people in healthcare come to

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make noise.

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Here's your host, Jimmy McKay.

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All right.

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It's a new, I should say new,

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it felt new a couple of years ago

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when we were talking about it,

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but this is a PT specialty that's gaining

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momentum.

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And it's about time.

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It's the newest thing.

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It's been around for a while.

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While millions of people are living with

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or beyond cancer,

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far too few know that physical therapy can

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be a game changer in their recovery,

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in their function,

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and in their quality of life.

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But today we've got a little CSM preview

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like we've been doing that isn't waiting

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for the referral.

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They're building the case for why every PT

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program,

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every clinic and every physical therapist

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needs to step up and meet the needs

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of this population.

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From classrooms to clinics to social

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feeds, conferences and clinical practice,

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these guests today are helping change the

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narrative.

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So let's welcome Amanda and Scott to the

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show.

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And Steve,

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Steve's here in spirit is what we'll say.

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Steve's been on the show before.

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Amanda, Scott's been on the show before,

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so I'm going to say welcome for the

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first time here to you, Amanda.

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Thank you.

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And you're in the Lone Star State of

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Texas.

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Real quick,

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what's your superhero backstory,

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just to give the audience of context about

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you and your career?

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Okay, so I went to,

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as Scott likes to say,

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the greatest physical therapy program in

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all the land in Ithaca, New York.

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It's gorgeous.

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I'm very proud.

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Oh yeah, it's gorgeous.

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Not this time of year.

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go over the summer,

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especially if you like wineries and

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waterfalls.

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But so I went there and everybody goes

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into PT school,

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maybe thinking athletics or some grand big

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picture with no inkling of oncology care.

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I graduated even in twenty twenty two.

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And so that's relatively recently and

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still didn't really know much,

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especially when I went in.

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So then over COVID they did a really

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good job of like keeping us engaged.

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They did some speaker series of the

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different specialties in physical therapy.

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So then in enters Scott on zoom does

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a great job explaining, you know,

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about oncology care.

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And I'm like, wow,

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that's a really cool niche kind of fills

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my little like nerdy void.

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And he said, oh,

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if anybody wants to come shadow me up

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in Connecticut, I'm like, okay,

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that's not too far from New Jersey where

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I'm from.

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So I went to go shadow him at

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least twice, uh,

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once in a survivorship program and then

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once in just a clinic day.

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And that was it for me.

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I just decided that that's what I wanted

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to pursue.

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So I worked, um,

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in the New York area after college was

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like kind of starting more of like their

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oncology program there.

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They had a really great like breast

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program.

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but nothing really coming from medical

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oncology.

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So I was a big advocate for that

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there and then moved down to Dallas,

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Texas, started working at UT Southwestern,

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which has an amazing oncology rehab

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program.

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We have like a physical medicine

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rehabilitation doctor.

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So been doing a lot of that here.

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power of story scott we've had you on

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the show before but i'm smart enough to

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know podcasting is like radio just because

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you told a story a couple years ago

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doesn't mean the same people are listening

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right now so how's that number one my

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first question is how'd that make you feel

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that you jump on just a zoom call

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right with ithaca right great program go

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bombers uh and then someone that story

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lands

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That's number one, but number two,

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they took a step.

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They liked it more.

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They took another step.

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So first I want you to do this,

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talk about that.

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And then I want you to tell the

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audience who may not have any idea who

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you are,

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even though you've been on the show

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before,

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what that story or a quick snapshot of

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what that story was.

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Yeah.

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I do think being a clinician,

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being a PT now for a long time,

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I do feel that it's my obligation to

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give back to the students.

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I realized that being an oncology physical

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therapist, like Amanda said,

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It is kind of a niche thing,

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even though there are twenty million

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cancer survivors living in the United

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States.

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So I would argue that it's not necessarily

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niche.

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But from a programmatic perspective,

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when we talk about DPT programs,

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it is rarely, if at all, ever covered.

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So that was really cool that I mean,

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I really, you know,

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I give this talk every year to Ithaca

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because it's my way of giving back.

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And I'll get into that more in a

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second.

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And I always say, listen, you know,

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I'm an open book and I want you

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to learn.

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You know,

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the best thing I can do at this

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point in my career is to help bring

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somebody else into this realm.

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So, you know,

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this is my cell phone and this is

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my email.

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And, you know, I love having students.

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They are the future of our profession,

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Jimmy.

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You know,

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so I'm closer to retirement than I am

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being a new graduate.

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So, yeah,

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so when Amanda reached out to me,

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she was like, yeah, like,

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I'm willing to make a drive, you know,

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yeah,

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I'm going to have to drive up to

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Georgia to Connecticut to hang out with

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you.

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And, like, awesome.

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Also, you know,

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to the power of our alumni association,

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and I think everywhere we go, Jimmy,

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I know that you've been really, you know,

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connected with your alumni association as

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well, you know, with your PT program.

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So I think that...

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Right there, you know,

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just the power of those of us that

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have graduated,

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wherever we've graduated from, you know,

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to be able to give back, you know,

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to our universities is great.

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So it was really, you know,

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it was really...

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it felt really good yeah to have Amanda

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reach out to me and I've had other

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students do that now too where they say

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listen I want to see what it actually

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looks like like it's one thing you know

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to have the PowerPoint but what exactly do

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you actually do with these patients like

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and how is it different and when they

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come and they've observed me in clinic

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they realize that you know it's just PT

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right

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It's just the extra twenty percent layer

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of knowing what the drugs are and knowing

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what these side effects are from the drugs

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and being able to read that chart and

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decipher it and be able to predict what

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those adverse effects are going to be.

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So that way we can put on our

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PT hats and say, oh,

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that chemotherapy in particular can cause

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peripheral neuropathy.

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If that person can't feel their feet

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because of neuropathy,

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they're a falls risk.

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So what do you do?

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Falls prevention.

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Any PT could do fall prevention.

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It's just a matter of understanding why we

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have to do fall prevention for that

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patient.

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And why would persons with cancer and who

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have survived cancer,

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why is that particularly,

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why is that something important to you?

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So I was diagnosed with cancer when I

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was in PT school.

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I was in my last year of PT

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school at Ithaca.

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And you could say that I didn't really

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fit the profile.

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I ran cross country and track for my

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four years there at Ithaca.

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And I never drank, and I never smoked,

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and I never did drugs.

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I was always the designated driver for all

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my friends and all my teammates.

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And there was also no family history of

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cancer.

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And so I never would have expected in

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a hundred years that I'd be diagnosed.

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But as a twenty two year old going

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into his last year of PT school,

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that's what happened.

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And, you know, again,

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the why I feel so strongly about our

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program at Ithaca is because my professors

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stood by me and my classmates stood by

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me and my professors said,

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We're going to get you through this.

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You are going to graduate with your

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cohort.

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You've been with your cohort all these

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years.

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You're not going to go back.

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You're not going to stay back a year.

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You will graduate with your classmates.

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And so that's why I always feel that

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this is a small thing that I can

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do to give back to my program.

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And that talk even kind of morphed over

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the years.

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you know,

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initially I'd go back and I would just

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tell my story.

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And really it was almost like a PSA

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of, Hey, I was and I got cancer.

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So start doing yourself exams now.

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Um,

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And then as I got more and more

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into oncology rehab,

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then it morphed more into the actual

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oncology lecture.

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You know, what is oncology rehab?

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What do I do?

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And why do these patients need care?

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In addition to telling my story.

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So, yeah, so Amanda,

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you and your classmates kind of heard that

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version of it, you know,

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both the didactic piece of it,

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but also the personal piece of it.

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So our audience obviously is not public

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facing.

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It's pretty much internal to the

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profession.

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How do you answer this when fellow PTs

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find out, this is for both of you,

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hey,

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this is the type of patients that you

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work with.

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How do you answer the question,

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why do people with cancer need PT?

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Why are so few getting it?

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I mean, even Amanda,

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you said in the middle of PT school,

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this wasn't something you went into and

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expected to be there,

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but once the rationale was there,

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I don't think you could shout this enough

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just because people like you understand

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this deeply.

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Why?

