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Making the world better for people with cancer

CANCER REHABILITATION INFORMATION

Whether you are a cancer patient, cancer survivor, care partner or health care professional, it is our hope you will find information here to give you a better understanding of cancer rehabilitation and its role in improving the lives of people affected by cancer.

Cancer Rehabilitation is the area of cancer care that treats the musculoskeletal, cardiopulmonary and functional impairments expected with cancer treatment, cancer survivorship, advanced disease and end of life. The most common of these problems include fatigue, pain, weakness, stiffness, fibrosis and scarring, difficulty walking and the overall inability to function normally. Depending on the type of cancer, additional problems can occur including poor balance, swelling, lymphedema, incontinence, weight loss or weight gain, problems swallowing, cognitive issues and sexual health issues. Rehabilitation can reduce, eliminate and even prevent many of these issues, making cancer treatment more effective and less damaging, and cancer survivorship healthier. Cancer rehabilitation services are provided by physical therapists (PTs), occupational therapists (OTs) and speech and language pathologists (SLPs).

Research shows that cancer rehabilitation can both increase the quality and length of life for people with cancer! Rehabilitation and exercise may even assist in decreasing the risk of recurrence of some cancers. Now that is some powerful stuff!

It is estimated that 90% of cancer patients and 40% of cancer survivors suffer with multiple physical problems that can be reduced, eliminated or prevented with rehabilitation. Rehabilitation is covered by nearly every insurance company. Still, rehabilitation is offered to less than 30% of the people that could directly benefit from it.

“Cancer rehabilitation is evidence based, insurance covered medical care that all people diagnosed with cancer deserve access to.” - Dr. Leslie J. Waltke

Ask yourself this…

  • Why would a person with fallopian tube cancer need a physical therapist?
  • Why would a woman with breast cancer who is pain free and has had “just” a partial mastectomy and a sentinel lymph node biopsy need a rehab consult?
  • Why would a man with terminal colon cancer need rehabilitation?


Don’t worry if you don’t know the answers, it is normal to be stumped! Read on a bit more and the answers will become clear or scroll to the bottom of the page now for the answers!

Just like shoulder, back and heart surgeries, cancer surgery often leads to pain, limited joint range of motion, scar tissue, and muscle and body weakness. Rehabilitation therapists intervene with treatment before and/or after surgery to restore pain free movement, physical strength, scar mobility and function. With rare exception, post-operative cancer rehabilitation should return people to their full pain free pre-operative level of function.
Research has shown rehabilitation during chemotherapy is not only safe, but effective in treating many chemotherapy related problems helping patients stay stronger and suffer less physical loss. Rehabilitation during chemotherapy works to reduce fatigue, muscle and physical weakness, minimize the effects of neuropathy, maintain good balance, and get to or maintain a healthy body weight.
The benefits of rehabilitation during radiation are also well documented. The best way to minimize fatigue and weakness during radiation is through a strengthening and aerobic exercise program. Rehab therapists can also help prepare the patient’s body for the radiation position (like getting both arms overhead after lung or breast surgery). Long term home stretching programs will also be developed to combat the tightness and fibrosis common months or years later.
Rehabilitation in cancer survivorship helps patients deal with the late and long term effects of cancer treatment and helps them get back to as healthy as possible, as fast as possible. Rehab treatment plans after the conclusion of cancer treatment can help reduce, eliminate and prevent problems such as fatigue, heart damage from chemotherapy, issues from neuropathy, aching muscles and joints, scar tissue, fibrosis and change in body weight. Rehab therapists will also develop plans to help cancer survivors meet the American Cancer Society’s activity guideline of 150 minutes per week of exercise.
For persons in their last weeks or months of life, rehabilitation can play a very valuable role. Exercise has been shown to be both safe and effective for people with advanced cancer. Treatment plans and goals aim to keep the person as independent, strong and mobile as possible, and will be centered on pain reduction, safe mobility instruction for the patient and family, maximizing quality of life and reducing the risk of falls and hospital stays.
Published Research Writings from Leslie J. Waltke, PT, DPT
This article was awarded "2014 Article of the Year" by the Journal of Patient-Centered Research and Reviews!
Overview of CA Rehabilitation & Exercise in the Literature
Physical Therapy and Cording

In 2011 Dr. Waltke co-founded Team Phoenix along with breast oncology surgeon, Dr. Judy Tjoe. Team Phoenix is a medically directed, goal oriented triathlon training program for female cancer survivors. We collect medical and psychological research data with the goals of increasing health and wellness after cancer and creating life long fitness GO TEAM PHOENIX!
"Survivors Speak"
Results: CA Survivor Triathlon Training

If you’ve ever heard Dr. Waltke speak, here are the bullet points she often highlights!

“Cancer rehabilitation is evidence based, third party reimbursed medical care that all patients with cancer deserve access to.”

“Persons after stroke, disease, accident and major surgery are routinely ushered into rehabilitation. Then why not after cancer?”

“We have to stop treating cancer patients like they’re going to break!”

“Evidence suggests that cancer rehabilitation increases quality of life, lengthens life and may improve overall survival.”

“As the volume of cancer patients and survivors increases, the need for cancer rehabilitation services is sky rocketing, and will continue to do so for decades to come.”

“Cancer rehabilitation is truly proactive care in the very reactive environment of cancer care.”

“Evidence suggests that rehabilitation in cancer care decreases hospital length of stays, decreases re-admissions, decreases fall risk, decreases emergency department visits.

“The best evidence based treatment for cancer-related fatigue, is exercise.”

“Rehabilitation and exercise are grossly underutilized in cancer care.”

“When we in healthcare possess the treatment tools to decrease the suffering and loss with cancer treatment and survivorship, it is imperative that we utilize them.”

“Rehabilitation can save the health system money while it makes the health system money.”

“Rehabilitation leads to happier and healthier cancer patients and survivors. Happier and healthier cancer patients and survivors lead to happier and healthier health systems.”

So back to those questions…

Why would a person with fallopian tube cancer need a physical therapist? Because she will likely have undergone surgery, chemotherapy and/or radiation this person will most likely develop fatigue, pain and weakness. The best way to treat and eliminate these problems is with physical therapy.

Why would a woman with breast cancer who is pain free and has had “just” a partial mastectomy and a sentinel lymph node biopsy need a rehab consult? Even if a patient is pain free and functioning well after surgery, those that will be exposed to chemotherapy and/or radiation (as in this case) will most likely encounter fatigue, pain, weakness and fibrosis and will be well served by a course of cancer rehabilitation.

Why would a man with terminal colon cancer need rehabilitation? Keeping people at the end of their lives, strong (both body and heart and lungs), safe and comfortable leads to better quality of life, improved independence and may even add to length of life.