UM-Flint Joins Study to Help Reduce Treatment Costs for Certain Breast Cancers

Research done by three physical therapy specialists from different institutions around the country holds the promise of helping to lower treatment costs for some cancer patients.

The study, by researchers at Walter Reed National Military Medical Center, National Institutes of Health (NIH)/Clinical Center and the University of Michigan-Flint, found that early diagnosis and treatment of breast cancer-related lymphedema by a physical therapist can significantly reduce costs and the need for intensive rehabilitation.

Led by American Physical Therapy Association member and spokesperson Nicole Stout, PT, MPT, CLT-LANA, the study compared a prospective surveillance model with a traditional model of impairment-based care and examined the direct treatment costs associated with each program. Treatment and supply costs were estimated based on the Medicare 2009 physician fee schedule. Researchers estimated that treatment for breast cancer-related lymphedema costs $636 per year when the prospective surveillance model was used, versus $3,125 for traditional treatment of advanced lymphedema.

"This study begins to paint a picture of evidence showing that prevention of chronic conditions such as lymphedema—using rehabilitation models of care—may result in significant cost savings," said Stout.

Professor Cindy Pfalzer, UM-Flint Physical Therapy Department's associate director of research, was a co-investigator of the study. She wrote the research protocol while a clinical research fellow at NIH, and she continues to contribute to data analysis, database updating, and manuscript generation.

"I am pleased to have collaborated with my colleagues from the federal health care system including the Breast Care Center at Walter Reed National Military Medical Center and the Rehabilitation Medicine Department at the Clinical Center in the National Institutes of Health to provide findings that will help in the recovery and reduce impairments and their costs in breast cancer survivors," said Pfalzer. "Physical Therapists collaborating on a variety of research projects can make a difference in our healthcare system."

The goal of a prospective surveillance model for cancer rehabilitation is to identify impairment at the earliest onset to alleviate impairment or prevent it from progressing. Soon after diagnosis, a physical therapist will perform a preoperative examination to establish a baseline level of function. Follow-up examinations are then conducted postoperatively at one month and then three-month intervals for up to one year. By contrast, a traditional model focuses on treating lymphedema once it has progressed and patients already have functional limitations.

The other co-primary investigator for the study was Ellen Levy, the PT from the NIH.