Celebrating One Year of Blogging About Cancer Rehab!

Celebrating One Year of Blogging About Cancer Rehab!

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

March 2015 marks one year of our blog! The past 12 months have been an exciting time for our practice as well as for the advancement of awareness of physical therapy services available to cancer patients and survivors.  

 As a tribute to our blog success, this month we have compiled highlights from our favorite blogs of the past year-those that garnered attention, provided enlightenment and best improved the knowledge available regarding the availability of and importance of physical therapy for all cancer survivors.  

March 2014: What Exactly Is Cancer Rehab?

It has long been understood that exercise is beneficial for everyone. It is also agreed that medically directed exercise offered in rehab can help greatly after someone has had a stroke, surgery, heart attack, back injury and more. Rehab is also routinely ordered for someone who has had a joint replacement, sports injury or developed a neurological disease among other things. Historically, patients who have had cancer have been told “go home, rest, your treatment is finished, resume your life.” Cancer patients are often left weakened, scarred, truly ill and unable to resume their life, or resume their life as prior to cancer. While some patients may be referred for therapy, a vast majority are not.  It is estimated that 65% – 90% of cancer patients develop life-limiting impairments. It is also estimated that only 20% – 30% of those patients are referred to and receive therapy to address these impairments. As cancer survival rates continue to increase, the number of patients being left with life changing limitations is growing as well. Cancer rehab is becoming a critical need as more and more patients are surviving. Quality of life (QOL) issues need to be addressed and survivors need to be given the chance to live the life they did before cancer.

What is cancer rehab? Cancer rehab is rehabilitation for cancer patients and survivors, directed by therapists who have received post therapy school education, training and specialty certifications in the identification and rehabilitation of impairments related to cancer and its treatments. They are knowledgeable in treatment protocols for specific impairments and problems that cancer patients often present with. Shouldn’t you trust your rehab needs to a physical therapist who specializes in what YOU are suffering from? The answer is simply, yes you should. You can read more here: https://oncrehabandwellness.com/what-exactly-is-cancer-rehab/

_____________________________________________________________________April 2014: How to find a qualified cancer rehab clinician Becoming a cancer rehab clinician is more than placing the word “cancer” in front of “rehab.” It requires time, dedication and ongoing education specific to how cancer and its subsequent treatments impact the human body and mind. The following nationally recognized certifications are indicative of experience and education in cancer rehab.

Nationally Recognized Certification Programs
STAR/C – A STAR Clinician Certification (Survivorship Training and Rehab) is administered by Oncology Rehab Partners. Certification includes comprehensive training on and testing for the identification and treatment of cancer-related impairments. Search for a STAR Certified Clinician at oncologyrehabpartners.com.

CLT – The Certified Lymphedema Therapist (CLT) designation is administered by several schools. Therapists participate in a rigorous 135 hours of education and training on Complete Decongestive Therapy, or CDT, which is the most effective method for treating lymphedema. The nationally recognized schools that provide such training and certification are:

APTA Sources.  You can easily locate a cancer rehab specialist (or a therapist with experience in the rehab of cancer survivors) in your region by using the “Find a PT” search tool at American Physical Therapy Associations (APTA) web site. You can search using zip code, city, distance, and therapist or practice name. Under “Practice Area” select “Cancer.”

Ask Questions. To ensure your therapist has adequate experience working with cancer patients and survivors and has the specialty professional designations you want, ask questions. Talk to your doctor about the clinician to whom he/she is referring you, and do not be surprised if cancer-specific rehab is new information. This is a rapidly growing – but relatively new area – of your cancer care team, so you may have more information than your physicians. Then talk to the rehab clinician during your initial visit. Although this visit is deemed an “assessment” visit for the clinician to determine your abilities and weaknesses, it is also an opportunity for you to learn more about this new person on your team. Ask about certifications, ongoing oncology education, and how much of their work is with cancer survivors. To read more, visit: https://oncrehabandwellness.com/finding-a-qualified-cancer-rehab-therapist-2/

_______________________________________________________________May 2014: Creating Better Systems for Cancer Rehab Care Coordination

The more I talk to cancer survivors and hear their stories, the more I believe the it is imperative we put in place guidelines for increasing cancer rehab referrals and improving care coordination.  There is currently still a knowledge gap when it comes to physicians referring their patients for cancer rehab. WHY? It is demonstrated time and time again that it is beneficial in improving the lives of cancer patients and survivors. There are a few reasons why there is such fragmentation when it comes to cancer rehab referrals.

