Introduction:

Cancer rehabilitation focuses on improving a person's physical and emotional functioning while undergoing cancer treatment. It can begin before, during, or after treatment. For someone having a heart attack or a knee replacement, rehabilitation has long been regarded as the standard of care, but cancer rehabilitation is a relatively new notion. Rehab isn't due to a lack of utility or need, though. Due to the increasing number of cancer survivors in the United States and a large number of these patients dealing with long-term treatment side effects, the need for rehabilitation services is likely to skyrocket shortly.

Most people are unaware of cancer rehabilitation because it is a relatively new treatment option. Ask yourself if there is anything you could be (or handle emotionally) before cancer that is more challenging today as a quick indicator of whether you could benefit. (Cancer Rehabilitation: Definition, Types, and Programs, n.d.)

What is cancer rehabilitation:

Cancer rehabilitation entails various treatments to improve a person's physical, emotional, spiritual, social, and financial functioning.

How is it helpful?

Cancer and its treatment frequently result in physical, psychological, and cognitive complications. These issues might make daily tasks and returning to work more difficult. They could potentially affect your health in the long run. These issues can arise during and after cancer treatment, and cancer rehabilitation can assist with them. Cancer rehabilitation seeks to achieve the following objectives:

Assist you in remaining active at work, in your family, and other aspects of your life. Reduce cancer's and its treatment's adverse effects and symptoms. Assist in maintaining your independence. Boost your life expectancy.

Who is a cancer survivor?

A cancer survivor is someone who has been diagnosed with cancer and has battled it from diagnosis until death. Cancer survivorship begins from diagnosis, not when treatment is completed (if it is ever met).

People can get benefit:

Following a cancer diagnosis, cancer rehabilitation can begin at any moment. It is frequently referred to as "cancer prehabilitation" when administered before or during treatment.use of cancer can be done for some cancer, and it may be beneficial for people with cancer at any stage of their disease, from early stage to advanced.

Why rehabilitation?

In January 2019, the United States had 16.9 million cancer survivors, and this figure is likely to increase the dependency for the next decade. (Miller et al., 2019) At the same time, studies show that many cancer survivors suffer from late consequences that impair their quality of life. This number is even more significant among pediatric cancer survivors, with 60 per cent to 90 per cent of survivors reporting late consequences from treatment. (Late Effects of Treatment for Childhood Cancer (PDQ)Health Professional Version - National Cancer Institute, n.d.)

The National Comprehensive Cancer Network Clinical Practice Guidelines, for example, now consider cancer rehabilitation to be an essential aspect of cancer care. Despite this, a 2018 study indicated that most National Cancer Institute-designated cancer centres (centres that stand out as the best institutions in cancer research and treatment) did not give survivors cancer rehabilitation information.

Types of Therapists:

Physical therapist (PT). Physical therapists specialize in assisting clients in regaining or restoring mobility. They can also aid in the reduction or elimination of pain. Oncology physical therapists specialize in working with cancer patients and survivors.

Physiatrist. Physical medicine and rehabilitation specialists are other terms for physiatrists. They aid in preventing, diagnosing, and treating nerve, muscle, and bone problems that affect people's mobility and function. These experts frequently assist patients with pain management.

Lymphedema therapist. Lymphedema therapists assess and treat the condition. They concentrate on lowering swelling and managing discomfort. Compression clothing, specialized massages, bandaging procedures, and workouts are frequently employed.

An occupational therapist(OT):. Occupational therapists (OTs) assist patients in maximizing their function, comfort, and safety in everyday situations. Managing daily routines such as showering and dressing can be part of this. The design is based on a home, school, or workplace layout. OTs also offer techniques for reducing the amount of effort required for specific tasks. It makes it easier for people to deal with fatigue and other restrictions.

A speech-language pathologist (SLP): Communication and swallowing difficulties are the specialities of speech-language pathologists. They can assist people with head, and neck malignancies keep their swallowing and feeding abilities following radiation and chemotherapy. An SLP may also be able to help patients with cognitive issues in improving their memory and killings.

Psychologist specializing in cognitive processes. Cognitive psychologists, sometimes known as neuropsychologists, specialize in studying how behaviour and brain function interact. They frequently assist in managing "chemobrain," the term for the cognitive issues that cancer patients often experience during and after treatment.

Counsellor for career advancement. During or after cancer treatment, vocational counsellors assist patients with returning to work. They can make it easier for someone to learn how to do routine job responsibilities. Find out more about going back to work after cancer and working while battling cancer.

Recreational activities therapist. Recreational therapists assist people in achieving and maintaining physical, mental, and emotional well-being by reducing stress, anxiety, and sadness. They also aid in the development of a person's confidence and personal abilities. Recreational therapy uses various methods to deliver treatment, including art, fitness, games, dance, and music.

Dietitian. A dietician, often known as a nutritionist, is a person who specializes in food and nutrition. Oncology dietitians assist patients in understanding nutrition guidelines for specific cancer types and supportive nutrition throughout treatment. They also help people in developing good eating habits to lower the risk of cancer recurrence.

