WHAT IS CANCER REHABILITATION?
Cancer rehabilitation can be defined as a process that assists the cancer patient to obtain maximal physical, social, psychological, and vocational functioning within the limits created by the disease and its resulting treatment. Cancer treatments take a toll on a patient's body in addition to the disease itself, so the eradication of cancer is not the final step in a patient's recovery.
Cancer Rehabilitation can be preventative, restorative, supportive, and palliative. It is recognised that patients may have rehabilitation needs throughout their care pathway. The fact that cancer patients are facing several months of chemotherapy and/or radiotherapy and usually major surgery, as well as the direct effect of immobility due to pain, means that muscle wasting, joint stiffness, as well as de-conditioning and fatigue are inevitable. Impairments that may be relatively easily addressed by rehab interventions if detected early can become very difficult and expensive to treat if they have progressed over weeks, months or years.
Cancer Rehabilitation can involve:
Individually prescribed exercises to improve joint movement, strength, fitness and energy levels
Education about management techniques for fatigue, swelling, pain, mental health issues, completing everyday activities and much more
Support and reassurance throughout all aspects of the cancer journey from specially trained health professionals who have the time and skills to listen and help.
WHAT IS THE EVIDENCE FROM RECENT RESEARCH ON THE BENEFITS OF CANCER REHABILITATION AND PHYSICAL ACTIVITY AFTER A CANCER DIAGNOSIS?
Clinical research has established exercise as a safe and effective intervention to counteract many of the adverse physical and psychological effects of cancer and its treatment. To date, the strongest evidence exists for improving physical function (including aerobic fitness, muscular strength and functional ability), attenuating cancer- related fatigue, alleviating psychological distress and improving quality of life across multiple general health and cancer-specific domains.
Emerging evidence highlights that regular exercise before, during and/or following cancer treatment is associated with reduced risk of developing new cancers and co-morbid conditions such as cardiovascular disease, diabetes and osteoporosis. Furthermore, epidemiological research suggests that being physically active provides a protective effect against cancer recurrence, cancer-specific mortality and all-cause mortality for some types of cancer (research has predominantly focused on breast, colorectal and prostate cancers).
WHY IS CANCER REHABILITATION IMPORTANT?
Cancer survival rates have dramatically increased in the past 40 years as a result of improved prevention, detection and treatment. The newest treatments are training the immune system to hunt tumour cells, medications are keeping cancer growth in check, and yet surviving cancer is just the first challenge.
Many people emerge from treatment facing struggles far beyond their illness. Some survivors have minimal pain and disability, some are completely debilitated and a great number lie in between. A few common challenges cancer survivors confront include physical concerns (fatigue, pain, or changes in appearance or memory) or emotional distress such as depression or fear of recurrence. There are often also financial and employment implications of cancer treatment and survival.
The effects of the disease process, and often of the treatment itself, mean that patients commonly develop unwanted side effects. These side effects include:
• Pain, restricted range of motion, scar adhesions
• Lymphoedema, osteoporosis, neuropathy
• Changes in physical body composition, Loss of muscle tone and strength (including
pelvic floor tone and control)
• Fatigue, nausea, depression,
• Decrease functional and cognitive capacity
• Reduced sleep, poor posture and decreased energy levels
• Reduced fitness levels and decreased body confidence
• An increase in incidence in co-morbidities is also commonly seen
These impairments may adversely affect patient’s participation in activities of daily living and employment and negatively affect healthy lifestyle behaviours such as regular exercise.
WHEN SHOULD SOMEONE COMMENCE CANCER REHABILITATION?
Emerging evidence highlights that regular exercise before, during and/or following cancer treatment decreases the severity of adverse side effects, improves treatment outcomes and reduces mortality and recurrence rates. Cancer Rehabilitation Programs such as the PINC Program, cater for people at all stages of their cancer treatment including pre-op, post-op, active treatment (chemo and radiation), survivorship and palliative. The focus is on helping people with cancer achieve their goals, maximise their health and give them a sense of control over their cancer. This can be worked on at all stages of cancer, but the earlier someone commences their cancer rehabilitation. A referral to a cancer rehabilitation specialist/program straight after diagnosis means we can help be there for cancer patients as a constant source of encouragement, knowledge, support and motivation.
WHO IS SPECIALLY TRAINED IN CANCER REHABILITATION?
Accredited exercise physiologists and physiotherapists are the most appropriate health professionals to prescribe and deliver exercise programs to people with cancer. This is because exercise recommendations should be tailored to the individual’s abilities noting that specific exercise programming adaptations may be required for people with cancer based on disease and treatment-related adverse effects, anticipated disease trajectory and their health status.