You may or may not have thought of incorporating an oncology rehab program into to your existing practice. Perhaps you felt ill-prepared to start such a program. Let me take a few minutes to dispel that line of thinking. As a profession, physical therapists are the best suited to meet the unmet debilitating physical impairment needs that are extremely common among cancer survivors during and after cancer treatments.
Surgery, chemotherapy, radiation therapy and immunotherapy can significantly deteriorate usual quality of life resulting in weakness, muscle atrophy, treatment related fatigue, neuropathy, balance dysfunction, osteoporosis, weight loss and weight gain just to name a few of the treatment induced side effects. Exercise and physical therapy interventions can play a huge role in preventing, mitigating and improving these impairments.
It is uncommon for oncology physicians to prescribe physical therapy for reducing stress, anxiety, depression, improving insomnia, nausea, constipation, anemia, reducing blood glucose levels, swelling and other frequent cancer treatments related symptoms; yet exercise and physical therapy has been shown to be most effective in managing all of these symptoms.
Evidence based studies have shown that breast and colorectal cancer survivors expending effective levels of exercise had a 50-60% increased survival to cancer and other leading causes of death compared to survivors not expending as many metabolic equivalents. Other studies support exercise intervention as effective in reducing the rate of metastatic disease and reducing cancer recurrence.
Dr. Andrea Chevelle, an oncology physiatrist at the Mayo Clinic reported that among 163 breast cancer women undergoing in-patient breast cancer treatment, 92% had at least one physical impairment (and a total of 584 impairments) that required some form of physical rehabilitation and 88% requiring PT/OT. However, only 21% of those requiring PT/OT ever received treatment. She went on further to point out that once discharged from the hospital these impairments were far less likely to have been addressed. These statistics probably account for why it was reported in the Journal of Gerontology in an article entitled Cancer Survivors in the US, Age Health and Disability that compared with individuals without cancer or chronic disease, cancer survivors are 3x more likely to report being in fair or poor health, >2x more likely to have psychological disability, > 2x more likely to be burdened with functional limitations and for those under the age of 65, survivors, were > 3x less likely to be able to return to work because of the health condition.
In an extensive report published in a Supplement of the Journal Cancer in 2012 a new model of care was recommended for adoption into the cancer care plan for breast cancer patients. It is referred to as the Prospective Surveillance Model of Care. With this paradigm shift the physical therapist is introduced to the patient at the time of diagnosis or early into the treatment plan. There the PT is assessing baseline function, educating patients about symptom management and enlightening them to the role of exercise and other healthy lifestyle behaviors. Then on a routine interval basis the patient is re-assessed by PT every 3 months or sooner if needed so that physical impairments can be prevented or detected earlier, leading to quicker resolution and when symptoms are in their infancy and more easily treated.
We have a responsibility to educate the medical and lay community as to the value added role that physical therapists can play as integral members in the treatment care plan for the cancer patient. If you or someone you know is struggling through their cancer treatments or have never regained their prior level of functioning after cancer treatment we would be happy to share in more detail how our therapists at Therapeutic Solutions, Inc. have been improving quality of life and restoring health to thousands of patients of our 42 years in practice.