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What is the answer to that?

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Why do people with cancer need PT and

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why are so few people getting?

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I think that I mean,

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I get this question a lot,

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usually not so much like from physical

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therapists, but like, obviously, yes,

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mostly from people like that are not in

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health care, be like,

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what do you do with cancer?

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And I'm like,

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everything they need so much.

00:10:02.658 --> 00:10:06.022
But from my peers, it's more like, well,

00:10:06.341 --> 00:10:08.984
OK, you know about the human body,

00:10:09.043 --> 00:10:09.485
obviously,

00:10:09.504 --> 00:10:10.765
and the movement systems and everything.

00:10:11.245 --> 00:10:13.488
Let's talk about what cancer treatment

00:10:13.548 --> 00:10:16.169
does to the human body.

00:10:16.509 --> 00:10:18.491
And I explained these things are so

00:10:18.552 --> 00:10:19.052
important.

00:10:19.113 --> 00:10:20.754
These things save the patient's life.

00:10:21.894 --> 00:10:22.956
And previous,

00:10:23.035 --> 00:10:24.756
and Scott can attest to this because he

00:10:24.777 --> 00:10:25.857
was a part of it as it was

00:10:26.238 --> 00:10:26.639
growing.

00:10:27.198 --> 00:10:28.799
But previously it was like, oh, no,

00:10:28.840 --> 00:10:30.581
like leave these patients alone,

00:10:30.922 --> 00:10:32.802
let them rest, let them recover.

00:10:33.504 --> 00:10:34.303
OK, well,

00:10:34.384 --> 00:10:36.525
now we have so many cancer survivors

00:10:37.046 --> 00:10:38.506
because of all these amazing treatments

00:10:38.626 --> 00:10:41.089
and they need to get back to doing

00:10:41.129 --> 00:10:42.269
things that they were doing before,

00:10:42.309 --> 00:10:43.510
whether that's child care,

00:10:43.850 --> 00:10:45.091
whether that's their job,

00:10:45.471 --> 00:10:47.514
whether that's caring for aging parents.

00:10:48.041 --> 00:10:50.501
So what are things that we can do

00:10:50.903 --> 00:10:53.043
that help them decrease the effect of

00:10:53.083 --> 00:10:53.724
neuropathy,

00:10:54.063 --> 00:10:57.326
decrease cancer-related fatigue, decrease,

00:10:57.667 --> 00:10:59.086
you know, help people sleep better?

00:10:59.366 --> 00:11:01.448
If you're not sleeping well because of,

00:11:01.548 --> 00:11:01.788
you know,

00:11:02.208 --> 00:11:04.289
like radiation fibrosis to your shoulder

00:11:04.450 --> 00:11:06.772
or shoulder pain and scapular dyskinesis,

00:11:08.793 --> 00:11:10.114
how can we help this person sleep better

00:11:10.153 --> 00:11:11.815
so they can function better during their

00:11:11.855 --> 00:11:12.575
daily life?

00:11:13.014 --> 00:11:13.755
With neuropathy,

00:11:13.816 --> 00:11:15.056
how can we help to decrease their

00:11:15.076 --> 00:11:16.616
neuropathy so that they can sleep better,

00:11:16.917 --> 00:11:17.778
so they can walk better?

00:11:18.153 --> 00:11:19.495
to decrease the risk of falls.

00:11:20.134 --> 00:11:24.197
I'm also studying for the specialty exam

00:11:24.236 --> 00:11:25.398
right now and just going through the

00:11:25.418 --> 00:11:25.798
textbook,

00:11:25.837 --> 00:11:27.899
it says something and don't quote me,

00:11:28.019 --> 00:11:29.159
numbers are not my strong suit,

00:11:29.580 --> 00:11:32.542
but something like forty percent of men

00:11:32.581 --> 00:11:34.822
that take androgen deprivation therapy for

00:11:34.842 --> 00:11:37.244
prostate cancer will have a fall and a

00:11:37.283 --> 00:11:39.384
fracture within the first few years of

00:11:39.404 --> 00:11:39.945
taking that.

00:11:40.605 --> 00:11:41.946
So we know what these patients are going

00:11:41.966 --> 00:11:43.486
to go through because we know the side

00:11:43.506 --> 00:11:44.248
effects of the treatment.

00:11:44.727 --> 00:11:46.389
So how can we help them during and

00:11:46.469 --> 00:11:46.729
after?

00:11:47.205 --> 00:11:48.426
or even getting prepared for it.

00:11:48.466 --> 00:11:50.126
Sure.

00:11:50.147 --> 00:11:50.346
Yeah.

00:11:50.767 --> 00:11:52.327
And to kind of answer the second half

00:11:52.347 --> 00:11:53.707
of that question, Jimmy, I think the,

00:11:54.528 --> 00:11:54.708
you know,

00:11:54.749 --> 00:11:56.149
I think there's still a lot of

00:11:56.289 --> 00:12:00.172
misconceptions, you know, probably about,

00:12:00.631 --> 00:12:03.933
you know, or with our oncology colleagues,

00:12:03.953 --> 00:12:05.495
first of all, you know, again,

00:12:05.534 --> 00:12:07.296
if somebody has been practicing for thirty

00:12:07.316 --> 00:12:08.336
years, thirty years ago,

00:12:08.416 --> 00:12:09.636
that's what the evidence said.

00:12:10.988 --> 00:12:12.067
Let these patients rest.

00:12:12.727 --> 00:12:13.769
Don't let them do anything.

00:12:13.788 --> 00:12:15.448
They need to conserve their energy while

00:12:15.469 --> 00:12:16.589
they're going through treatment.

00:12:17.009 --> 00:12:19.129
So that's what they got in medical school,

00:12:19.809 --> 00:12:21.110
oh, thirty years ago.

00:12:21.169 --> 00:12:22.750
And so that's probably what their mindset

00:12:22.791 --> 00:12:24.770
still is today.

00:12:24.870 --> 00:12:26.350
I'm noticing that I'm getting more and

00:12:26.370 --> 00:12:26.551
more.

00:12:27.072 --> 00:12:28.611
Most of my referrals are coming from

00:12:28.672 --> 00:12:30.371
younger oncologists because they're

00:12:30.392 --> 00:12:32.533
getting it more in in med school.

00:12:33.952 --> 00:12:37.394
And and again, we have the evidence now

00:12:38.274 --> 00:12:39.355
In twenty twenty six,

00:12:39.455 --> 00:12:41.636
we have all this evidence that shows the

00:12:41.677 --> 00:12:43.238
benefit of exercise.

00:12:44.339 --> 00:12:46.880
And so now I think the oncologists are

00:12:46.921 --> 00:12:47.902
starting to come up with that.

00:12:48.201 --> 00:12:50.063
But we're going to have a whole other

00:12:50.104 --> 00:12:51.384
conversation about, you know,

00:12:51.445 --> 00:12:53.025
we need to make this easier.

00:12:53.046 --> 00:12:53.147
Right.

00:12:53.586 --> 00:12:54.587
Like, Jimmy,

00:12:54.628 --> 00:12:55.568
we've talked about this before.

00:12:55.589 --> 00:12:56.909
You talk about this all the time, Jimmy,

00:12:56.950 --> 00:12:58.230
the easy button, you know,

00:12:58.530 --> 00:13:00.052
the target like, you know,

00:13:00.152 --> 00:13:01.312
or Staples easy button.

00:13:02.333 --> 00:13:04.135
We need to make it easier for these

00:13:04.196 --> 00:13:04.916
oncologists.

00:13:05.777 --> 00:13:07.697
and these oncology nurses to get these

00:13:07.758 --> 00:13:08.519
patients to us.

00:13:09.078 --> 00:13:10.639
They are dealing with so much.

00:13:11.659 --> 00:13:13.961
Exercise and rehab is not the first thing

00:13:13.981 --> 00:13:15.442
that's on their minds.

00:13:15.923 --> 00:13:17.004
And so we need to be able to

00:13:17.244 --> 00:13:17.504
build,

00:13:17.964 --> 00:13:20.164
if you're in a big academic institution,

00:13:20.546 --> 00:13:23.787
like use Epic to our advantage,

00:13:23.826 --> 00:13:26.009
like build it into the order set to

00:13:26.028 --> 00:13:28.330
make it easier for them to make that

00:13:28.429 --> 00:13:28.690
referral.

