The Role of Physical Therapy and Rehabilitation in the Cancer Care Plan
The integration of an oncology physical therapist into the oncology team throughout the cancer survivor trajectory can benefit both advanced practitioners and survivors. Physical impairments of patients undergoing cancer treatment can impact functioning and quality of life throughout survivorship, but exercise and rehabilitation may mitigate some of these treatment-related adverse effects and comorbidities.
Among the 14.5 million cancer survivors alive today in the United States, very few have had the opportunity to partake in a well-designed exercise program or have been referred to a physical therapy program for their impairments
INVOLVING PHYSICAL THERAPISTS IN CARE
Advanced practitioners in oncology are facing many challenges, many of which can be assisted by the role of the physical therapist and the rehabilitation team. Treatment goals in physical therapy will be set through shared decision-making with the patient, This helps with patient responsibility and accountability, and that in turn increases compliance in their medical treatments.
REDUCE HEALTH-CARE COSTS AND IMPROVE QUALITY OF LIFE
Exercise can play many roles for the cancer survivor. It has been shown to ameliorate physical and psychosocial side effects, improve cardiovascular, metabolic, and immune function, help restore proinflammatory/anti-inflammatory homeostasis, reduce health-care costs, and improve quality of life. There is also strong epidemiologic evidence that physical activity can improve survival.
Despite the many benefits of physical therapy, it is often underutilized in the oncology setting. There is often a lack of consensus as to when (or even if) to initiate an exercise program during treatment. Additionally, the use of drugs as first-line treatment may marginalize the benefits of exercise.
One area in which physical therapists can be useful is in managing cancer-related fatigue. Fatigue is experienced by up to 90% of patients treated with radiation therapy and up to 80% of those treated with chemotherapy; it may already be present in 40% of patients at diagnosis.
The impact of fatigue on a patient’s quality of life, physical functioning, and ability to perform can be both profound and pervasive. We recommend physical therapy for patients with comorbidities, recent surgeries, functional and anatomic deficits, and substantial deconditioning.
Many physicians feel that their patients may be too frail to start an exercise program or will not make much progress in an exercise program, but studies have shown that the most deconditioned and frail [patients] make the greatest improvements in strength. Also, many physicians stress the beneficial effects of postural and strength training, balance and endurance training, and pulmonary rehabilitation in the physical therapy setting for patients with osteoporosis, peripheral neuropathy, or other conditions that put patients at an increased risk of falling.
Contact Western New York Physical and Occupational Therapy Center, if you want to know more about our Cancer Rehabilitation Care.