By Susan Allen, OTR-L, CLT-LANA, Steward Health Care Rehabilitation Services
Cancer survivors may have endured round after round of chemotherapy, radiation and, perhaps, even surgery during their treatment phase. Unfortunately, these life-preserving treatments can at times cause undesirable side effects. Side effects can vary from patient to patient, even among those receiving the identical treatments. The type and frequency of treatments, as well as the patient’s age and other health issues, also factor into side effects.
Cancer rehabilitation is a growing area in medicine due to the increase in cancer survivorship. Because of advances in medical technology, treatment and early detection, more and more individuals are beating cancer. As the number of cancer survivors increases, there will be a growing need for recovery strategies.
The cancer rehabilitation team is a group of therapists that can include occupational, physical and speech therapists. This team helps patients return to doing the things they want and need to do through the therapeutic use of daily activities (occupations), functional mobility, overall body strengthening, endurance activities, and soft-tissue mobilization. Rehabilitation enables people to live life to its fullest by helping them restore function, decrease pain and cope with their illnesses. People who reach their goals and improve their function can often achieve an increase in quality of life.
Decreased range of motion: After surgery, an individual may experience a decreased ability to move a specific part of the body as freely as he or she once did. In addition, people may experience pain as they try to achieve normal movement. Axillary web syndrome (also called “cording”), shoulder impingements and repetitive-use injuries may be side effects of cancer treatment. Stretching and massage may increase movement and a home exercise program the individual continues upon discharge from rehabilitation may also help.
Fatigue, endurance and deconditioning: Some cancer treatments take months, sometimes years. Medications and treatment techniques often make the person feel nauseated, tired, run down and lacking energy. This may lead to weakness and decreased stamina. Therapists establish a regimen of exercise, progressive strengthening and reconditioning to improve physical strength and stamina.
Lymphedema: During cancer treatment, the surgeon may remove lymph nodes, or the patient may require radiation therapy. If the lymphatic system is involved, the lymph fluid may not drain properly. It can build up in the tissues and cause swelling of the extremities or the face. In such cases, a manual lymph drainage by a certified lymphedema therapist (CLT) can help. This special massage reroutes the fluid to lymph nodes that accommodate it. Coupled with banding techniques and other compression strategies, the procedure can reduce swelling. It can also reduce discomfort, risk of recurrent infections (cellulitis) and other symptoms from the buildup of fluid in the extremities.
Pelvic floor dysfunction: The pelvic floor is a group of muscles in the pelvic region. Just like any other muscle in the body, the pelvic floor can weaken as a result of medication, surgeries, radiation and other cancer treatments. Strengthening pelvic floor muscles will help reduce incontinence and dyspareunia, the pain associated with sexual intercourse. It can decrease generalized pain and improve quality of life.
Scar reduction: The initial surgery, as well as reconstructive follow-up surgeries, can lead to scar adhesions. When scar adhesions and radiation fibrosis occur, cancer survivors may have increased pain and muscle spasms. Scar mobilization techniques, myofascial releases – followed by manual lymph drainage – can prevent adhesions and greatly reduce post-surgical pain.
Memory or concentration problems: Treatments such as chemotherapy may cause difficulty with thinking, concentration and memory loss. Some types of biological therapies and radiation therapy to the brain can cause these problems as well. Memory strategies and cognitive retraining assist cancer survivors with their day-to-day functions.
Emotional support and quality-of-life issues: Depression, fear of the cancer returning, financial stressors and physical limitations are long-term effects of cancer treatment. Cancer rehabilitation can give cancer survivors hope by helping them return to jobs and leisure activities. Physical activity releases chemicals in the brain that can help a person feel happier and sleep better.
During an individualized evaluation, members of the rehabilitation team will determine appropriate goals and customize a plan to improve the person’s ability to perform daily activities and reach desired outcomes. Ongoing assessments by the cancer rehab team help ensure that the goals are being met and, if not, what changes to the intervention plan may be necessary.
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