New PT space at Hollings gives patients with cancer a place to heal

Susan Nunes’ life was upended on Valentine’s Day 2024 when what should have been a heart-filled day brought a heartrending diagnosis instead: breast cancer.

“I thought I was just becoming an old lady,” she joked, recalling how she first noticed something was off. “But within a week of getting it checked out, I was diagnosed with a 5-centimeter tumor in my breast. I was scared but thought it would be an easy fix.”

Instead, her path led to a double mastectomy, followed by 15 sessions of radiation over four weeks. The physical toll from those treatments was immense, especially as Nunes, who is certified in mat Pilates, had always lived an active, movement-centered life.

“I came out of surgery, and I couldn’t move my arm. I couldn’t even breathe. I thought I would be able to rehab myself – but I couldn’t. It was terrifying.”

That is when she connected with Katie Schmitt, DPT, a board-certified clinical specialist in oncologic physical therapy (PT) at MUSC Hollings Cancer Center. With Schmitt’s patience and expertise, Nunes steadily regained her strength, mobility and confidence.

Her experience in rehab had such a lasting impact that Nunes felt compelled to give back. She did so by donating a Pilates reformer machine, a specialized piece of equipment that supports low-impact strength and mobility training. The machine helps cancer patients to regain their strength, flexibility, balance and mobility after treatment.

“The reformer isn’t just for the gym crowd. It’s a rehabilitation tool,” she explained. “You don’t need to be fit or experienced to use it. It meets you where you are and grows with you.”

 

The reformer is not the only new piece of equipment PT patients will encounter.

Hollings is also receiving new balance, strength and manual therapy equipment, thanks to a patient Schmitt treated for vagus nerve problems who specifically asked that his donation go to supporting other patients in their recovery journeys.

“The equipment will give us so many more ways to challenge patients and play with balance and strength that we didn't have before,” Schmitt said. “So that's been really generous and wonderful.”

From a corner office to a center of care

The new workout pieces are the centerpiece of an expanded rehabilitation program space at Hollings. The expansion is over five years in the making and a testament to what a clear vision, a motivated team and a little bit of ingenuity can accomplish.

When Schmitt started at MUSC in 2019, she saw an unmet need.

“So many patients with cancer experience side effects like fatigue, pain, numbness and cognitive challenges that rehab can directly address,” she said.

Leaders like Dave Comeau, PT, director of rehabilitation, and Denis Guttridge, Ph.D., then-acting director of Hollings, saw the value of her vision for an in-house PT program tailored to the specific needs of cancer survivors.

 

Schmitt began by seeing patients once a week. Less than two years later, she was seeing patients five days a week out of a corner office on Hollings’ second floor.

“I always told people, ‘Just put me in the corner. I’ll be fine. I’ll do PT and do wonders for cancer patients,’” Schmitt recalled with a smile. “Now we’ve leveled up to four corners. Eventually, we’ll have a whole floor!”

One of the biggest wins came almost a year to the day of the ribbon-cutting when occupational therapist Valerie Salmon Kelley, OTD, was brought on. Salmon Kelley, a former graduate student at MUSC who did a capstone project on integrating occupational therapy (OT) into oncology care, now specializes in treating cancer patients and survivors.

“Bringing Val on as our full-time occupational therapist has been fantastic,” Schmitt said. “She does a lot of work with patients with head and neck cancer and breast cancer. She is lymphedema-certified as well, and she works on cancer-related cognitive issues, a need that had long been unmet.”

Whereas PT focuses on mobility, strength and balance, OT takes a broader view of daily life. This duality is especially important in cancer care, where the disciplines work together to restore not only physical strength but also a sense of identity and normalcy.

“Physical therapists ask, ‘Where is your pain, and how is it affecting your life?’” Schmitt explained. “Occupational therapists ask, ‘Who are you and what matters to you?’ and then work backward from there.”

