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Not many of us are aware about the exact role physiotherapy plays in cancer rehabilitation. Despite advances in medical treatments, there are some side effects that patients face during and after the treatment. Cancer related fatigue, pain, nerve damage, lymphedema, deconditioning, and incontinence are some of the common conditions that patients face. This is where the role of physical therapy comes in. There is strong evidence to support conservative management of these impairments through physical therapy. The disease itself requires a team of medical specialists, thus the rehabilitation and management requires professionals with the knowledge of how cancer affects the body, but more importantly an understanding of how the treatment of cancer (surgery, radiation, chemotherapy) affects every body system. As each individual experiences different impairments during and after cancer treatment, it is important to have an individualized evaluation to focus on whether physical therapy is required or not.
Cancer rehabilitation includes helping a person with cancer to help himself or herself to obtain maximum physical, social, psychological functioning within the limits inflicted by the disease and its treatment. Depending upon the progressive nature of the disease, the successful outcomes depend upon in-time identification of the functional problems and immediate referral to rehabilitation.
As the condition is progressive in nature, physiotherapists understand the gradual decline in the physical status. Physiotherapy is effective in reducing fatigue, improving exercise capacity and quality of life.
Cancer patients who are undergoing treatment typically face side effects of chemotherapy or radiation, myopathies and neuropathies, pain and swelling, fatigue, generalized deconditioning, osteoporosis, and depression.
Fatigue is one of the most common symptoms many patients face. There is extraordinary exhaustion associated with high levels of distress, disproportionate to the patient's activity and not relieved by rest or sleep. It can be managed by bed rest, aerobic exercise, activity/ exercise program, diversional activities, rest/ sleep patterns, stress management, nutrition management.
At Nightingales, we have served many patients with varied types of oncological conditions, be it surgical or post chemotherapeutic sessions. Such patients require long term physiotherapy care at home. Unlike other patients, in such conditions, therapy requires utmost balance of intensity and frequency of exercise.
Onco rehabilitation can be categorized based on the stage of the patient's prognosis.
Physical therapy also plays a key role in the prevention of diseases like cancer. A physically active lifestyle helps in reducing the risk of many cancers. We need to educate people about the importance of physical activity, encourage healthy lifestyle and discontinue habits such as smoking.
Prehabilitation can optimize adherence to cancer therapy to reduce complications by improving pliability to the effects of the cancer therapy, reducing the length of hospital stay, and also improving the overall sense of well being.
The treatment focus and goals change as the person progresses through the cancer treatment. The good news is that it is never too late to start rehabilitation for cancer related impairments.
The article is authored by Dr. Sagar Pathare, Lead Rehabilitation, Mumbai, Nightingales Home Health Services.
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