00:13:28.710 --> 00:13:29.730
They just have to hit the button.

00:13:30.291 --> 00:13:32.913
rather than fill out all the referral

00:13:32.953 --> 00:13:34.115
stuff.

00:13:34.316 --> 00:13:36.018
That's where a lot of it gets lost,

00:13:36.038 --> 00:13:40.722
honestly.

00:13:41.063 --> 00:13:42.264
You've said before that oncology,

00:13:42.304 --> 00:13:42.905
physical therapy,

00:13:42.966 --> 00:13:44.707
landscape is constantly changing.

00:13:45.948 --> 00:13:46.730
What's new

00:13:47.727 --> 00:13:50.370
What's new that PTs need to know?

00:13:50.629 --> 00:13:52.331
Maybe something that even if they thought

00:13:52.370 --> 00:13:54.772
they were on the cutting edge a year

00:13:54.851 --> 00:13:55.672
or two ago,

00:13:56.153 --> 00:13:58.894
what's something that's a big disruptor

00:13:58.913 --> 00:14:00.315
that maybe PTs still,

00:14:00.455 --> 00:14:02.035
even if they're ahead of the curve

00:14:02.076 --> 00:14:03.496
normally, that they don't know?

00:14:04.231 --> 00:14:06.413
Yeah, well, two things there, Jimmy.

00:14:06.472 --> 00:14:06.953
First of all,

00:14:07.014 --> 00:14:09.414
last year in twenty twenty five in the

00:14:09.434 --> 00:14:10.775
New England Journal of Medicine,

00:14:11.235 --> 00:14:12.797
kind of what I would consider the holy

00:14:12.817 --> 00:14:15.398
grail that we've been searching for for

00:14:15.498 --> 00:14:16.438
all of these years.

00:14:17.299 --> 00:14:20.081
The challenge trial was published and it

00:14:20.100 --> 00:14:24.264
was this huge multicenter study had almost

00:14:24.384 --> 00:14:26.865
nine hundred patients with stage two or

00:14:26.884 --> 00:14:28.765
stage three colorectal cancer.

00:14:29.506 --> 00:14:31.307
And the intervention group

00:14:32.268 --> 00:14:34.788
exercise and they had supervised exercise

00:14:35.269 --> 00:14:38.051
programs and one of the big things too

00:14:38.091 --> 00:14:39.951
about this this trial was that these

00:14:39.991 --> 00:14:42.113
patients could do cardio they had to do

00:14:42.173 --> 00:14:44.313
forty five minutes of cardio three or four

00:14:44.333 --> 00:14:46.034
times a week but they got to choose

00:14:46.534 --> 00:14:47.855
the kind of cardio that they wanted to

00:14:47.875 --> 00:14:49.235
do so it could have been walking it

00:14:49.256 --> 00:14:50.437
could have been hiking it could have been

00:14:50.456 --> 00:14:52.197
biking gonna be kayaking

00:14:53.736 --> 00:14:55.538
And so they had these checkpoints with

00:14:55.578 --> 00:14:57.421
their physiotherapists and exercise

00:14:57.461 --> 00:15:01.484
physiologists twice a month for one year.

00:15:01.904 --> 00:15:04.366
And then they can continue to still have

00:15:04.626 --> 00:15:06.448
touch points once a month for an

00:15:06.489 --> 00:15:08.110
additional two years beyond that.

00:15:08.130 --> 00:15:09.511
So three years total,

00:15:10.131 --> 00:15:11.634
they had somebody checking on them to

00:15:11.673 --> 00:15:14.375
making sure they were adhering to exercise

00:15:14.416 --> 00:15:14.956
and rehab.

00:15:16.038 --> 00:15:19.061
And the researchers found that

00:15:20.562 --> 00:15:23.427
Those that exercise decrease the risk of

00:15:23.466 --> 00:15:26.250
recurrence of the cancer of colorectal

00:15:26.289 --> 00:15:29.274
cancer by twenty eight percent and

00:15:30.075 --> 00:15:33.379
decrease the risk of death by thirty seven

00:15:33.418 --> 00:15:34.000
percent.

00:15:34.581 --> 00:15:35.902
I'm a huge fan of not dying.

00:15:35.942 --> 00:15:36.702
So that sounds good.

00:15:37.423 --> 00:15:39.065
Right, right there.

00:15:39.205 --> 00:15:40.206
Just by exercising,

00:15:40.225 --> 00:15:41.908
you decrease your risk of death by one

00:15:42.008 --> 00:15:42.528
third.

00:15:42.788 --> 00:15:44.250
And that's just the exercise piece of it,

00:15:44.269 --> 00:15:44.791
right?

00:15:44.831 --> 00:15:47.273
But those patients were monitored.

00:15:47.994 --> 00:15:50.657
They had accountability partners.

00:15:51.157 --> 00:15:53.580
They also got to choose that type of

00:15:53.620 --> 00:15:54.179
exercise.

00:15:55.191 --> 00:15:56.671
And then the kicker out of this study,

00:15:56.730 --> 00:15:58.091
out of all this great data,

00:15:58.392 --> 00:16:00.432
was that when they did an even bigger

00:16:00.471 --> 00:16:03.452
analysis and they put exercise up against

00:16:03.533 --> 00:16:04.133
chemo,

00:16:04.474 --> 00:16:06.153
a very particular chemotherapy drug,

00:16:06.394 --> 00:16:10.534
oxaloplatin, they found that exercise,

00:16:11.075 --> 00:16:12.515
the patients who exercise,

00:16:12.975 --> 00:16:15.256
it was more effective than the

00:16:15.297 --> 00:16:16.417
chemotherapy was.

00:16:17.136 --> 00:16:17.856
So that's it.

00:16:18.037 --> 00:16:21.018
We have the proof that exercise and rehab

00:16:21.618 --> 00:16:23.078
can be better than chemo.

00:16:24.195 --> 00:16:27.197
improving overall survival for our

00:16:27.236 --> 00:16:31.340
patients so that's one big thing that just

00:16:31.360 --> 00:16:33.701
came out less than twelve months ago the

00:16:33.780 --> 00:16:35.822
other thing and this is kind of you

00:16:35.842 --> 00:16:38.244
know alluding to the the talk that amanda

00:16:38.264 --> 00:16:39.284
steve and i are going to do at

00:16:39.565 --> 00:16:44.227
csm is the the increase in availability

00:16:44.288 --> 00:16:46.169
and the development of immunotherapy

00:16:47.412 --> 00:16:49.333
Immunotherapy is different than

00:16:49.394 --> 00:16:50.333
chemotherapy.

00:16:50.754 --> 00:16:53.417
Immunotherapy is more targeted therapy to

00:16:53.456 --> 00:16:56.840
try to turn the immune system on to

00:16:56.879 --> 00:16:59.961
try to identify the cancer cells and go

00:17:00.081 --> 00:17:00.523
after them.

00:17:01.263 --> 00:17:02.203
And again,

00:17:02.683 --> 00:17:05.487
new data that just came out in January

00:17:05.527 --> 00:17:06.267
of twenty six.

00:17:07.448 --> 00:17:08.909
The American Cancer Society always

00:17:08.949 --> 00:17:11.490
releases updated stats every year.

00:17:12.392 --> 00:17:13.512
for the first time,

00:17:14.574 --> 00:17:17.237
the overall cancer survival rate,

00:17:17.277 --> 00:17:18.657
if we put all the cancers together,

00:17:19.798 --> 00:17:21.980
has finally eclipsed seventy percent.

00:17:22.442 --> 00:17:24.202
So that's a big deal, right?

00:17:24.223 --> 00:17:25.565
That is a big deal because it was

00:17:25.605 --> 00:17:28.346
not that twenty, thirty years ago.

