What can physiotherapists do in cancer?

As I've mentioned before in my first blog post, physios are involved in many spheres of medicine. You will find us in the ICU, medical wards, rehab centers, on the sports field, in old age homes, in private practices, and, now you will also be seeing us in oncology. Yes, you read correctly. If someone had orthopaedic surgery, they would most likely get physiotherapy before discharge. The same goes for patients who suffered head injuries, or strokes.

Cancer patients have far-reaching side effects from cancer, the treatments they undergo, or both. They are medically complex, and this could be intimidating, but they deserve rehabilitation too. They deserve to also have someone take their hand and walk them through their journey of treatment and hopefully into survivorship. This diagnosis is daunting enough on its own, and on top of that, these patients do not want to do anything to compromise the success of their treatments. Therefore they often only stick to strict medical instruction from their oncologist or medical provider that they trust. This is where oncology physiotherapists can step in. We can join the oncology team, and together, provide holistic treatment to patients by using a multidisciplinary approach.

I stumbled upon the field of oncology rehabilitation while I was treating a patient I knew for neck pain. She was a stage 4 breast cancer patient, and I quickly realised that she was dealing with many side effects from the cancer treatments, such as chemo, surgery, and radiation. This lead me to investigate how I could potentially help treat each side effect, and voila! This whole world of oncology rehab opened up to me. It is safe to say that I have found my passion.

I feel that our undergraduate physiotherapy degree did not offer enough insight into the specific treatment of cancer patients. Therefore, I decided to do a course through the USA to gain better insight into safe exercise-prescription for patients with all types of cancer. I would say that this field requires a solid understanding of the disease, its medical treatments, as well as surgeries. We have to understand the immediate and long-term side effects of patients undergoing any one, or all of these treatments. After an in-depth assessment we essentially identify the "problem list" and then we develop a treatment plan aimed at addressing each of these problems or side effects, and we also anticipate future problems that we attempt to address now.

Some common side effects that cancer patients experience:

• Cancer-related fatigue (fatigue that does not improve with sleep or rest, so rest is NOT the answer, in fact, it could make it worse!)

• Lymphoedema (swelling in a limb or area after surgically removing or irradiating lymph nodes)

• Chemo-induced peripheral neuropathy (nerve like pain or dysfunction, typically of the hands and feet due to the chemo)

• Scar tissue (often areas of tightness after surgery that restricts range of motion)

• Radiation fibrosis (hardening of tissue after radiation to an area)

• Weakness or muscular imbalances after surgery

The good news is that although some of these side effects are common, they are treatable, and in some cases even preventable. I would love to see South Africa follow in the footsteps of Australia and refer every cancer patient to an oncology rehab professional from diagnosis so that they can be assisted through their cancer journey from the start. This could help reduce those symptoms that they so often suffer from, and aid in improving their quality of life from the start.

Chat soon!

-Lomé