The Benefits of Physical Therapy After Cancer

by Jane Ashley

Getting our bodies back into condition after cancer treatment is an important part of survivorship. Rehabilitation after cancer treatment can help us regain what we thought we might have lost and enjoy an enhanced quality of life.

Flexibility

Evidence shows that physical therapy after cancer treatment is underprescribed. We might only think of physical therapy as being for people who were injured in an accident or who had hip-or-knee replacement surgery.

You may not realize that physical therapy can help you recover from treatment-related issues including fatigue and quickly tiring, deconditioning and difficulty with your gait and/or balance. Physical therapy can also help us overcome radiation treatment side effects or learn how to cope with lymphedema after breast cancer surgery.

Studies show that even the most active person before cancer treatment feels older and sicker than they did when they were diagnosed. This is where physical therapy can help us reverse the effects of cancer treatment.

What kind of problems can physical therapy help?

PT, as physical therapy is often called, can help restore your energy and zest for life. It can also address specific body functions adversely affected by surgery or radiation treatment.

Pain. Studies show that about one-third of all cancer patients suffer from pain after treatment. Pain may be a result of damage done by the cancer itself (weakened bones that fracture). Pain can also be a result of treatment. A physical therapist is trained to assess the cause of your pain so that they can effectively treat it. Pain can come from compression fractures, a compressed nerve or peripheral neuropathy caused by chemotherapy. Breast cancer survivors may suffer shoulder pain, caused by range-of-motion issues on the surgery side. Reduced strength on the surgery side may be an issue too.

Deconditioning. Even the most active person loses strength and mobility during extended treatment. Lung cancer patients who lose lung tissue because of surgery face decreased oxygen capacity. Fatigue from chemotherapy derails patients’ best intentions to keep exercising.
Chemo patients often lack the energy to go out for a walk or lift weights in their basement. Survivors, just out of treatment, may resist attempting exercise because of their lack of stamina and fear of failure.

Physical therapy helps patient get stronger in graduated steps so that patients regain confidence in their ability to resume their favorite activities — like golf, gardening, walking or yoga.

Strength

Fatigue. Fatigue is REAL for people with cancer and survivors. In fact, it’s called “cancer-related fatigue (CRF).” The National Comprehensive Cancer Network (NCCN) defines CFT as “distressing persistent, subjective sense of tiredness or exhaustion related to cancer or cancer treatment that is not proportional to recent activity and interferes with usual functioning.’’ Studies show that physical activity is the best way to treat cancer-related fatigue.

Physical therapists are trained to work with people who have become deconditioned by illness and/or surgery. They can help patients regain their stamina and flexibility.

Balance/falling. As many of can attest, we, as patients and survivors, are at increased risk for falls. About six months after my last chemo, I fell in the bathroom — the fall knocked me unconscious, and I had a gash above my right eye that required six stitches. There are a number of reasons that we are more prone to falls. These reasons include:

*Weaker strength in our legs.
*Decreased sensations in our feet from peripheral neuropathy.
*Declining sense of balance (perhaps from chemotherapy and hormone therapy).
*Many cancer patients suffer from decreased bone mineral density. Combine decreased bone strength and a fall — you have a formula for broken bones.
*Physical therapy helps patients regain their sense of balance. Weight-bearing exercises help rebuild bone strength.
*Peripheral neuropathy. Several chemotherapy drugs, including vincristine, cisplatin, paclitaxel and oxaliplatin, cause peripheral neuropathy. Patients experience tingling and numbness in their hands and feet resulting in dropped objects and falls.

Physical therapy helps in several different ways:
*Improves range of motion.
*Strengthens muscles.
*Retrains balance skills to help prevent falls.
*Use of braces or splints to improve posture.
*Teaching patients to be aware of the terrain and its fall risks.
*Electrical stimulation therapy benefits many patients too.
*Incontinence. Patients may experience urinary or fecal incontinence after cancer treatment. There is no need to feel embarrassed about this problem. It’s a common issue after cancer treatment. Pelvic floor physical therapists can help retain your muscles to help you regain control so that you can live a normal life again.
*Difficulty swallowing. Patients who have head and neck cancer may experience difficulty swallowing after surgery and/or radiation. You may have scarring or swelling/shrinking of the esophagus.

Swallowing

A swallowing specialist teaches patients new ways to swallow and how to avoid gagging or choking. They also help in these areas:

*Strengthening the muscles in your throat.
*Swallowing exercises.
*Tongue exercises.
*Jaw exercises.
*Lymphedema.
Not only do breast cancer survivors experience lymphedema, other patients have lymphedema occur in their lower extremities. Lymphedema is caused by removal of lymph nodes during cancer surgery. This causing swelling because the lymphatic tissue can no longer drain. Physical therapists teach manual message, compression sleeves and limb exercises that are done at home on a continuing basis.
*Vaginal stenosis. Women diagnosed with cervical, ovarian, uterine, rectal and anal cancers often have pelvic radiation as part of their treatment. One of the side effects is vaginal stenosis, scarring, shortening and narrowing of the vagina. This may make intercourse and pelvic exams very painful or even impossible. A pelvic floor physical therapist utilizes gentle massage and graduated size dilators to help restore the vaginal passage to near normal.

The Bottom Line …

It may seem counterintuitive, but exercise helps reduce fatigue. Physical therapy targets specific muscle groups to restore specific bodily functions including swallowing, continence, balance and everyday living tasks liking climbing stairs and getting up and down from chairs.
Ask to be referred to physical therapy after treatment to help you fully recover. When referred by your physician, PT is covered by your insurance. If you’ve already met your max-out-of-pocket, there won’t even be a copay involved. Take advantage of the help that physical therapy provides.

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