Arielle Crist, LOTR and Lillian M. O’Cain, LOTR
According to the National Cancer Institute, there are currently over 14.5 million people living with cancer in the United States and over 1.5 million people newly diagnosed each year. With advancements in diagnostic capabilities and treatment options, more individuals are living longer. Despite better outcomes, survivors may be left facing physical, cognitive, emotional, or psychosocial issues. The question becomes “where do patients go after finishing cancer treatment to address these issues?”
What is Cancer Rehabilitation?
Surprisingly, cancer rehabilitation is relatively new in the healthcare system. So much focus has always been on removing or decreasing cancer in the body but issues such as endurance, balance, emotional well-being, and social participation can be overlooked. Cancer treatment can lead to impairments that impact everyday quality of life during or after treatment, which for some could have been completed months or years earlier. These issues can severely limit an individual from living a healthy and productive life. Therefore, cancer rehabilitation is now becoming an essential component of cancer care.
Cancer rehabilitation was created to fill a gap in the continuum of cancer care. After treatment such as surgery, chemotherapy, or radiation therapy is completed, many individuals need follow-up care to address new deficits. Common deficits include cognitive and sensory changes, decreased range of motion, lymphedema, difficulty swallowing, incontinence, decreased strength and endurance, fatigue, and pain. These can prevent survivors from returning to their regular lifestyle and participating in their home, work, and community.
Cancer rehabilitation teams consist of many healthcare professionals including but not limited to: oncologists, physiatrists, nurses, navigators, occupational therapists, physical therapists, speech-language pathologists, recreational therapists, dietitians, psychologists, and case managers. Examples of how each profession fits into the team include:
- A survivor may discuss difficulties with everyday tasks with the treating oncologist or radiation oncologist.
- A referral to physical therapist may be indicated for the survivor experiencing difficulty climbing stairs, poor balance, falls, diminished core strength, or chemo-induced peripheral neuropathy in the feet.
- An occupational therapist may be needed for the survivor who cannot perform basic self-care, prepare a meal, complete home management tasks, or care for a family member due to deficits such as decreased strength or energy conservation.
- A survivor of head or neck cancer may have difficulty swallowing or with voice production. A speech therapist can assess the survivor’s abilities and provide exercises or a diet to manage and improve these deficits.
- Survivors experiencing incontinence or pelvic pain can be referred to a physical therapist with specific training of the pelvic floor.
- Survivors diagnosed with breast cancer or gynecological cancer may experience lymphedema, or swelling of an extremity due to removal of lymph nodes, and can be referred to a lymphedema therapist to learn ways to manage swelling.
What is Prehabilitation?
Prehabilitation is a familiar term for those preparing for a joint replacement with the goal of improving the outcome and having a faster recovery from elective surgery. This concept is entering the cancer rehabilitation field for head and neck, prostate, lung, and breast cancer patients. A better informed patient who has the knowledge of what to do and what to look for can advocate for intervention sooner and typically have better outcomes. Knowledge is power.
Rehabilitation is commonly associated with strokes, spinal cord injuries, brain injuries, joint replacements, or the weekend warrior. Now cancer survivors have the benefit to improve quality of life for themselves and not settle for the sequela of the medically necessary treatments. Each profession provides a piece of cancer care needed to help individuals heal.
Touro Infirmary’s Cancer Rehabilitation Program
Through cancer rehabilitation, survivors are able to increase their function and independence for better quality of life. Touro‘s Cancer Rehabilitation program is the third in the nation to receive CARF accreditation. We provide cancer survivors with several options for rehabilitation, depending on their needs and conditions. Click here to learn more.
Arielle Crist, LOTR is from Mandeville, Louisiana. She is a recent graduate of Louisiana State University Health Science. She is an Occupational Therapist for Touro Infirmary’s Cancer Rehabilitation Program.
Lillian O’Cain, LOTR, CAPS has over 25 years of experience as an Occupational Therapist at Touro Infirmary and in 2013 was promoted to Program Manager for Touro’s Cancer Rehabilitation Program. Lil received a bachelor of science in Occupational Therapy from Louisiana State University School of Allied Health Professions in 1986. She has developed a passion in the field of study for both fall prevention and Aging in Place and regularly volunteers her time to offer innovative programming and opportunities to educate seniors, caregivers, physicians and Touro staff.
Statistic reference https://www.cancer.gov/about-cancer/understanding/statistics