 

Bob Wilkes is another patient who has seen dramatic results from both therapies. Wilkes, who was unable to perform basic tasks like picking up objects or tying his shoes after receiving immunotherapy for Stage 4 melanoma, described his experience seeing Schmitt for PT and Salmon Kelley for OT as focusing on the micro versus the macro.

“The advantage of having them both in the same room is tremendous. They listen to each other, and if they work with the same patient, they already have an understanding of what’s going on and what they can do to further it.”

Grateful for the role that rehab played in his recovery, Wilkes has made it his mission to spread the word, sharing his story to help others find the same support and sense of accomplishment. As a member of the Hollings Advisory Board, he lends his voice to build awareness for Hollings’ broad efforts across the region and especially for cancer rehab.

“I don’t think people have a full appreciation of what oncology PT and OT do,” he said. “They helped me a bunch, and my results have been dramatic. So many patients would benefit from visiting with Katie and Val.”

“I don’t think people have a full appreciation of what oncology PT and OT do. They helped me a bunch, and my results have been dramatic. So many patients would benefit from visiting with Katie and Val.”

Bob Wilkes
cancer survivor

Sue Wing is another passionate advocate of the program. In 2021, she went in for a routine scan and came out with a devastating diagnosis. The scan revealed two spots on her upper right lung, which were diagnosed as lung cancer.

After undergoing surgery and four rounds of chemotherapy, Wing was cancer-free. But soon another problem emerged when she began having intense tingling and pain in her feet.

Wing had peripheral neuropathy – a common side effect of chemotherapy affecting up to 85% of patients. Neuropathy can start at the first dose of chemo or show up months later. Some patients even end treatment early because the symptoms are so debilitating.

“I woke up one morning and couldn’t trust the messages my brain was getting from my feet. I was confused and didn’t know what it was or how to fix it.”

That all changed when she began PT. While her neuropathy is not entirely gone, it is much more manageable, and that success has made her a champion for rehab.

“I realized I needed to be an ambassador for the great work Katie’s doing. Four of my neighbors have already gone to her because of what I shared with them.”

Now, Wing is celebrating her recovery and rehab’s role in it. She is also raising awareness about neuropathy and other cancer side effects and the value of PT in treating them.

Building out compassionate care

Packed schedules have led the program to skyrocket. The number of PT patients more than tripled in 2024 compared with 2021, plus hundreds more who were seen for OT.

The only way to accommodate the influx of patients and continue to grow was to build out the space. With support from Hollings’ leadership and guidance from Hollings’ survivorship team, Schmitt got the green light for expansion, with construction completed in June.

The recent renovation doubles the size of the rehab space. Where there was once room for only two treatment tables, there are now three, a game-changer that allows for another full-time therapist. There are also designated areas for PT, OT and lymphedema treatment.

"The space is more than just a room – it’s a reflection of a shared vision for comprehensive, personalized cancer care,” Schmitt said.

 

The expansion also sets the stage for the next chapter of rehab at Hollings. Schmitt looks forward to bringing in more PTs and OTs, staffing teams for both inpatient and outpatient care, training new students and expanding research initiatives.

"We want to make this a hub. Somebody could come train with us for a month and then bring that knowledge to patients across the state,” she continued.

To make a PT or OT appointment, patients can:

• Ask the front desk when they check out.
• Call 843-792-9300 for Hollings or 843-985-6878 for off-site locations.
• Schedule through MyChart for oncology-centered PT.

Already, Schmitt and Salmon Kelley have built a program recognized as a model of best practice. Hollings was recently cited as an example of excellence in survivorship by the National Accreditation Program for Breast Centers, thanks in part to its on-site rehab.

Plans are also underway to expand community offerings, such as group classes and partnerships with survivor networks, creating a model of care that extends beyond treatment. The team has even been tapped by the American Physical Therapy Association to help develop an oncology rehabilitation certification that standardizes and recognizes the expertise and knowledge of PTs and OTs who specialize in cancer care.

But the key message Schmitt hopes to share with cancer patients and survivors?

"Cancer rehab is here. If you need it, don’t wait for a phone call – ask your provider and call us directly. We’re ready to help."
 

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