Cancer Rehabilitation Starts at Diagnosis

Survivorship care typically begins at the end of active treatment. The goal is to provide support and resources for moving forward after treatment. In reality, survivorship care is most helpful when it looks at your whole cancer experience, from diagnosis forward. You are a survivor from day 1. A vital starting point is a baseline assessment, at diagnosis, of your preparedness for cancer treatment.

Survivorship Care Starts with a Physical and Cognitive Baseline Assessment

Nancy Litterman Howe

The baseline assessment measures key indicators of your physical and cognitive (mental) status before you start treatment. The results of this assessment can help your providers predict how you will respond to treatment. They can point out specific activities that can significantly reduce issues like fatigue, pain, impaired range of motion, muscle weakness, as well as cognitive impairments like anxiety, depression, and fear of recurrence. The baseline assessment, survivor education, and subsequent re-evaluations and recommendations are all part of what cancer rehabilitation (rehab) providers do.

The Vital Expertise of the Cancer Rehabilitation Team

Ideally, when your team makes your treatment plan, they will send you to a physiatrist (pronounced “fizz-EYE-a-trist”). A physiatrist is a doctor with training in how to keep and get back function in the face of debilitating disease and treatments like surgery, chemotherapy, radiation, and hormonal therapy.

The physiatrist checks your physical and cognitive health.  Ideally, this would happen before starting treatment. They consider the order, intensity, and functional impact of the treatments you will be getting. Based on these things, they will recommend activities that will help to reduce impairments and help keep function at all points on the survivorship continuum.

The physiatrist’s plan is carried out by rehab practitioners who include physical and occupational therapists, speech-language pathologists, pain specialists, and psychosocial experts. These providers have the skills to safely, effectively, and compassionately manage the impairments linked to cancer and its treatments, such as pain, fatigue, weakness, swelling, stiffness, and mental challenges.

Retake Control Over Your Survivorship

Before treatment starts, you can take part in rehab activities that build stamina and strength to better prepare you for treatment. This is sometimes called pre-hab. A physiatrist on your team can alert you to symptoms that you should seek help for. This can help your practitioners to address issues early when treatment may be more effective and less invasive. The support of a rehab provider can help you better handle the side effects of treatment.

Once treatment is done, cancer rehab plays a big role in helping you recover faster and get back your independence. This can help you return to your life roles more successfully in the family and on the job. Ask your oncologist for a referral to a physiatrist who can include rehab recommendations in your survivorship care plan and give guidance for potential long-term and late effects of treatment.

Why Haven’t I Ever Heard of Cancer Rehab?

By now, you may be asking yourself why all patients aren’t referred to a rehab provider. I wonder the same! In part 2 of this blog, we will look at the reasons why cancer rehab hasn’t yet had its day in the limelight and what we can do to change that.

About the author: Nancy Litterman Howe, MS, CES was diagnosed with throat cancer in 1997. An avid runner at the time, she realized that exercise did not protect her from cancer, but physical activity could greatly enhance her survivorship. Howe is working on her Ph.D. dissertation which is focused on helping survivors become more active. 

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