Exercise Physiologist Exercise physiologists assess a person's fitness to assist them in bettering their function. They examine cardiovascular function and metabolism using stress tests and other methods. They can also create fitness programs tailored to the demands of cancer patients both before and after treatment. (travelling what Cancer Rehabilitation Is? | Cancer.Net, n.d.)

Uses and Evidence:

The following are some of the concerns that may address:

Deconditioning:

Deconditioning is a typical side effect of practically any type of cancer, and it can be caused by time spent travelling to appointments and waiting. While deconditioning is frequently ignored as a "nuisance" symptom, it can substantially influence one's quality of life and lead to severe disability.

Research in this field is still not comprehensive, one study indicated that a rehabilitation program was quite efficient in helping persons with blood malignancies recover from deconditioning centres travelling.

Pain:

People dealing with or after cancer frequently experience pain. Pain can affect one's quality of life and lead to depression, from chronic post-mastectomy pain to post-thoracotomy pain, among other things. Each person's preferred therapies will differ, but requesting a consultation is the first step toward a better life. They may take to improve or avoid some of these therapeutic side effects.

Fatigue:

Cancer tiredness is highly prevalent among cancer patients, and it can last for years after treatment is finished, even in early-stage tumours. Often, the first step in cancer fatigue treatment is to rule out any possibly curable reasons (there are many, including hypothyroidism related to cancer treatments). If It can determine no curable causes, various therapies can help people manage better with their weariness. (Cancer-Related Fatigue (CRF): Causes & Management, n.d.)

Lymphedema:

Lymphedema is prevalent in breast cancer survivors, particularly following lymph node dissection or sentinel node biopsy. It may happen to you if you have any of the other malignancies. A trained lymphedema specialist can be quite beneficial, and many people are shocked to realize that they dont have to live with he kind of difficulty they formerly did.

Peripheral neuropathy:

One of the side effects of chemotherapy is peripheral neuropathy, which causes pain and tingling in the fingers and toes. 8 While neuropathy is rarely "curable," there are a variety of pain-relieving treatments available. Neuropathy consequences, such as falls, can also be reduced with the therapy. (Neuropathy (Peripheral Neuropathy), n.d.)

Cognitive concerns:

After chemotherapy and other cancer therapies, cognitive problems such as memory loss, multitasking difficulties, and "brain fog" are frequent. 9 Women on aromatase inhibitors for breast cancer, for example, have been observed to suffer cognitive abnormalities. There is no simple fix for the vexing alterations known as chemobrain, and treatment typically consists of various therapies ranging from "brain training" to vitamins.

Stiffness:

Fibrosis (the production of scar tissue) and stiffness are both possible adverse effects of surgery, and fibrosis is also one of the long-term adverse effects of radiation. 10 Discomfort from fibrosis from breast cancer, as well as other types of tumours and treatment, can lower your quality of life, albeit it is less commonly discussed than specific other side effects of treatment. There have been various therapy approaches tested, and a combination of them is usually the most beneficial in lowering pain and improving movement.

Depression:

People who have survived cancer are far too likely to suffer from depression.

In other circumstances, such as lung cancer and depression, the depression may be caused by inflammation, and treating the inflammation is the primary therapy option.

Not only is living with depression unpleasant, but the danger of suicide in cancer patients is also alarming. Suicidal thoughts are more prevalent early after a diagnosis than people may believe, and they can happen even in persons with highly treatable cancers. Many people hesitant to bring up the subject of depression ("shouldn't you feel depressed if you have cancer?"), but it is critical to do so. (Depression (PDQ)Patient Version - National Cancer Institute, n.d.)

Stress and Anxiety:

Anxiety is widespread among cancer patients. 12 Anxiety is common, whether your tumour is current or you have no evidence of disease but are concerned about recurrence. Surprisingly, many cancer survivors believe they are less capable of dealing with day-to-day challenges, even minor ones, than they were before their diagnosis.

Counselling with someone familiar with cancer can be pretty beneficial. Stress management education, integrative therapies like yoga or massage, and much more can help you cope not only with cancer-related stressors but with everyday stressors as well. https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/emotional-mood-changes.html,

Sleep Issues:

After cancer therapy, sleep problems are almost unavoidable. We're learning that sleep disturbances can harm your quality of life and your survival.

Emotional needs:

In more ways than one, attending to the emotional needs of cancer survivors is crucial. Anxiety and stress are undoubtedly widespread among cancer patients, but unresolved emotional issues can manifest themselves physically as well. According to one study, mental well-being following a physical sickness predicts long-term prognosis. 17 This is a significant unmet need, given the familiar dread of recurrence and progression of cancer, as well as the fact that many cancer survivors have been shown to have symptoms consistent with posttraumatic stress.

The need for cancer rehabilitation is becoming increasingly apparent as we learn more about cancer's "financial toxicity." the necessity for cancer rehabilitation becomes increasingly apparent. Cancer rehabilitation may lessen incapacity and the need for early retirement, while medical problems are a primary cause of bankruptcy in the United States.

