The role of rehabilitation, and specifically — physical therapy rehabilitation — during cancer care is often not understood. The patient has so much they are facing each day that the last thing they want to do is go to one more appointment. However, physical therapy, occupational therapy or speech therapy, are life-changing when it comes to preventing long-term physical impairments and overall well-being during oncology care.
Pain is a major contributor to the quality of life during cancer care. Pain occurs in 30-50 percent of all patients. Due to early detection and treatment, longevity has increased in most of all cancer patients. However, quality of life is sometimes sacrificed if pain is a major contributor. Pain can decrease your quality of life, especially uncontrolled pain.
Pain can come from direct tumor involvement, diagnostic procedures, therapeutic procedures, side effects of cancer treatment and toxicities of cancer treatments. Uncontrolled pain can affect all aspects of your quality of life. Often isolation and suffering can occur; sleep interference and decreased appetite; reduced physical activity and social interaction. On a pain scale, pain over a 5 or a 6 out of 10 is too much daily pain, and it interferes with your brain’s ability to function well and make decisions.
Pain often comes from three predominate pathophysiology areas. Visceral pain is from internal organs or organ systems. Pain there is often described as deep, dull or diffuse in nature. It could be due to damage or blockage of structures, i.e. opioids causing constipation. Neuropathic pain arises from the somatosensory system which are nerves; either peripheral, autonomic or central in nature. Pain there is described as tingling and numbness, or pins and needles. There can be neuropathy due to tumor erosion, chemotherapy or radiation. Somatic pain arises from external structures such as skin, soft tissue and musculoskeletal tissue. Patients often say this pain feels sharp and more superficial in nature. Often there is joint pain due to postural changes and loss of mobility issues.
Prevention is the key with pain. Often the pain that comes with cancer can be mitigated with early intervention, especially if you can stop a pain cycle before it starts.
Physical therapy in relationship to cancer can be preventative, restorative, supportive and of course, palliative.
According to the UN Standard Rules for the Equalization of Opportunities for Persons with Disabilities, “rehabilitation refers to a process aimed at enabling persons with disabilities to achieve and maintain their optimal physical, sensory, intellectual, psychiatric and/or social functional levels providing them with the tools to adapt their lives toward a higher level of independence.” Rehabilitation, which includes physical therapy, is focused on improving the quality of life for our patients during cancer treatment and preventing physical loss, pain and impairments.
So how do you know if you need physical therapy or a rehabilitation evaluation? Ask yourself some simple questions and if you answer no to any of them, then you need a physical therapy evaluation. Can you walk, sit and stand for 60 minutes? Can you put on your shoes, socks and pants without help? Are you sleeping 7-8 hours a night? Can you talk, chew, swallow and sing? Can you bathe, wash your hair and get in and out of shower or tub? Can you drive to the market for groceries and pick up your medicine? Can you void and defecate with no issues? Can you squat to the floor without losing your balance? Can you get up off the floor if you fall down? Can you write, type and use the phone with ease? Do you have heaviness, pressure or dullness in a limb or trunk region? Do you have numbness and tingling or pins and needles? Are you falling a lot?
Rehabilitation care addresses and answers these questions through direct intervention with physical therapy, occupational therapy and or speech therapy.
Dr. Sara Cuccurcello stated in the Physical Medicine Board Review in 2004, “rehabilitation of the patient should begin when disability is anticipated, rather than after it has occurred.” Don’t wait! Call your physical therapist to get the quality of life you need.
• • •
Sheree DiBiase, PT, is the owner of Lake City Physical Therapy and she and her incredible staff are thankful for the moments they get to share with their amazing cancer patients as they journey through time of their life. Call us for an appointment in Hayden, 208-762-2100; Coeur d’Alene, 208-667-1988; and in the Spokane Valley, 509-891-2623.