Cancer rehabilitation can be utilized prior to, during, and after cancer treatment(s) with the primary goals of:

• Helping the individual with cancer to stay as active as possible and participate in work, family, and other life roles
• Lessening the side effects and symptoms of the cancer and its treatment(s)
• Helping to keep the individual with cancer as independent as possible
• Improving quality of life for the individual with cancer and their caregivers

Cancer rehabilitation involves an interdisciplinary team often consisting of a physical therapist, occupational therapist, speech language pathologist, psychologist, and other disciplines—depending on the specific needs of the patient. Below is a list of potential members of the cancer rehabilitation team and a brief description of general services provided.

• Physical therapist (PT). PTs specialize in helping people improve or restore mobility. They can also help reduce or eliminate pain and designtreatments to maintain or restore muscle strength and joint function required for safe mobility. PTs can help assess and train patient’s in the use of a variety of mobility devices and techniques such as fall prevention to increase safety with movement. Oncology PTs work specifically with people who have cancer and cancer survivors.
• Occupational therapist (OT). OTs help maximize the function, comfort, and safety of patients during performance of everyday activities. This can include training in adaptive techniques and use of adaptive equipment for management of daily tasks, such as bathing and dressing. It can also include assessment of the home/work environment and skilled recommendation of modifications to maximize a patient’s safety and independence at home. OTs focus on increasing a patient’s participation and performance in desired daily activities with overarching goals of increasing patient quality of life, increasing safety and independence during activities, and reducing caregiver burden.

• Speech pathologist (SLP). SLPs specialize in communication and swallowing disorders. They can help patients maintain their swallowing, eating, and speaking ability after radiation therapy and chemotherapy. An SLP may also help people with cognitive problems improve their memory and organization skills.
• Physiatrist. Physiatrists are also called physical medicine and rehabilitation specialists. They specialize in the prevention, diagnosis, and treatment of nerve, muscle, and bone disorders that can change how people move and function. These specialists often work with people on pain management.

• Lymphedema therapist. Lymphedema therapists evaluate and treat lymphedema. They focus on reducing swelling and controlling pain. They often use techniques such as compression garments, specialized massages, bandaging methods, and exercises.

• Cognitive psychologist. Cognitive psychologists, also called neuropsychologists, are experts in understanding how behavior relates to brain function. They often help manage “chemobrain,” a word used to describe the cognitive problems that people with cancer often face during and after cancer treatment.
• Vocational counselor. Vocational counselors support people in returning to work during or after cancer treatment. They can help a person learn how to do daily job-related tasks more easily.
• Recreational therapist. Recreational therapists treat and help maintain a person’s physical, mental, and emotional well-being by helping to reduce stress, anxiety and depression through engagement in recreational activities. They also help build a person’s confidence and strengthen personal skills. Recreational therapy provides treatment services in many ways, including through art, exercise, games, dance, and music.

• Dietitian. A dietitian, or nutritionist, is a food and nutrition professional. Oncology dietitians help people understand nutrition guidelines for specific types of cancer and supportive nutrition during treatment. They also help people adopt healthy eating patterns to reduce the risk of cancer recurrence.
• Exercise physiologist. Exercise physiologists evaluate a person’s fitness and design personalized fitness plans to help them improve function. Some exercise physiologists are also certified Cancer Exercise Specialists, with additional training designing fitness plans that meet the unique needs of people during and after cancer treatment(s).

Unfortunately, comprehensive cancer rehabilitation is often underutilized. Not all doctors refer patients and their caregiver(s) to each of the resources listed above. Additionally, not all patients and their caregiver(s) utilize all these services—whether due to accessibility and insurance limitations, limited knowledge of services available and potential benefits, or a strict focus on the immediate medical needs of the patient. Cancer rehabilitation should be comprehensive, with treatments uniquely designed to provide supports and improve function of mind, body, and soul. It is recommended that patients and their caregiver(s) research and explore all available services and talk to their doctor about the referral process to access different treatments that they feel could be beneficial.

Source: Amanda Beaton, OTR/L Master of Occupational Therapy