Research evidence:

Many doctors associate rehabilitation with people who have survived cancer and completed treatment; however, palliative rehabilitation has been demonstrated to improve a person's ability to move around and do activities (mobility), safety and increase the quality of life with cancer.

Rehabilitation (or prehabilitation) may be beneficial even before a diagnosis has been made. According to a 2018 systematic analysis, persons with colon cancer who completed nutritional rehabilitation without exercise treatment before surgery had an average stay of two days less.

Risk of Rehab:

Rehabilitation's possible hazards must be considered as well as its advantages. Physical therapy can raise the risk of a fracture if cancer treatments cause diseases like osteoporosis. It's critical to assess the risks and benefits of any given therapy, which necessitates doctors who are trained in both the needs and additional precautions that cancer survivors require.

REFERENCES

Cancer-Related Fatigue (CRF): Causes & Management. (n.d.). Retrieved July 5, 2021, from https://my.clevelandclinic.org/health/diseases/5230-cancer-fatigue

Cancer Rehabilitation: Definition, Types, and Programs. (n.d.). Retrieved July 3, 2021, from https://www.verywellhealth.com/cancer-rehabilitation-4580095#citation-17

Cha, S., Kim, I., Lee, S. U., & Seo, K. S. (2018). Effect of an inpatient rehabilitation program for recovery of deconditioning in hematologic cancer patients after chemotherapy. Annals of Rehabilitation Medicine, 42(6), 838845. https://doi.org/10.5535/arm.2018.42.6.838

Depression (PDQ)Patient Version - National Cancer Institute. (n.d.). Retrieved July 5, 2021, from https://www.cancer.gov/about-cancer/coping/feelings/depression-pdq

Drake, M. T. (2013). Osteoporosis and cancer. Current Osteoporosis Reports, 11(3), 163170. https://doi.org/10.1007/s11914-013-0154-3

Lamers, S. M. A., Bolier, L., Westerhof, G. J., Smit, F., & Bohlmeijer, E. T. (2012). The impact of emotional well-being on long-term recovery and survival in physical illness: A meta-analysis. In Journal of Behavioral Medicine (Vol. 35, Issue 5, pp. 538547). Springer. https://doi.org/10.1007/s10865-011-9379-8

Late Effects of Treatment for Childhood Cancer (PDQ)Health Professional Version - National Cancer Institute. (n.d.). Retrieved July 5, 2021, from https://www.cancer.gov/types/childhood-cancers/late-effects-hp-pdq

Miller, K. D., Nogueira, L., Mariotto, A. B., Rowland, J. H., Yabroff, K. R., Alfano, C. M., Jemal, A., Kramer, J. L., & Siegel, R. L. (2019). Cancer treatment and survivorship statistics, 2019. CA: A Cancer Journal for Clinicians, 69(5), 363385. https://doi.org/10.3322/caac.21565

Neuropathy (Peripheral Neuropathy). (n.d.). Retrieved July 5, 2021, from https://my.clevelandclinic.org/health/diseases/14737-neuropathy

Palesh, O., Aldridge-Gerry, A., Zeitzer, J. M., Koopman, C., Neri, E., Giese-Davis, J., Jo, B., Kraemer, H., Nouriani, B., & Spiegel, D. (2014). Actigraphy-measured sleep disruption as a predictor of survival among women with advanced breast cancer. Sleep, 37(5), 837842. https://doi.org/10.5665/sleep.3642

Silver, J. K., Raj, V. S., Fu, J. B., Wisotzky, E. M., Smith, S. R., Knowlton, S. E., & Silver, A. J. (2018). Most National Cancer Institute-Designated Cancer Center Websites Do Not Provide Survivors with Information About Cancer Rehabilitation Services. Journal of Cancer Education, 33(5), 947953. https://doi.org/10.1007/s13187-016-1157-4

Smith, S. R., & Zheng, J. Y. (2017a). The Intersection of Oncology Prognosis and Cancer Rehabilitation. In Current Physical Medicine and Rehabilitation Reports (Vol. 5, Issue 1, pp. 4654). Springer Science and Business Media B.V. https://doi.org/10.1007/s40141-017-0150-0

Smith, S. R., & Zheng, J. Y. (2017b). The Intersection of Oncology Prognosis and Cancer Rehabilitation. In Current Physical Medicine and Rehabilitation Reports (Vol. 5, Issue 1, pp. 4654). Springer Science and Business Media B.V. https://doi.org/10.1007/s40141-017-0150-0

Straub, J. M., New, J., Hamilton, C. D., Lominska, C., Shnayder, Y., & Thomas, S. M. (2015). Radiation-induced fibrosis: mechanisms and implications for therapy. In Journal of Cancer Research and Clinical Oncology (Vol. 141, Issue 11, pp. 19851994). Springer Verlag. https://doi.org/10.1007/s00432-015-1974-6

What is Cancer Rehabilitation? | Cancer.Net. (n.d.). Retrieved July 5, 2021, from https://www.cancer.net/survivorship/rehabilitation/what-cancer-rehabilitation