  • A lack of knowledge about cancer rehab and its availability.
  • No systematic screening for rehab currently in place.
  • Not enough cancer care coordination support for already overburdened patients and their families.

There is movement in the right direction, though. The Commission on Cancer (CoC), a consortium of professional organizations that sets standards with the intention of improving survival and quality of life for cancer patients, has developed Cancer Survivorship Care Plans with mandated guidelines in order to improve the delivery of cancer care in CoC-accredited facilities. Three areas of patient-centered treatment in the CoC standards include:

  1. A patient navigation process to address healthcare disparities and barriers to care.
  2. Screening patients for psychosocial distress.
  3. A survivorship care plan that documents care received and seeks to improve cancer survivors’ quality of life.

These guidelines ensure access to rehabilitation services and identifies the rehabilitative services that are provided either on-site or by referral.

We know that increasing awareness of cancer signs and symptoms leads to early detection and treatment and, thus, better outcomes. It makes sense that early detection and treatment of cancer related physical impairments also creates better outcomes. Although cancer rehab was first introduced in the 1970s, only recently has it become an integral part of the cancer care continuum. We need to step up education and awareness so it is an option for every survivor. Interested in more on this topic? See: https://oncrehabandwellness.com/creating-better-systems-for-cancer-rehab-care-coordination/

_______________________________________________________________June 2014: Cancer Rehab Assessments Minimize Complications After Treatments

Throughout a person’s cancer experience, it is critical to maintain the things in life that are important to you – energy, activity level, relationships. In fact, research shows that an active lifestyle that includes exercise can actually enhance your body’s recovery and contribute to a better quality of life during and after cancer treatment. Life doesn’t stop after cancer, but cancer can change a person’s life.

Survival rates are steadily increasing for those affected by cancer. More people than ever before live through a cancer occurrence, but it brings new challenges. For many cancer survivors the aggressive, life saving interventions may take a harsh toll on the human body. So while the fight against cancer is won, patients may experience debilitating side effects that can be long lasting. Fatigue, joint pain and stiffness, weakness, emotional strain, bowel or bladder dysfunction, muscular pain, mobility limitations, lymphedema, chemo brain, neuropathy and significant physical deconditioning are just some of the after effects possible with cancer treatments . . . and may not show up until years after treatment ends.

With all of these possible complications, it is prudent to seek out the advice of your oncology team – including a trained cancer rehabilitation clinician and cancer exercise specialists – prior to beginning any exercise or activity program. It is through their knowledge that any contraindications to certain activities or exercises can be identified and modifications to your program will be made. Failure to do so, in some circumstances, can place a cancer survivor at risk of serious health complications with exercise.

If you have been released back into the care of your primary care physician, start the conversation with her (or him) and ask to her to confer with your oncology team. Although your primary care physician may not be as familiar with the benefits and importance of cancer rehab and fitness, there is an abundance of evidence-based information available online starting with this blog and our Research and Article Library. To see more of this blog post, visit: https://oncrehabandwellness.com/where-does-post-cancer-treatment-assessment-fit-in-to-your-life/

_______________________________________________________________January 2015: Physical Therapy on the Cancer Journey

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.

Because of the specialized needs of cancer patients, it is recommended that you find a physical therapist who has specialized training in oncology rehabilitation.  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 dedicate 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. For the rest of this story, read: https://oncrehabandwellness.com/physical-therapy-on-the-cancer-journey/

_____________________________________________________________________You can read all of our blog posts by visiting our website blog page: https://oncrehabandwellness.com/patient-resources/survivor-blog/ or click on the quick links below:

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