Hidelisa Manibusan, PT, DPT
Jill Gleason, PT, DPT
Jordan Labrec, PT, DPT
When Hidelisa Manibusan, PT, DPT, began treating patients with cancer at UCSF 14 years ago, the department didn’t offer specialized cancer rehabilitation or lymphedema services. With Dr. Manibusan’s support, UCSF has worked diligently to fill this critical need.
With the opening of the UCSF Health Bayfront Medical Building and the continued growth of satellite sites, UCSF now has five therapists dedicated to oncology care. Each brings a unique focus: Jill Gleason, PT, DPT, treats patients with breast cancer and general oncology needs; Jordan Labrec, PT, DPT, works with patients with prostate and gastrointestinal cancers; Elizabeth Holt, PT, DPT, splits her practice between patients with breast cancer and general oncology; Andy Tsui, PT, MSPT, provides patient care across the cancer spectrum; and Dr. Manibusan works with patients with breast cancer.
The program also reaches patients closer to home with services in Burlingame and Berkeley. In addition, rehabilitation is woven into the entire continuum of cancer care. Group therapy classes, as well as survivorship programs such as Strength After Cancer, Strength After Breast Cancer and Core and More help patients transition from intensive treatment to independence. “It’s been exciting,” Dr. Manibusan said.
"We’ve slowly gone from just me doing the care to a full team of five therapists. The growth means more patients can access rehab at the right time, and we can keep building services like lymphedema care and survivorship programs.” As cancer treatments advance and patients live longer, managing functional limitations and complex health needs is paramount.
“It’s not just about surviving treatment,” Dr. Manibusan said. “We have to think about what that means for their ability to take care of their kids, to work full time, to manage their daily lives.”
Preventing and Managing Lymphedema
One of the most important recent advances is in lymphedema care. Education and early intervention can dramatically reduce the risk of this chronic condition, which can develop after surgery, radiation or chemotherapy. A new lymphedema surveillance clinic at the Precision Cancer Medicine Building (PCMB) helps identify and treat the condition early, reducing long-term complications and improving quality of life. Patients are taught when to use compression, how to perform lymphatic massage, and how to safely build strength. Research shows that strength training alone can lower the risk of lymphedema by about 30%.
“The goal is to help patients move through treatment and survivorship with as little disruption as possible,” Dr. Manibusan said. “When we catch lymphedema early, we can often keep patients close to their baseline and independent in daily life. But when it progresses unchecked, it can be debilitating.”
A Personal and Professional Mission
For Dr. Manibusan, the expansion of cancer rehabilitation at UCSF is both a professional milestone and a personal calling. “Cancer has touched my own family, and I know firsthand how many gaps patients face,” she said.
“Rehab gives people not only strength and function, but dignity and a sense of self when everything else feels uncertain. That’s what makes this work so meaningful.” That sense of purpose is reinforced by patients such as a young woman Dr. Manibusan treated several years ago. Diagnosed with metastatic stage IV breast cancer at just age 25, she came into the clinic in a wheelchair, debilitated by neuropathy. Her goal was simple but profound: to walk down the aisle and dance with her husband when they renewed their vows.
“We spent weeks working on her balance, building her strength, and finding ways to compensate for her neuropathy,” Dr. Manibusan recalled. “I got to know her and her family really well.”
Although the patient later passed away, her family sent Dr. Manibusan a card and photo after the ceremony. She had achieved her goal: walking down the aisle unassisted and sharing a dance with her husband. “That stays with me,” Dr. Manibusan said. “It’s always hard losing a patient, but being able to give them some sense of independence and dignity, even as things are failing, is so important.”