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.
The Institute of Medicine (IOM) report From Cancer Patient to Cancer Survivor: Lost in Transition* documented that many patients complete cancer treatment with functional deficits, in addition to the psychosocial, financial, medical and occupational issues that are not adequately addressed. Some of these deficits are outwardly apparent, but many are not.
A significant number of cancer survivors should not proceed directly from cancer treatment to a community based or independent exercise program because of the severity of deconditioning or physical deficits that must be addressed first. Deconditioning is the loss of muscle tone and endurance often experienced by cancer survivors. A comprehensive assessment completed by a physical therapist is beneficial for improving a cancer patient’s ability to safely transition to a community-based or independent exercise program. A cancer survivors’ rehabilitation assessment (and possibly rehabilitation) needs will depend on many factors, including the type of tumor, the affected organs, treatment methods (i.e. chemotherapy, surgery or radiation), and the level of prolonged bed rest or inactivity.
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.
What to Expect from a Post-Cancer Treatment Physical Therapy Assessment
As with all cancer treatments, you should have a clear understanding of what to expect before you are in the throws of your assessment appointment. This is what you should expect:
• A thorough health history
• Comprehensive assessment of vital signs including oxygen saturation
• Assessment of joint range of motion, muscular strength, and muscular flexibility
• Identification of soft tissue restrictions and painful movements
• A fitness assessment (cardiovascular response to exercise/exertion and recovery (responses)
• Neuropathy screening and evaluation
• Balance and coordination assessment
• Gait analysis
• Body Mass Index (BMI) measurement and assessment
• Skin integrity assessment and edema assessment
• Instructions and recommendations for exercise/activity
• Recommendations for assistive devices and/or lifestyle modifications
• Lymphedema risk reduction education
• Referrals to other appropriate health care practitioners and community resources as needed
In the next several weeks, our blog posts will continue to focus on the effects of cancer, cancer treatments and cancer-related deconditioning on the body. Our goal is to improve the knowledge of those with cancer – and those who know someone with cancer – to support survivors on their journey.
If you have questions or comments regarding this post or previous blog posts, please contact Cheryl Guarna at firstname.lastname@example.org.
*Although this study was conducted in 2005, the data still stands.