Cancer has long been associated with excruciating pain and suffering and the condition is a powerful stirrer of multiple negative emotions.
The battle with cancer is a long fight. But remember, modern- day research in the field of Cancer rehabilitation and treatment, has found a myriad of solutions to put up a brave fight against the condition along with oncology occupational therapy. We wish to fight along with you through our oncology physical therapy. Cancer rehabilitation is a significant part of overcoming its consequences. Our rehabilitation clinic in Chennai offers an array of programs that include solutions in the form of breast cancer rehabilitation, lung cancer rehabilitation and more.
Patients with cancer have physical and cognitive problems due to cancer itself or due to radiation or chemotherapy. Some of them being
- Brain tumors and spinal cord tumors that are discussed in brain injury and spinal cord injury sections respectively
- Radiation-induced cognitive impairment – As the name suggests, cognitive dysfunction can be noted in patients undergoing radiation and it’s dose-dependency
- Transient radiation myelopathy – This is a condition where there is damage to spinal cord due to radiation therapy. It is reversible and starts anywhere between 1-30 months after the radiation has started
- Delayed radiation myelopathy – This condition is also radiation-induced damage to spinal cord but starts much later and the condition is irreversible
- Peripheral neuropathy – It is a condition, which affects multiple peripheral nerves due to cancer or it could be due to chemotherapy (particularly platinum-based agents, taxol agents or vinca alkaloid agents) or radiation therapy
- Myopathies such as dermatomyositis, polymyositis, or steroid-induced myopathy – myopathies are conditions, which cause damage to the muscles. It could be because of steroids that are used for cancer treatment, or an autoimmune condition (when immune system malfunctions and attacks your own body cells) causing damage to the muscles
- Lymphedema – A condition which is characterized by swelling of the arm with a sense of fullness and it’s a frequent complication of breast cancer
- Metastasis to the bone (cancer spread to the bone), osteoporosis (bone thinning), fractures – Commonly seen in breast cancer, lung cancer, prostate, thyroid and kidney cancer
SYMPTOMS AND MEDICAL COMPLICATIONS
Collectively these conditions can cause a wide range of symptoms and complications such as
- Severe pain
- Burning sensation, tingling, and numbness of the arms and/or legs
- Weakness of the muscles of the arms and/or legs
- Cognitive impairment
- Difficulty in swallowing
- Poor endurance
- The above symptoms can affect someone’s ability to walk and perform day-to-day activities independently, which can cause depression and anxiety and significantly worsen their quality of life
Our comprehensive, interdisciplinary team approach (i.e. care being provided by various disciplines in a coordinated fashion) involving a Physician (Physiatrist), Physiotherapist, Occupational Therapist, Speech Language Pathologist, Neuropsychologist, Nutritionist and a Rehabilitation Nurse can help reduce your symptoms directly related to the illness as well as prevent medical complications that occur as a result of impaired mobility such as blood clots in the veins of the arms and legs, blood clot in the lungs, pressure ulcers, and muscle wasting. Not all patients will require all services and usually, a combination of these services is required for an individual patient. You will be evaluated at the initial visit to determine what services you require and a tailored treatment plan will be initiated.
Patients will be evaluated by the Physician first to determine the severity of the condition and it’s impact on the patient and then formulate a treatment plan that best suits them. Depending on the patient’s symptoms, the treatment plan will include training on various exercises and treatment modalities, which will be executed by the rest of the team. The physician also recommends appropriate orthosis if the patient has significant muscle weakness to help walk or perform daily activities better or to prevent joint deformities. The physician also performs injections for muscle, tendon or joint pain. If the pain is excessive, the physician also prescribes medications that can help control it on top of prescribing other treatment modalities.
The Physiotherapist trains patients on various physical exercises to improve their walking and balance, improve strength in the arms and legs, improve endurance, and decrease fatigue. They use physical modalities to reduce joint and muscle pain, burning sensation and treat and prevent muscle atrophy. They focus on compression therapy, using compression garments and strategic positioning of the arm to reduce lymphedema.
The Occupational therapist will help patients with severe physical impairment to be independent by training on various physical activities required for daily living such as moving in the bed, transferring from one place to another, eating, dressing, bathing, toileting, and driving. The final phase of treatment involves patient training for successful community integration (education, employment etc).
The Neuropsychologist evaluates patients with depression and anxiety, that is commonly seen after any major life-changing illness and guides them through the process of rehabilitation thereby improving their quality of life through motivation and counseling. Performing an in-depth cognitive assessment and planning cognitive re-training exercises and compensatory strategies is also a major treatment aspect of the Neuropsychologist.
As adequate nutrition intake is essential for optimal recovery, the Nutritionist recommends an appropriate intake of nutrition.
The Rehabilitation nurse focusses on performing and teaching wound care management for patients with wounds due to immobility.
Expectations of Recovery
The Treatment duration depends on the nature and severity of the condition. Cancer rehabilitation treatment can be done in a lot of ways. For patients who are considered to be in remission or cancer free, full recovery is often possible. For patients with physical limitations the goal is to provide functional independence despite their limitations and integrate them back into the community (i.e. return to school, return to college, return to household work, return to employment etc). For patients who are actively undergoing cancer treatment, rehabilitation can be helpful to reduce their symptoms. Studies have shown that cancer rehabilitation helps patients to be more compliant with cancer treatment because they are physically and mentally stronger to participate in such treatments, which can decrease cancer-related morbidity and mortality. For patients whose cancer is progressing, and have physical limitations, the goal is to provide them with means to have as much independence as possible with daily activities, reduce symptoms and keep them comfortable using methods described above.