00:17:29.107 --> 00:17:31.471
And we specifically saw an increase in

00:17:31.510 --> 00:17:33.332
survival in some of the harder

00:17:34.413 --> 00:17:36.513
cancers that are out there, like melanoma,

00:17:37.454 --> 00:17:39.756
that survival rate almost doubled.

00:17:40.415 --> 00:17:42.076
The survival rate of patients with liver

00:17:42.116 --> 00:17:43.278
cancer almost tripled.

00:17:45.305 --> 00:17:47.746
And you could probably say that

00:17:47.885 --> 00:17:50.627
immunotherapy had a big role in that

00:17:50.667 --> 00:17:53.769
because immunotherapy was not readily

00:17:53.808 --> 00:17:55.210
available and readily used,

00:17:55.970 --> 00:17:58.730
in the treatment of a lot of these

00:17:58.931 --> 00:17:59.632
types of cancer.

00:18:00.172 --> 00:18:00.811
And now they are.

00:18:01.231 --> 00:18:03.192
And so we're seeing an improvement in

00:18:03.272 --> 00:18:06.234
overall survival by adding immunotherapy

00:18:06.654 --> 00:18:09.256
to some of the traditional treatments such

00:18:09.296 --> 00:18:10.957
as chemotherapy and radiation therapy.

00:18:12.627 --> 00:18:13.268
So we know better,

00:18:13.909 --> 00:18:15.449
it's just time to make sure we do

00:18:15.469 --> 00:18:16.329
better, right?

00:18:16.349 --> 00:18:17.830
We've been yelling for research left and

00:18:17.871 --> 00:18:19.131
right, now we have it,

00:18:19.632 --> 00:18:20.971
now it's time to execute.

00:18:20.991 --> 00:18:21.873
Well,

00:18:21.893 --> 00:18:24.273
this brings us to your talk at CSM,

00:18:24.314 --> 00:18:26.974
doing a lot of these sort of hype

00:18:26.994 --> 00:18:28.715
videos, which I think is good.

00:18:28.796 --> 00:18:30.416
If you're gonna huck yourself all the way

00:18:30.457 --> 00:18:31.136
out to LA,

00:18:31.617 --> 00:18:32.798
make sure you understand what's on the

00:18:32.817 --> 00:18:33.117
menu,

00:18:33.798 --> 00:18:35.019
because I wouldn't want you to miss it.

00:18:35.318 --> 00:18:36.660
So Thursday the twelfth,

00:18:37.339 --> 00:18:38.520
ten thirty to noon,

00:18:38.760 --> 00:18:39.781
nice in the middle of the day,

00:18:39.902 --> 00:18:41.962
not too early, not too late, smart.

00:18:42.803 --> 00:18:45.384
Um, I like the title.

00:18:45.663 --> 00:18:46.845
I don't know if I'm saying it right.

00:18:46.924 --> 00:18:47.825
Pronounce it for me.

00:18:50.346 --> 00:18:51.605
Sibs, nibs, and mabs.

00:18:51.986 --> 00:18:52.626
Oh my.

00:18:54.547 --> 00:18:56.428
And identifying opportunities in

00:18:56.448 --> 00:18:57.667
immunotherapy rehabilitation.

00:18:58.348 --> 00:19:00.308
I gotta be honest, sibs, nibs, and mabs.

00:19:00.729 --> 00:19:01.390
I don't know what they are.

00:19:01.470 --> 00:19:01.990
Help me out here.

00:19:05.378 --> 00:19:05.618
Yeah,

00:19:05.659 --> 00:19:08.720
so I think that that's the whole point.

00:19:09.059 --> 00:19:10.060
The sibs, mibs, and mabs,

00:19:10.101 --> 00:19:12.300
that is the tail end of a lot

00:19:12.340 --> 00:19:13.102
of these drugs.

00:19:13.801 --> 00:19:16.722
And again, as a student,

00:19:17.242 --> 00:19:18.323
as a new clinician,

00:19:18.703 --> 00:19:20.223
even a seasoned clinician,

00:19:20.263 --> 00:19:22.924
but you're getting into oncology rehab,

00:19:23.005 --> 00:19:25.885
or you're working in a sports rehab

00:19:26.026 --> 00:19:28.086
center, and you have this patient come in,

00:19:28.146 --> 00:19:29.626
and you look at their chart,

00:19:29.646 --> 00:19:30.586
and you see these things.

00:19:30.627 --> 00:19:31.508
You're like, what?

00:19:32.288 --> 00:19:34.892
and God's green earth are these drugs.

00:19:36.153 --> 00:19:38.896
And so that's why we wanted to demystify

00:19:38.936 --> 00:19:39.096
that.

00:19:39.116 --> 00:19:40.858
We wanted to talk about what is

00:19:40.919 --> 00:19:42.922
immunotherapy and the effects of

00:19:43.021 --> 00:19:44.202
immunotherapy on the body.

00:19:44.963 --> 00:19:46.946
And then what we can do as PTs

00:19:47.326 --> 00:19:49.430
to make sure that we're keeping our

00:19:49.470 --> 00:19:50.131
patients healthy

00:19:51.192 --> 00:19:53.813
and keeping them moving and potentially

00:19:53.833 --> 00:19:58.575
even helping to help enhance the effects

00:19:58.694 --> 00:20:01.737
of immunotherapy as they're trying to work

00:20:01.777 --> 00:20:03.478
towards getting rid of the cancer.

00:20:04.637 --> 00:20:05.097
Amanda,

00:20:05.919 --> 00:20:07.798
what do you hope people who walk out

00:20:07.839 --> 00:20:11.181
of your talk are able to do?

00:20:11.921 --> 00:20:12.701
What is the goal?

00:20:12.741 --> 00:20:13.981
What should they look like?

00:20:14.001 --> 00:20:15.883
What should they feel empowered to do?

00:20:15.923 --> 00:20:18.824
What's the change happen in ninety minutes

00:20:18.844 --> 00:20:20.845
with you guys in L.A.? ?

00:20:21.298 --> 00:20:21.698
Yes.

00:20:21.897 --> 00:20:22.538
So I,

00:20:23.218 --> 00:20:25.138
something that I really want to emphasize

00:20:25.259 --> 00:20:28.239
is that even though like the title of

00:20:28.259 --> 00:20:28.980
our presentation,

00:20:29.240 --> 00:20:30.420
not that it seems daunting,

00:20:30.480 --> 00:20:32.779
I think I love Scott's, uh, you know,

00:20:32.880 --> 00:20:34.601
idea of bringing in lions, tigers,

00:20:34.641 --> 00:20:35.080
and bears.

00:20:35.921 --> 00:20:36.201
Um,

00:20:36.421 --> 00:20:40.301
but it's not just for seasoned oncology

00:20:40.342 --> 00:20:41.122
PTs.

00:20:41.882 --> 00:20:42.162
Um,

00:20:42.201 --> 00:20:43.721
I think that's a lot of the audience

00:20:43.761 --> 00:20:45.202
that we're going to capture.

00:20:45.843 --> 00:20:46.803
Um, but.

00:20:47.394 --> 00:20:49.816
I want anybody to be able to come

00:20:49.836 --> 00:20:53.337
to our presentation and know what are the

00:20:53.397 --> 00:20:55.700
possible side effects that they should be

00:20:55.759 --> 00:20:56.579
looking for,

00:20:57.060 --> 00:20:58.701
for patients that are receiving

00:20:58.760 --> 00:20:59.761
immunotherapy,

00:21:00.061 --> 00:21:02.103
because it could be somebody that's coming

00:21:02.143 --> 00:21:04.285
to you in an ortho clinic for a

00:21:04.305 --> 00:21:04.805
knee pain.

00:21:05.365 --> 00:21:06.986
It might not be somebody that's going to

00:21:07.006 --> 00:21:08.807
a specialized cancer clinician.

00:21:09.907 --> 00:21:12.328
They could have either be on immunotherapy

00:21:12.348 --> 00:21:13.849
because people are on it for longer

00:21:13.890 --> 00:21:14.789
periods of time,

00:21:14.871 --> 00:21:15.631
or they have

00:21:16.020 --> 00:21:19.261
something big like a CAR T cell therapy.

