Advances in cancer treatment – including surgery, chemotherapy, radiation, immunotherapy, targeted therapy, and other treatment options – mean more people are beating cancer and living longer. The American Cancer Society (ACS) reports that almost 17 million people living in the U.S. have a history of cancer.
Though their cancer prognosis may be excellent, too many people with a history of cancer are struggling with unwanted side effects. In fact, cancer survivors are nearly three times more likely to say they are in fair or poor health after treatment compared to people without cancer. Those under 65 are also three times less likely to return to work than people without cancer.
Cancer survivors are more likely to experience disabilities and limitations, with 90% experiencing fatigue, affecting survivors physically, mentally, and emotionally. During cancer treatment and after, people may need to learn skills to manage fatigue, pain, and mobility issues as well as cancer-related cognitive impairment (sometimes called “chemo brain”). Unfortunately, most cancer survivors will not be offered rehabilitation services that could help boost their quality of life. According to an American Cancer Society report, only 1% to 2% of cancer survivors receive the therapy and rehab they need.
Why Rehabilitation for Cancer Patients?
If you are a cancer survivor, cancer rehabilitation can teach you how to address the side effects that you experience both during and after treatment. Rehabilitation can help you to get back to your normal activities and enjoying time with family and friends.
Physical therapists can help you regain strength, motion, balance, and stamina. Specially trained physical therapists address issues related to sex, bladder and bowel function, and neck, tongue, or mouth stiffness associated with head and neck cancer. Speech language therapists can help you address cognitive issues like memory, as well as speech and swallowing issues. Occupational therapists can help you perform everyday tasks with less difficulty.
You may set your own goals for your cancer rehab and your therapist may suggest other goals to work toward. For many people, the goals are as simple as independence, improved quality of life, and being able to return to work. For others, goals may be very specific, including return to high level activities.
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How Can Physical Therapists Help?
Physical therapists (PTs) specialize in helping you learn to move with greater ease and efficiency. Physical therapy can be helpful while undergoing cancer treatment or after you have completed treatment if you have:
- Pain, such as joint and muscle pain which may be associated with muscle weakness.
- Fatigue, especially a lack of endurance.
- Mobility issues, including trouble getting out of bed, sitting down, or moving comfortably in different environments.
- Difficulty reaching overhead, which may be difficult for many people but especially for breast cancer and head and neck cancer survivors, as well as anyone with weakness or balance challenges.
- Balance problems, such as unsteadiness and a fear of falling, often from neuropathy or numbness in the feet. This can be addressed by specialized physical therapists within the balance and vestibular therapy program.
- Bladder, bowel, and sexual concerns, including leaking urine or stool, difficulty urinating or defecating, and reduced satisfaction with intimacy. This can be addressed in a private treatment room with specialized PTs who are pelvic health experts within the pelvic health physical therapy program.
- Difficulty eating due to limited mouth opening (trismus), swallowing due to tight neck tissues, chewing due to tight tissues inside the mouth, forward head posture, or face, neck, or oral swelling. This is managed by specifically trained head and neck cancer rehabilitation physical therapists.
- Limb, trunk, or face edema which may occur after radiation or removal of lymph nodes. This is addressed by lymphedema physical therapy.
Yes, Physical Therapy Is Safe for People with Cancer
People may not exercise during or after cancer treatment because they are afraid to move or don’t know where to start. Establishing an exercise routine that can progress as your skills improve is an effective way to reach your physical activity goals. Working with a physical therapist who understands how to prescribe progressive movement at the appropriate intensity while simultaneously understanding your limitations will help you get back to the things you enjoy doing.
Some of the most common issues cancer survivors must manage are housed within the musculoskeletal system, impacting the muscles, ligaments, tendons, joints, and bones. For example, you may have muscles that have become deconditioned because of how ill you felt during treatment resulting in fatigue. You may also have balance issues when standing up or turning around, pain from scar tissue while you reach up for a glass, or muscle weakness or incoordination during everyday tasks, all of which make movement more difficult. By nature of their training, PTs are experts in providing musculoskeletal care and helping you overcome these challenges.
What Happens in Physical Therapy for Cancer?
What your exercise treatment plan looks like depends on your goals.
For example, an athlete who sprains their ankle likely has a goal to get back to competitive play. A person who’s had chemotherapy and is dealing with weakness or dizziness has goals too. These goals could range from getting back to a competitive sport to feeling confident walking around the house again.
After your PT assesses your mobility and pain, and hears your goals for therapy, they will create an exercise plan with you. The plan may start with simple exercises and stretches that you do under supervision. You may come to the physical therapy gym one to two times each week and then work toward self-management and a home exercise program.
Occupational Therapy After Cancer Treatment
Occupational therapy (OT) helps you do the activities of daily life. This includes bathing, dressing, cooking, eating, and getting around your home. It can also include the activities you need to be able to do to return to work.
OTs can help give you strategies for managing fatigue, which is a major side effect of many cancer treatments.
OT is different than PT because it’s more holistic. OTs work with people at a physical, mental, and emotional level. For example, an OT can help with strategies to re-engage socially, including cognitive tricks (like how to remember names despite chemo brain).
OTs also help people regain fine motor skills that declined due to cancer or treatment. And finally, they are experts at using adaptive devices. These are devices that help with dressing, eating, reading, writing, grabbing, lifting, standing, and other activities.
How Speech Therapy Helps Cancer Survivors
Did you know that speech language pathologists (SLPs) can help with problems related to memory, concentration, and disorganization? After cancer treatment, these are all common issues people struggle with.
SLPs do far more than mouth, lip, and tongue exercises (though the exercises may help some cancer survivors). SLPs engage people in word games, do cognitive exercises, and practice conversations. They also offer people strategies and techniques for managing the brain fog that sometimes goes along with chemotherapy.
Some types of cancer may also affect swallowing. SLPs have many techniques for helping people improve their swallowing abilities and patterns. They also work with nutritionists to make sure people are getting enough to eat and drink.
To learn more, please visit UPMC Rehabilitation Institute or call 1-888-723-4277.
American Cancer Society. What is Cancer Rehabilitation? Link.
The UPMC Rehabilitation Institute offers inpatient, outpatient, and transitional rehabilitation, as well as outpatient physician services so that care is available to meet the needs of our patients at each phase of the recovery process. Renowned physiatrists from the University of Pittsburgh Department of Physical Medicine and Rehabilitation, as well as highly trained physical, occupational, and speech therapists, provide individualized care in 12 inpatient units within acute care hospitals and over 80 outpatient locations close to home and work.