Cancer Rehabilitation: Challenging and Incredibly Rewarding
Estimated Reading Time: 3 minutes
Imagine the following 3 patients are referred to your physical therapy clinic.
The first is a 54-year-old man, referred for "deconditioning." He feels worn out and too fatigued to perform his work duties as a construction worker.
The second patient is a 46-year-old woman, referred for "decreased right shoulder ROM." Her chief complaint is difficulty getting dressed and an inability to participate in her regular exercise routine.
The third patient is a 63-year-old woman referred for low back pain that began insidiously and is worse when sitting.
Even as a student, you may feel confident that you have knowledge and tools to address these patients' complaints. A closer look at their medical histories, though, reveal more complexity.
You find that the first patient has a history of prostate cancer and is currently undergoing androgen deprivation therapy. The second patient is 8 weeks status post right-sided partial mastectomy and lymph node biopsy for invasive ductal carcinoma. The third patient, diagnosed with stage III ovarian cancer 2 years ago, underwent a total abdominal hysterectomy and salpingo-oophorectomy.
How do you feel now? Has your confidence been cracked? Do these medical histories complicate the approach that you had envisioned? Is your mental list of potential red flags growing? If your answer to any of these questions is yes, fear not! You are certainly not alone. I felt the same way just a few years ago.
The population of survivors of cancer, like the ones listed above, is growing at an unprecedented rate. Evidence demonstrates that a large portion of these survivors have unmet physical needs, many of which may be amenable to physical therapy interventions.
As cancer care continues to be disseminated throughout the country and into rural communities, we, as physical therapists, regardless of practice area, must be well prepared to evaluate and treat this population.
As physical therapists we have an opportunity to play a key role on an interdisciplinary team for cancer survivors. It's well within our scope of practice to understand the potential impact of cancer and its treatments, including chemotherapy, hormone therapies, surgery, radiation, and immunotherapy.
So how do we tailor our approach to safely and effectively treat survivors of cancer like the ones proposed here?
How can we root our interventions in current evidence to effect a positive change for these patients?
Beyond our physical therapist interventions, what can we learn from survivors of cancer?
At APTA's National Student Conclave 2018, I will present the essential components of oncologic rehabilitation. My goal is to provide the latest evidence and information that will expand your interest and your confidence for when you next have the opportunity to work with a survivor of cancer, whether it is on your next clinical affiliation or as you enter into the professional phase of your career.
Cancer rehabilitation is a realm of physical therapy that I have found challenging, though incredibly rewarding. I look forward to sharing my own experience and the pathway that led to discovering the world of oncologic rehabilitation.
Steve Wechsler, PT, DPT, is a board-certified clinical specialist in neurologic physical therapy and a clinical specialist at Memorial Sloan Kettering Cancer Center in New York City. He serves as secretary for APTA's Academy of Oncologic Physical Therapy, and he received an Emerging Leader Award from APTA in 2017. You can find him on Twitter at @SteveWechslerPT.