00:21:20.042 --> 00:21:21.163
And we'll get into that in our

00:21:21.202 --> 00:21:21.803
presentation,

00:21:22.343 --> 00:21:25.924
but it might not be somebody that looks

00:21:26.025 --> 00:21:28.705
super ill that needs like specialized

00:21:28.746 --> 00:21:31.446
cancer care, or just in your community,

00:21:31.487 --> 00:21:34.607
you might not have a specialized oncology

00:21:34.647 --> 00:21:35.147
clinician.

00:21:35.508 --> 00:21:37.068
So it could be somebody going to any

00:21:38.029 --> 00:21:40.730
office for any problem that may have a

00:21:40.810 --> 00:21:42.832
history of immunotherapy or may be

00:21:42.872 --> 00:21:44.053
currently on it.

00:21:44.093 --> 00:21:46.614
So a big thing in our presentation is

00:21:46.773 --> 00:21:48.054
what are these side effects?

00:21:48.493 --> 00:21:50.494
How do they impact the human movement

00:21:50.515 --> 00:21:50.914
system?

00:21:50.954 --> 00:21:53.115
That's Steve's whole thing.

00:21:53.175 --> 00:21:54.636
It's how do they impact the human movement

00:21:54.656 --> 00:21:57.317
system and what like emergencies are you

00:21:57.337 --> 00:21:58.159
looking out for?

00:21:58.219 --> 00:22:00.219
Because some of these side effects can be

00:22:00.298 --> 00:22:00.819
life threatening,

00:22:00.859 --> 00:22:02.220
but some of them are very mild.

00:22:02.279 --> 00:22:04.621
So we're going to go over the mild

00:22:04.760 --> 00:22:06.342
ones, the life threatening ones,

00:22:06.686 --> 00:22:08.067
how to keep an eye out for them

00:22:08.167 --> 00:22:11.029
in your practice and how to discuss these

00:22:11.049 --> 00:22:11.691
with your patient.

00:22:11.711 --> 00:22:12.711
Yeah.

00:22:13.416 --> 00:22:15.077
I do want to say thanks to Empower

00:22:15.198 --> 00:22:15.637
EMR.

00:22:15.657 --> 00:22:17.377
If your clinic's stuck in an EMR that

00:22:17.417 --> 00:22:18.238
slows you down,

00:22:18.258 --> 00:22:19.558
you shouldn't have that EMR.

00:22:20.338 --> 00:22:22.098
Empower gives you speed, clean workflows,

00:22:22.138 --> 00:22:24.500
and features PTs actually ask for.

00:22:24.539 --> 00:22:26.000
Better notes, faster documentation,

00:22:26.039 --> 00:22:27.621
smooth operations.

00:22:27.881 --> 00:22:29.421
All wrapped in customer support that

00:22:29.441 --> 00:22:30.122
doesn't ghost you.

00:22:30.442 --> 00:22:32.142
EmpowerEMR.com.

00:22:32.342 --> 00:22:33.823
EmpowerEMR.com.

00:22:33.843 --> 00:22:34.942
Got to pay the bills here, guys.

00:22:34.962 --> 00:22:35.182
Otherwise,

00:22:35.202 --> 00:22:36.623
we don't keep the lights on the podcast.

00:22:39.064 --> 00:22:40.443
If someone says,

00:22:40.624 --> 00:22:42.484
I feel a little bit unprepared,

00:22:44.320 --> 00:22:45.122
Why should they come?

00:22:45.701 --> 00:22:46.843
Amanda just sort of touched on it.

00:22:47.423 --> 00:22:49.684
Is this going to be too over someone's

00:22:49.744 --> 00:22:53.028
head or is this pretty available and

00:22:53.067 --> 00:22:53.868
accessible?

00:22:54.068 --> 00:22:55.990
Like we want those advanced courses,

00:22:56.069 --> 00:22:56.289
right?

00:22:56.750 --> 00:22:58.211
Just who's this right for?

00:22:58.271 --> 00:23:00.614
Who should walk in and sit down?

00:23:03.688 --> 00:23:04.388
Yeah.

00:23:04.429 --> 00:23:04.788
And as Amanda,

00:23:04.888 --> 00:23:06.170
as you were just alluding to,

00:23:06.289 --> 00:23:09.791
I think any student and any clinician,

00:23:10.231 --> 00:23:12.772
whether they're an oncology specialist or

00:23:12.833 --> 00:23:13.114
not,

00:23:13.453 --> 00:23:15.755
they should walk in because we hope to

00:23:15.795 --> 00:23:18.115
be able to answer those questions so that

00:23:18.155 --> 00:23:20.637
anybody who walks in then walks out nine

00:23:20.678 --> 00:23:22.038
minutes later and says, oh, okay.

00:23:22.719 --> 00:23:24.582
You know, these immunotherapies,

00:23:24.622 --> 00:23:25.742
these sims, mibs and mabs,

00:23:25.782 --> 00:23:26.744
they're not that scary.

00:23:26.765 --> 00:23:27.025
Right.

00:23:28.186 --> 00:23:30.048
Because, you know, Amanda,

00:23:30.088 --> 00:23:33.673
you just said it like not every clinician

00:23:33.814 --> 00:23:34.955
is an oncology clinician.

00:23:35.016 --> 00:23:36.037
But again,

00:23:36.257 --> 00:23:37.880
with twenty million cancer survivors

00:23:37.920 --> 00:23:38.740
living in the country.

00:23:39.682 --> 00:23:41.782
This patient could walk into your

00:23:42.063 --> 00:23:45.943
traditional mom and pop outpatient sports

00:23:46.003 --> 00:23:48.304
clinic in East Tumbleweed, Kansas.

00:23:49.023 --> 00:23:51.365
But you have to be prepared for that.

00:23:51.724 --> 00:23:55.445
And so we want all clinicians and we

00:23:55.486 --> 00:23:56.165
want students,

00:23:56.365 --> 00:23:58.547
because I guarantee that's not like we

00:23:58.567 --> 00:23:59.446
talked about earlier.

00:23:59.906 --> 00:24:01.188
A lot of this is not being covered

00:24:01.228 --> 00:24:02.307
in DPT programs.

00:24:02.807 --> 00:24:04.288
I would love students to show up to

00:24:04.308 --> 00:24:06.090
this so that that way they feel empowered

00:24:06.111 --> 00:24:07.632
when they go out on their clinicals.

00:24:08.051 --> 00:24:09.953
They could be the ones that are teaching

00:24:09.973 --> 00:24:12.895
their CIs what this is.

00:24:15.157 --> 00:24:16.179
I like myth busting.

00:24:17.298 --> 00:24:18.681
I like correcting at least.

00:24:19.060 --> 00:24:20.142
So this is for both of you.

00:24:20.162 --> 00:24:21.583
You each get to pick maybe one.

00:24:22.222 --> 00:24:24.545
What's a myth about either oncology,

00:24:24.585 --> 00:24:26.507
physical therapy, or immunotherapy?

00:24:26.527 --> 00:24:27.688
What's one myth?

00:24:28.479 --> 00:24:30.740
that you find yourself sort of saying,

00:24:30.801 --> 00:24:32.103
well, yeah, okay, yes,

00:24:32.163 --> 00:24:34.625
but maybe they're not completely off,

00:24:34.786 --> 00:24:36.307
but maybe it's a couple degree course

00:24:36.346 --> 00:24:36.948
correction.

00:24:37.368 --> 00:24:38.630
I'll give you each an opportunity to

00:24:38.650 --> 00:24:41.153
correct one myth or update or drop a

00:24:41.192 --> 00:24:44.715
well actually about oncology PT that other

00:24:44.756 --> 00:24:47.660
clinicians need to stop missing the mark

00:24:47.700 --> 00:24:47.779
on.

00:24:52.304 --> 00:24:52.443
Well,

00:24:52.483 --> 00:24:53.486
I think one of the things that I

00:24:53.506 --> 00:24:54.586
would consider here,

00:24:54.646 --> 00:24:56.068
and maybe we're going to get into it

00:24:56.128 --> 00:24:57.309
in our talk specifically,

00:24:57.410 --> 00:25:00.034
is that immunotherapy is easier than chemo

00:25:00.954 --> 00:25:01.816
because it's not chemo.

