Chances are you know someone whose life has been touched by cancer, or maybe you are living with a cancer diagnosis yourself. According to the most recent data available from United States Cancer Statistics, more than 1.7 million new invasive cancer cases were diagnosed in 2019. That same year, over 16.6 million people were living with cancer in the United States.
In most cases, cancer is treatable. After an initial diagnosis, a myriad treatment options exist, including chemotherapy drugs, radiation, and surgical interventions. Yet cancer and its treatment can have long-lasting effects even after a patient has achieved remission. Physical therapists are uniquely equipped to help patients restore function after cancer.
Patients experience various emotional, mental, and physical challenges after a cancer diagnosis. Casey K. is a 26-year-old who has been in remission for four years. She describes her experience with physical therapy.
“As a leukemia patient, my hospital stays were lengthy,” she said. “For example, I was diagnosed and admitted to the hospital on the same day and did not leave until six weeks later. The treatment regimen was extremely harsh on my body, as if I was not already sick enough, so my physical conditioning went downhill pretty rapidly.
“PT was ordered early on to try to lessen the extent of my deconditioning. I believe I received PT every other day, if not every day. The PT would come to my room, and if I hadn’t been out of bed yet, that was always the number one priority. We did a lot of range of motion and some light exercises to try to maintain some strength.
“The physical therapist encouraged me to get out of my room and walk around the floor as well. When I was in the hospital for my bone marrow transplant, I was not allowed to leave the room, so the physical therapist brought an exercise bike to my room. Overall, the focus seemed to be on keeping me mobile and maintaining as much strength and endurance as possible.
“A few years after remission I still had some deficits. I was experiencing chronic pain, particularly in my ankles. I had been prescribed to some pretty strong pain medications to try to manage it, but I made a decision to be taken off of them as I wanted to return to school. I sought outpatient PT in hopes that something could be done.
“A PT evaluation led to the discovery that I had poor ankle mobility and stability, likely due to the amount of time I spent in bed. The PT worked with me to strengthen my ankles and increase mobility, and ultimately, I did experience a reduction in pain and was able to return to running.”
Casey’s story and symptoms may be similar to your own or to those of a loved one. Here are some common issues affecting patients with a diagnosis and how physical therapy may help cancer patients restore function:
Fatigue is the most common effect of cancer and its treatment. Between 80% and 100% of people with cancer experience cancer-related fatigue. Fatigue due to cancer has been described as feeling weak, listless, or drained.
It is more persistent and prolonged than the normal fatigue one may feel after strenuous activity. Someone with intense cancer-related fatigue may feel too tired to get dressed or use the restroom. Studies show that moderate exercise, like that performed in physical therapy, can improve symptoms of fatigue in cancer survivors.
Casey describes prolonged bed rest because of the pain, illness, and energy demand of cancer can lead to weakness and decreased endurance. This is called deconditioning, and it can occur after just a few days of inactivity.
Physical therapy helps cancer patients by addressing the effects of deconditioning with an individualized exercise program to build strength and cardiovascular endurance gradually and safely over the course of multiple sessions.
Joint pain, or arthralgia, can be a side effect of some chemotherapies, some hormonal therapies, an after-effect of radiation, or occur after a period of inactivity.. It may feel like the joint pain and stiffness many individuals with arthritis experience. It can occur in several joints at various times and is often felt in the joints of the wrists, arms, knees, feet, hips, and back. Physical therapists can prescribe exercises to relieve joint pain and improve joint mobility that has decreased because of radiation therapy, chemotherapy, or prolonged immobility.
Lymphedema is a common post-treatment side effect after radiation or surgical interventions for breast cancer. The removal of, or damage to the lymph nodes can cause chronic swelling in the upper extremities because of a build-up of lymph fluid. Regular exercise, compression garments and manual interventions by specially trained physical therapists can improve lymphedema.
Chemotherapy can reduce bone density causing osteopenia, or osteoporosis, which make bones more susceptible to fractures. While some risk factors for osteoporosis cannot be prevented, everyone can make healthy lifestyle choices to keep bones as strong as possible.
It is important to get enough Vitamin D, avoid smoking, limit alcohol, and eat a variety of nutrient-rich foods every day, especially after chemotherapy. Physical therapists can also prescribe appropriate weight-bearing exercises to promote bone reformation.
Another side effect of chemotherapy is neuropathy, or numbness and tingling, primarily in the extremities. This can take months to years to resolve, if at all.
In one clinical study, taxane-based chemotherapy for breast cancer was shown to cause long-term peripheral neuropathy more than two years after the start of treatment. Trial participants with severe symptoms reported a lower quality of life than those without. Physical therapy can address balance deficits and promote adaptation to improve function for clients with these symptoms.
This list of post-cancer health concerns that can be addressed through physical therapy is far from exhaustive. Physical therapy during chemotherapy can help improve these and more symptoms to restore function after cancer treatment.
Consult your healthcare provider for a referral or contact a clinic in your area if you feel physical therapy could address your specific health and wellness needs.