Physical Therapy on the Cancer Journey

By Cheryl Guarna, PT, MPT, CLT, STAR/C

When I tell people that I am a physical therapist that specializes in treating cancer patients, they often say, “That must be so hard.” I respond, “Actually, it would be better described as challenging but incredibly inspiring”.  Traditionally, physical therapists treat people after surgery, with sports injuries, or after work-related or general musculoskeletal injuries to improve joint motion, decrease pain and increase strength. They also treat people who have suffered neurological setbacks to assist them with regaining maximal function. How could cancer patients be so different? Well, they can be. Unlike other people needing physical therapy, cancer patients often have a multitude of treatments to conquer or manage their disease. These can include surgery, radiation, hormone therapy and chemotherapy, all of which can cause physical impairments. When one treatment is over, often another is scheduled to begin. Cancer treatments can be of short duration, but often the treatment spans months if not years.   Imagine having a difficult surgery-which can itself take months to heal from and then know that you have to begin radiation treatments and perhaps even chemotherapy treatments. When your body is trying to heal, the ongoing treatments can further hinder recovery. Often, chemotherapy and radiation pose their own threats to a persons well being, such as severe fatigue, nausea, pain, nerve damage, blood chemistry alterations, cardiac complications and can impair immune system functioning.


During the past 2 years of developing the groundwork for Oncology Rehab and Wellness Resources, I have had many discussions with the general community, the health care community and even the physical therapy community about the benefits of a cancer-specific rehab practice and the differences between such a practice and a general PT practice. Often, even therapists have said to me, “ general PT practices treat range of motion deficits and strength deficits- what is so different?”, and have even had an oncology nurse navigator state to me, “so you are a general rehab clinic that only sees cancer patients.” Both statements are in part true but here is the differentiating factor.   A cancer rehab practice has therapists and adjunct staff that pursue rehab specific training/education in cancer rehab and complete specialty certifications in the rehabilitation of cancer patients…only”. So, instead of someone who can treat a lot of different populations, you get someone who has chosen to dedictate their time, and their career, to helping cancer patients and survivors in their journey. They remain up to date on the latest cancer surgeries, treatments and treatment complications and have a better understanding of the more specific needs- and precautions- that cancer patients have. This knowledge can make a critical difference in outcomes. This knowledge is what makes a cancer rehab specialist just that.


Because of the specialized needs of cancer patients, it is recommended that you find a physical therapist who has specialized training in oncology rehabilitation. “How do I find one?” Go to to find a PT and enter your zip code, “cancer” as the area of specialization. Do an internet search and seek out cancer rehab programs. But don’t stop there. Ask about the certifications held by their therapists. It is one thing for a practice or hospital to state they have a cancer rehab program. It is another to back that up with specialized protocols and programs specifically designed for cancer related impairments. It is yet another to have therapists that have dedicated their career to helping cancer patients and survivors on their journey.


Cheryl Guarna has been a physical therapist since 1998 and has several specialty certifications in cancer rehabilitation. She is a certified lymphedema therapist and STAR Clinician Certified. Cheryl has started Oncology Rehab and Wellness Resources to develop a comprehensive oncology rehabilitation program. She has a passion for using the tools of physical therapy to help make a marked difference in the physical and functional well being of cancer survivors throughout their cancer journey.