00:25:02.478 --> 00:25:02.678
Right.

00:25:02.718 --> 00:25:04.818
Like we all know we have a pretty

00:25:04.838 --> 00:25:05.578
good understanding,

00:25:05.638 --> 00:25:07.279
even if you're not an oncology PT,

00:25:07.299 --> 00:25:09.461
like if you've had a loved one go

00:25:09.480 --> 00:25:10.320
through cancer treatment,

00:25:10.361 --> 00:25:11.662
like you're kind of used to seeing,

00:25:11.801 --> 00:25:12.082
you know,

00:25:12.102 --> 00:25:13.643
kind of the telltale signs of what chemo

00:25:13.722 --> 00:25:15.222
is, you know,

00:25:15.242 --> 00:25:16.943
the hair loss and the nausea and the

00:25:16.983 --> 00:25:19.984
vomiting and the fatigue and all that.

00:25:20.444 --> 00:25:22.965
And so you look at immunotherapy and you

00:25:23.006 --> 00:25:23.207
say, well,

00:25:23.227 --> 00:25:26.228
that immunotherapy is not chemotherapy.

00:25:26.548 --> 00:25:26.667
Right.

00:25:26.688 --> 00:25:28.689
It's not designed to kill all these all

00:25:28.729 --> 00:25:30.450
the cells at different points of their

00:25:30.569 --> 00:25:31.150
development.

00:25:31.769 --> 00:25:34.131
so there's no side effects so it's got

00:25:34.171 --> 00:25:36.231
to be good for you but amanda you

00:25:36.271 --> 00:25:38.353
were talking about this that there are

00:25:38.772 --> 00:25:40.594
mild side adverse effects and there are

00:25:40.614 --> 00:25:42.835
some pretty significant side effects from

00:25:42.914 --> 00:25:45.496
immunotherapy and as clinicians we might

00:25:45.536 --> 00:25:47.497
be the ones who see that for the

00:25:47.537 --> 00:25:49.958
first time in these patients and we have

00:25:49.998 --> 00:25:52.398
to know what that is recognize it then

00:25:52.439 --> 00:25:53.078
be empowered

00:25:54.059 --> 00:25:55.820
And to run that up the chain to

00:25:55.840 --> 00:25:57.061
the oncologist and say, hey,

00:25:57.442 --> 00:26:00.826
I saw Mary Jane in clinic today and

00:26:00.846 --> 00:26:02.527
this is how she presented and I know

00:26:02.948 --> 00:26:05.609
that she's on, you know, her luzumab.

00:26:06.490 --> 00:26:09.334
So I think you need to reach out

00:26:09.374 --> 00:26:10.714
to her and get her in clinic and

00:26:10.954 --> 00:26:12.115
do a full, you know,

00:26:12.155 --> 00:26:12.896
full workup of her.

00:26:13.257 --> 00:26:15.018
So I think that's one of the myths

00:26:15.038 --> 00:26:19.340
that specifically for our our talk at CSM

00:26:19.881 --> 00:26:22.522
to try to bust that myth that just

00:26:22.563 --> 00:26:24.324
because it's not chemo,

00:26:24.503 --> 00:26:26.025
that it's a breeze.

00:26:26.065 --> 00:26:28.967
All right, Amanda, you got to follow that.

00:26:29.007 --> 00:26:30.268
What's the thing that you that you know,

00:26:30.347 --> 00:26:32.430
what's the what's the rock in your in

00:26:32.450 --> 00:26:34.590
your flip flop that you'd like people to

00:26:34.891 --> 00:26:35.892
get right once and for all?

00:26:37.643 --> 00:26:37.742
Man,

00:26:38.722 --> 00:26:39.963
I have so many things in my brain.

00:26:40.163 --> 00:26:42.165
I think an important thing that Scott just

00:26:42.185 --> 00:26:43.606
brought up about pembrolizumab.

00:26:43.946 --> 00:26:46.528
So if you've ever heard of Keytruda in

00:26:46.567 --> 00:26:47.108
a commercial,

00:26:47.429 --> 00:26:48.970
I'm sure everybody's seen the Keytruda

00:26:48.990 --> 00:26:49.289
commercial.

00:26:49.589 --> 00:26:50.990
You know what immunotherapy is.

00:26:51.510 --> 00:26:52.251
That's pembrolizumab.

00:26:53.173 --> 00:26:54.773
So it's much more common than you think.

00:26:54.854 --> 00:26:56.674
There are a lot of these drugs out,

00:26:56.714 --> 00:26:58.115
even though they're relatively new,

00:26:58.576 --> 00:27:00.297
they're being used a lot, like Scott said,

00:27:00.356 --> 00:27:02.317
and they are responsible for some of the

00:27:02.377 --> 00:27:03.699
increase in cancer survivors.

00:27:04.058 --> 00:27:04.940
So there's that.

00:27:05.325 --> 00:27:09.226
Jimmy, you do know an immunotherapy, but,

00:27:10.465 --> 00:27:10.865
um,

00:27:12.185 --> 00:27:14.866
I think a rock in my shoe is

00:27:15.166 --> 00:27:20.167
that number one, cancer rehab is sad.

00:27:20.228 --> 00:27:20.508
Right.

00:27:20.827 --> 00:27:22.189
So a lot of like, man, like,

00:27:22.249 --> 00:27:23.209
how do you do that?

00:27:23.229 --> 00:27:23.888
Like, you know, I'm like, Oh,

00:27:25.148 --> 00:27:27.009
because so many people are surviving.

00:27:27.049 --> 00:27:27.230
I mean,

00:27:27.250 --> 00:27:29.230
of course I do have some patients that

00:27:29.269 --> 00:27:31.030
are stage four more end of life.

00:27:31.431 --> 00:27:32.871
It's equally as important for them.

00:27:34.055 --> 00:27:34.095
Um,

00:27:34.394 --> 00:27:35.994
but I have so many patients that are

00:27:36.035 --> 00:27:38.776
surviving and we're doing prehab and it's

00:27:38.816 --> 00:27:40.816
not just death and dying,

00:27:41.056 --> 00:27:43.277
but I think that the most important thing

00:27:43.297 --> 00:27:44.636
that I do want to bring up is

00:27:44.696 --> 00:27:44.977
that.

00:27:45.936 --> 00:27:49.077
PT belongs in hospice and palliative care.

00:27:49.278 --> 00:27:50.637
I think there's a misconception,

00:27:50.758 --> 00:27:52.659
especially on an inpatient side,

00:27:52.679 --> 00:27:53.898
because I've done that as well.

00:27:54.298 --> 00:27:55.638
When you go into the patient's chart,

00:27:55.679 --> 00:27:57.680
you see a palliative or a hospice note

00:27:57.740 --> 00:27:58.599
and you're like, Oh, defer.

00:28:00.116 --> 00:28:01.478
Get that patient off my list.

00:28:02.198 --> 00:28:03.739
And, um,

00:28:03.759 --> 00:28:06.119
there's another really awesome CSM

00:28:06.140 --> 00:28:07.240
presentation about.

00:28:08.161 --> 00:28:09.161
You know, palliative care.

00:28:09.461 --> 00:28:09.601
Um,

00:28:09.661 --> 00:28:11.481
I believe that's Chris Wilson's doing that

00:28:11.582 --> 00:28:11.701
one.

00:28:12.462 --> 00:28:12.742
Um,

00:28:13.282 --> 00:28:15.663
so PT belongs in palliative care and

00:28:15.683 --> 00:28:17.384
palliative care is not just when the

00:28:17.424 --> 00:28:18.986
patient's dying palliative care,

00:28:19.246 --> 00:28:20.767
especially for patients for cancer

00:28:20.807 --> 00:28:23.567
patients is often involved from the point

00:28:23.587 --> 00:28:25.429
of diagnosis to help with comfort,

00:28:25.588 --> 00:28:27.789
but it's not just comfort care and dying.

00:28:28.330 --> 00:28:29.352
it's helping them.

