Until relatively recently, there was no such thing as cancer rehab" to help cancer patients cope with the grueling and sometimes lasting physical and psychological effects of chemotherapy, radiation, surgery or other treatment. Patients, many of whom considered themselves lucky just to be alive, dealt with the problems largely on their own.
Now: Just as patients who have suffered a heart attack or stroke are likely to receive guidance on how to cope with the aftereffects of treatment, more and more cancer patients are beginning to get the help they need to regain the quality of life they had before getting sick.
Who can benefit: Of the 12.6 million cancer survivors in the US, an estimated 3.3 million continue to suffer physical consequences of their treatment, such as fatigue and/or chronic pain.. and another 1.4 million live with mental health problems, such as depression and/or a form of mild cognitive impairment known as "chemo brain."
Latest development: As cancer rehab becomes more prevalent throughout the UShundreds of facilities nationwide offer such programs-there is mounting evidence showing how this type of care can help accelerate recovery, improve a patient's quality of life and perhaps even reduce risk for cancer recurrence. In fact, the American College of Surgeons Commission on Cancer now requires cancer centers in the US to offer rehab services in order to receive accreditation.
When Cancer Rehab Helps
Even though it was first conceived as a resource for patients immediately after their acute phase of treatment, cancer rehab can help long after treatment has taken place. For example, people who were treated years ago and are now cancer-free-but not free of side effects from treatment can benefit from cancer rehab. Just because you went for, say, physical therapy two years ago after you finished cancer treatment, it doesn't mean that you can't get more help now for the same problem or a different one.
Insurance picks up the tab: Because the benefits of cancer rehab are now so widely accepted, insurance generally covers the cost—regardless of when you were treated for cancer—including consultations with physiatrists (medical doctors who specialize in rehabilitation medicine), physical therapists, occupational therapists, speech language pathologists and others.
Even though cancer rehab therapies tend to be short term (typically requiring two to three sessions weekly in the provider's office for a period of a few weeks), insurance plans often limit the number of visits for such therapies. Be sure to check with your insurer for details on your coverage.
Each cancer patient's situation is different, but here are some common problems and how they are treated with cancer rehab…
Mild Cognitive Impairment (“Chemo Brain”)
Cancer patients who have received chemotherapy often complain that they don't think as well and that they have less energy and decreased attention spans. If anxiety or hot flashes due to chemo interfere with sleep, that can decrease cognitive functioning, too.
Cancer "Prehab” Can Help, Too
Cancer "prehab" is useful during the window after a patient is diagnosed with cancer but before treatment begins to help boost his/her physical and emotional readiness for cancer treatment. For example, a specific exercise program, such as interval training, may be advised to increase strength before surgery. A nutrition program may be used to improve a patient's nutritional status before treatments that may sap appetite or lead to nutrition problems such as anemia. Working with a psychologist can help identify and deal with anxiety and stress before treatment starts. Cancer prehab usually is offered at centers that provide cancer rehab services.
*To find a medical center near you that offers cancer rehab services, consult Oncology Rehab Partners, www. Oncologyrebabpartners.com
How cancer rehab helps: A physical therapist might work with a cancer patient by using a specific therapeutic exercise plan. Exercise has been shown to improve cognitive functioning—perhaps by improving blood flow to the brain.
An occupational therapist or speech therapist may recommend strategies to help concentration, attention and memory. This may involve computer-based programs that improve short-term memory.
Anemia And Fatigue
Anemia is common with many hematological (blood) cancers, such as leukemia and lymphomas.
How cancer rehab helps: In a young person who has just undergone a bone marrow transplant, for example, if there is a low red blood cell count an indicator of anemia) or a risk for infection, a tailored exercise program can build strength and endurance to help fight fatigue.
For an older adult, exercise is also a key part of a fatigue-fighting regimen that improves endurance and overall fitness. If fatigue results in problems with balance and gait, an occupational therapist can help the patient remain independent at home by suggesting a smartphone-based monitoring device such as a motion sensor that notifies a family member or friend if the patient falls.
Difficulty breathing and feeling short of breath are common problems in lung cancer survivors. These patients also may experience pain after surgery and have trouble exercising and performing their usual daily activities due to shortness of breath.
How cancer rehab helps: In addition to improving strength and physical performance through targeted exercises, a cancer patient who is having breathing problems would need to improve his/her ability to get more air into the lungs. This may involve "belly breathing" exercises that will allow him to complete his daily activities without getting out of breath so quickly.
What Exercises Are Best for You? If you have cancer…
Exercise may help fight the nausea and muscle wasting that sometimes occur with cancer and its treatment. In fact, a recent meta-analysis of 56 studies found that aerobic exercise, including walking and cycling-both during and after treatment-reduced fatigue in cancer patients.
Interestingly, strength training was not found to reduce fatigue. But strength training helps maintain muscle mass, so some use of weights or resistance machines should be included for 15 to 20 minutes twice a week, if possible.
Because cancer patients sometimes have trouble maintaining their body weight, it's especially important for those who are exercising to increase their calorie intake.
*Always talk to your doctor before starting a new exercise program. If you have a chronic illness, it may be useful to consult a physical therapist for advice on exercise dos and don'ts for your particular situation.