As OncoPTs, we tend to treat what we see.  But there’s some side effects of cancer treatment that are invisible.  So they often go untreated.

Cardiopulmonary toxicities are some of the most sinister long-term side effects of cancer treatment.  In fact, breast cancer survivors are more likely to die of heart disease than from their breast cancer (see this article for more).

Since we tend to treat the easily apparent problems our patients experience, our interventions often ignore the cardiovascular & pulmonary systems.  However, PT absolutely taxes these systems, so cardiopulmonary effects of cancer treatment must be addressed.

In my interview with Dr. Julie Skrzat, PT, & Scott Capozza, PT, we discuss the overlooked, important aspects of patients in treatment & the long term effects that continue after treatment, the “Silent Sequelae.”

With so many patients living longer after their diagnosis, it’s crucial to consider the systemic & local effects of oncology treatments on the cardiovascular and pulmonary systems.  If you don’t have a basic understanding, you are doing a disservice to your patients & not preparing them for life after treatment. 

The cardiovascular & pulmonary systems are closed systems. The blood should flow in a single direction. Adding chemotherapy, a systemic drug with toxic effects, to our systems can cause the circuit to malfunction, which negatively impacts the other systems. Long-term heart conditions, heart attacks, and heart failure can result. 

Furthermore, radiation may lead to valve disease, pericardial disease, & arrhythmias, depending on the area of the body that is treated. If the heart is effective in pumping blood, the body must work harder to compensate for the inefficiency. 

Scott & Julie, plus their colleagues Dr. Aubriene Fiore, PT, & Dr. Laura Friedman, PT are bringing these two systems together for a more holistic cancer treatment plan at APTA-CSM 2023.

Register for Julie & Scott’s session at APTA-CSM 2023:

Learn more about The Silent Sequela: Addressing Cardiovascular & Pulmonary Toxicities in the Oncology Population:

Julie is an Assistant Professor in the Physical Therapy Program at Murphy Deming College of Health Sciences at Mary Baldwin University, Fishersville, VA. She earned her BS, MS, and DPT degrees from Ithaca College, and her PhD from Template University. She has been an APTA board certified Cardiovascular and Pulmonary Specialist since 2015. Julie’s clinical practice has primarily been in acute care hospital settings, where she continues to practice one day per week. It is through her clinical practice that she developed a passion for patients who are critically ill, ultimately leading her down a research pathway. Her research agenda focuses on optimizing patient outcomes in the acute care setting. In addition to research and clinical practice, she has been a guest lecturer at multiple universities, and spoken nationally on various physical therapy related topics, most notably early mobilization in the intensive care unit. Julie has had her work published in journals and textbooks. Julie serves through the profession by being on the Nominating Committee of the Academy of Cardiovascular and Pulmonary Physical Therapy and an abstract reviewer for the APTA-PA. Julie is founder and owner of Dusza, LLC, a company dedicated to cardiovascular and pulmonary physical therapy education.

About Dr. Julie Skrzat

Follow Julie on Twitter & Instagram: @duszallc

About Scott Capozza

Scott Capozza, MSPT, serves as the physical therapist for the multi-disciplinary Smilow Cancer Hospital Survivorship Clinic at Yale Cancer Center and is also Yale New Haven Hospital’s first dedicated outpatient physical therapist in oncology rehabilitation. Scott was among the first class of board-certified clinical specialists in oncologic physical therapy in the country and also serves as a SACE II Item Writer for the oncology certification exam through the ABPTS. He currently is the Membership Engagement and Leadership Development Chairperson for the American Physical Therapy Association’s Academy of Oncologic Physical Therapy as well as the APTA CT Chapter’s Oncology SIG co-chairperson. He is also serving as an adjunct professor in Oncology Physical Therapy for both Sacred Heart and Quinnipiac Universities in Connecticut.
Follow Scott on Twitter & Instagram: @scottcapozza