00:28:29.731 --> 00:28:32.394
And there are ways that physical therapy

00:28:32.474 --> 00:28:35.097
should be involved in palliative care.

00:28:35.417 --> 00:28:36.898
And just because like,

00:28:36.919 --> 00:28:38.961
let's say a patient was, you know,

00:28:39.040 --> 00:28:41.123
more end stage, you know,

00:28:41.182 --> 00:28:43.184
you weren't expecting them to improve.

00:28:43.204 --> 00:28:44.606
You're expecting a decline.

00:28:44.906 --> 00:28:46.888
That's an even more important reason why

00:28:46.969 --> 00:28:48.911
physical therapy should be involved in

00:28:49.771 --> 00:28:51.512
And there are ways to write a plan

00:28:51.532 --> 00:28:53.593
of care and write goals for maintenance

00:28:53.613 --> 00:28:55.913
therapy where you're not saying, oh,

00:28:55.953 --> 00:28:57.054
the patient's not approving,

00:28:57.094 --> 00:28:59.174
so I have to discontinue care.

00:28:59.255 --> 00:28:59.474
No,

00:29:00.615 --> 00:29:02.816
you should be involved to help prevent

00:29:02.875 --> 00:29:03.415
decline,

00:29:03.455 --> 00:29:05.896
to help prevent increased reliance on

00:29:05.957 --> 00:29:06.737
caregivers,

00:29:06.896 --> 00:29:08.676
to help them maintain their function and

00:29:08.696 --> 00:29:10.278
independence through their end of life,

00:29:10.298 --> 00:29:13.439
which is such a huge quality of life

00:29:13.638 --> 00:29:13.878
thing.

00:29:14.866 --> 00:29:15.488
Yeah, I mean,

00:29:15.508 --> 00:29:17.489
I'm so glad you brought that up because,

00:29:18.048 --> 00:29:19.230
you know, and right there,

00:29:19.250 --> 00:29:20.151
what you were talking about,

00:29:20.171 --> 00:29:22.532
like goal writing for that patient who's

00:29:22.613 --> 00:29:23.854
at end of life care,

00:29:24.034 --> 00:29:25.714
like one of the biggest things that we

00:29:25.755 --> 00:29:27.656
could do as rehab professionals in that

00:29:27.737 --> 00:29:30.419
setting is caretaker education.

00:29:31.159 --> 00:29:33.701
Because if the caretaker, you know,

00:29:33.760 --> 00:29:35.502
is trying to do transfers for that

00:29:35.542 --> 00:29:36.103
patient, you know,

00:29:36.123 --> 00:29:37.923
trying to do bed to commode transfers or

00:29:37.944 --> 00:29:38.944
whatever that might be,

00:29:39.566 --> 00:29:42.228
and the caregiver throws their back out,

00:29:43.451 --> 00:29:45.134
They can't care for their person.

00:29:46.494 --> 00:29:48.476
So there is always a role for physical

00:29:48.496 --> 00:29:49.856
therapy, especially in that setting.

00:29:49.876 --> 00:29:50.218
So Amanda,

00:29:50.258 --> 00:29:52.439
thank you so much for saying that.

00:29:52.459 --> 00:29:55.141
That's the rock in my shoe.

00:29:55.161 --> 00:29:57.262
You each get one shot, one opportunity.

00:29:57.282 --> 00:29:57.982
Don't throw it away.

00:29:58.723 --> 00:30:00.986
Someone who's listened to this episode to

00:30:01.006 --> 00:30:02.707
this point and they're going to get on

00:30:02.747 --> 00:30:03.907
a plane or they're on a plane right

00:30:03.948 --> 00:30:05.169
now as they're listening and putting

00:30:05.209 --> 00:30:07.651
their, their schedule together for CSM.

00:30:08.652 --> 00:30:09.432
What's your pitch?

00:30:09.612 --> 00:30:11.233
What's your one or two sentences and why

00:30:11.253 --> 00:30:12.815
they need to come to your talk?

00:30:16.479 --> 00:30:17.660
When they come to our talk,

00:30:17.700 --> 00:30:22.583
they are going to feel empowered that they

00:30:22.603 --> 00:30:25.545
can treat any patient with a history of

00:30:25.585 --> 00:30:26.086
cancer.

00:30:26.546 --> 00:30:28.787
We want to be able to demystify not

00:30:28.866 --> 00:30:32.910
just immunotherapy specifically and its

00:30:32.950 --> 00:30:34.611
treatment in cancer,

00:30:34.852 --> 00:30:36.833
but we want to be able to demystify

00:30:36.853 --> 00:30:40.816
the whole aspect of oncology care and that

00:30:41.195 --> 00:30:43.897
any PT can care for anybody with a

00:30:43.917 --> 00:30:44.498
history of cancer.

00:30:44.538 --> 00:30:45.679
And they need it.

00:30:47.664 --> 00:30:50.205
Amanda, what do you got?

00:30:50.226 --> 00:30:52.547
I think that, yes, Scott,

00:30:52.686 --> 00:30:54.268
that's it as well.

00:30:54.968 --> 00:30:57.969
And we are also going to go over

00:30:58.009 --> 00:31:00.710
some cases in our presentation.

00:31:00.750 --> 00:31:03.050
So I'm really excited about that.

00:31:03.330 --> 00:31:07.232
And it's going to show that there is

00:31:07.252 --> 00:31:09.314
a huge opportunity for prehab,

00:31:09.753 --> 00:31:11.294
not just in immunotherapy,

00:31:11.374 --> 00:31:12.694
but in cancer care.

00:31:13.603 --> 00:31:15.003
Because like I mentioned before,

00:31:15.463 --> 00:31:18.964
since we know roughly the route that these

00:31:18.984 --> 00:31:20.326
patients are going to take with their

00:31:20.346 --> 00:31:20.746
treatments,

00:31:20.826 --> 00:31:22.886
of course it changes as they monitor the

00:31:22.906 --> 00:31:23.946
disease progression,

00:31:24.247 --> 00:31:25.448
hopefully lack thereof.

00:31:27.087 --> 00:31:29.209
But since we know what they're going to

00:31:29.249 --> 00:31:31.269
be going through with the treatments and

00:31:31.289 --> 00:31:32.630
the medications that they're prescribed,

00:31:33.029 --> 00:31:36.192
how can we prepare these patients for what

00:31:36.211 --> 00:31:37.172
they're going to be going through?

00:31:38.182 --> 00:31:39.803
which then helps to improve their

00:31:39.864 --> 00:31:40.463
function.

00:31:40.784 --> 00:31:43.006
It also helps to decrease their anxiety

00:31:43.506 --> 00:31:44.826
about the treatments that they're going to

00:31:44.846 --> 00:31:45.627
be going through.

00:31:45.768 --> 00:31:47.388
And it also helps them move their body

00:31:47.429 --> 00:31:47.888
through it.

00:31:48.930 --> 00:31:51.692
So I think that highlighting prehab there

00:31:51.852 --> 00:31:54.074
and showing the opportunity for

00:31:54.153 --> 00:31:56.736
intervention at that point is going to be

00:31:56.776 --> 00:31:59.657
so empowering for physical therapists of

00:31:59.897 --> 00:32:02.319
any specialty,

00:32:02.380 --> 00:32:04.101
but also our oncology colleagues.

00:32:05.019 --> 00:32:06.441
Sibs, Mibs, and Mabs, oh my,

00:32:06.540 --> 00:32:08.321
demystifying challenges and identifying

00:32:08.342 --> 00:32:09.743
opportunities with immunotherapy and

00:32:09.763 --> 00:32:10.443
rehabilitation.

00:32:10.844 --> 00:32:13.086
That is Thursday at CSM,

00:32:13.185 --> 00:32:14.547
ten thirty till noon.

00:32:15.007 --> 00:32:17.808
And that is in the oncology section.

00:32:18.529 --> 00:32:20.510
Last chance for what we call the parting

00:32:21.092 --> 00:32:21.491
shot.

00:32:21.511 --> 00:32:24.775
This is the parting shot.

00:32:25.295 --> 00:32:27.316
One last mic drop moment.

00:32:27.375 --> 00:32:28.196
No pressure.

00:32:28.616 --> 00:32:30.759
Just your legacy on the line.

00:32:32.173 --> 00:32:32.972
pressure whatsoever.

00:32:33.432 --> 00:32:33.653
Scott,

00:32:33.673 --> 00:32:35.653
we'll let you go first since you've done

00:32:35.673 --> 00:32:36.114
this before.

00:32:36.134 --> 00:32:38.193
Amanda, give you some time to formulate.

00:32:38.453 --> 00:32:39.753
Parting shot is just whatever your mic

00:32:39.773 --> 00:32:41.214
drop moment is, your soapbox statements.

00:32:41.255 --> 00:32:43.015
What's the last thing you want to leave

00:32:43.375 --> 00:32:48.336
with the audience as we wrap up?

00:32:48.375 --> 00:32:49.655
I think we've already covered it,

00:32:49.715 --> 00:32:54.777
but I would say that use CSM.

00:32:55.817 --> 00:32:57.497
I would say my parting shot right now

00:32:58.057 --> 00:33:00.458
is use CSM to network.

00:33:01.580 --> 00:33:04.022
build your network, talk to people.

00:33:04.483 --> 00:33:07.926
It is absolutely a good thing to have

00:33:07.967 --> 00:33:09.308
a little bit of imposter syndrome,

00:33:09.588 --> 00:33:13.071
but check your imposter syndrome and go

00:33:13.153 --> 00:33:13.952
talk to somebody,

00:33:14.294 --> 00:33:16.236
go talk to a seasoned clinician,

00:33:16.276 --> 00:33:18.637
because I guarantee you,

00:33:19.318 --> 00:33:20.980
those of us that are seasoned clinicians,

00:33:21.079 --> 00:33:22.141
we want to talk to you.

00:33:23.462 --> 00:33:25.424
And again, like we let off,

00:33:26.326 --> 00:33:30.268
I'm already like way into my profession

00:33:30.328 --> 00:33:30.489
now.

00:33:30.848 --> 00:33:33.309
I know that the future of our profession

00:33:33.650 --> 00:33:35.509
are students and new grads.

00:33:36.070 --> 00:33:37.770
Please come talk to me because you are

00:33:37.790 --> 00:33:39.092
going to grow this profession.

00:33:39.771 --> 00:33:43.593
And so use CSM as an opportunity to

00:33:43.653 --> 00:33:45.314
talk to somebody.

00:33:45.354 --> 00:33:46.294
Please come talk to me.

00:33:46.354 --> 00:33:47.555
That's Scott's parting shot.

00:33:47.595 --> 00:33:48.335
Please come talk to me.

00:33:49.231 --> 00:33:49.971
Amanda, what do you got?

00:33:49.991 --> 00:33:51.553
You can reiterate a point you did before

00:33:51.573 --> 00:33:52.252
or drop something new.

00:33:52.272 --> 00:33:52.692
Doesn't matter.

00:33:52.712 --> 00:33:53.453
What's your parting shot?

00:33:53.673 --> 00:33:54.153
Yes.

00:33:54.394 --> 00:33:56.674
So I'm going to piggyback off of what

00:33:56.694 --> 00:33:57.414
Scott just said.

00:33:58.976 --> 00:34:03.237
And so I am on the APT Oncology

00:34:03.777 --> 00:34:06.558
Students New Professional SIG.

00:34:07.219 --> 00:34:10.360
And we host a networking session where...

00:34:11.047 --> 00:34:13.447
Anybody interested in oncology rehab,

00:34:13.608 --> 00:34:15.349
students, new professionals.

00:34:15.650 --> 00:34:18.371
We also have some really awesome seasoned

00:34:18.811 --> 00:34:21.172
oncology practitioners like Scott that

00:34:21.193 --> 00:34:21.893
always pops in.

00:34:22.173 --> 00:34:23.954
Chris Wilson typically pops in as well.

00:34:24.815 --> 00:34:26.516
So we are planning to have a really

00:34:26.576 --> 00:34:27.817
awesome networking session.

00:34:27.976 --> 00:34:29.538
It is Friday the thirteenth.

00:34:30.077 --> 00:34:30.539
Spooky.

00:34:31.938 --> 00:34:33.860
Nine thirty to ten thirty a.m.

00:34:33.900 --> 00:34:36.641
You will find that in the oncology section

00:34:36.702 --> 00:34:39.643
in the programming on the app.

00:34:40.460 --> 00:34:43.242
And we love to have people that are

00:34:43.262 --> 00:34:45.282
just kind of intrigued by oncology.

00:34:45.603 --> 00:34:46.543
They don't know much about it,

00:34:46.563 --> 00:34:47.684
but they want to learn more.

00:34:47.724 --> 00:34:49.646
They want to talk to other students,

00:34:49.706 --> 00:34:50.527
new professionals,

00:34:50.887 --> 00:34:53.789
even seasoned professionals about it and

00:34:53.829 --> 00:34:54.108
just,

00:34:54.818 --> 00:34:58.081
make the community grow.

00:34:58.101 --> 00:34:58.701
So that's what we like to do.

00:34:58.740 --> 00:34:59.762
So I hope we need a better name

00:34:59.802 --> 00:35:00.643
though for next year.

00:35:00.682 --> 00:35:01.483
This is already locked,

00:35:01.503 --> 00:35:02.844
but students and new professionals

00:35:03.005 --> 00:35:03.925
networking session.

00:35:03.985 --> 00:35:04.987
I feel like with AI,

00:35:05.027 --> 00:35:05.467
we can come up.

00:35:05.507 --> 00:35:06.648
We will, we got to, we,

00:35:06.668 --> 00:35:07.889
this needs to be judged.

00:35:08.269 --> 00:35:09.550
We got to judge this and we'll do

00:35:09.590 --> 00:35:10.331
it for next year.

00:35:11.431 --> 00:35:12.532
Hey, thanks for doing what you do.

00:35:13.293 --> 00:35:15.954
Coming to a conference is a great

00:35:15.994 --> 00:35:16.994
networking experience,

00:35:17.094 --> 00:35:18.835
but the amount of work that you guys

00:35:18.876 --> 00:35:21.237
put together and put into these things is

00:35:21.317 --> 00:35:22.297
usually no small feat.

00:35:22.416 --> 00:35:23.998
A ninety minute presentation doesn't just

00:35:24.038 --> 00:35:24.338
happen.

00:35:24.378 --> 00:35:25.759
So thanks for doing this.

00:35:26.239 --> 00:35:26.918
Steve's not here,

00:35:26.938 --> 00:35:29.400
but Steve is a great friend of the

00:35:29.420 --> 00:35:29.639
show.

00:35:30.039 --> 00:35:32.300
So we'll see you guys in in L.A.

00:35:32.320 --> 00:35:33.822
and Anaheim in just a couple of weeks.

00:35:34.081 --> 00:35:35.943
And thanks for doing this.

00:35:35.963 --> 00:35:36.802
Thanks for having us.

00:35:36.842 --> 00:35:38.083
This is great.

00:35:38.103 --> 00:35:38.483
Yes.

00:35:38.523 --> 00:35:39.483
Thanks, Jimmy.

00:35:41.567 --> 00:35:42.626
That's it for this one,

00:35:42.907 --> 00:35:44.588
but we're just getting warmed up.

00:35:45.047 --> 00:35:46.969
Smash follow, send it to a friend,

00:35:47.168 --> 00:35:48.829
or crank up the next episode.

00:35:49.349 --> 00:35:50.369
Want to go deeper?

00:35:50.730 --> 00:35:54.751
Hit us at pgpinecast.com or find us on

00:35:54.811 --> 00:35:57.351
YouTube and socials at pgpinecast.

00:35:57.771 --> 00:36:00.052
And legally, none of this was advice.

00:36:00.112 --> 00:36:01.833
It's for entertainment purposes only.

00:36:01.893 --> 00:36:03.494
Bulls**t!

00:36:03.534 --> 00:36:04.114
See, Keith?

00:36:04.333 --> 00:36:05.394
We read the script.

00:36:05.695 --> 00:36:06.335
Happy now?