What is rehabilitation for cancer?

Cancers treated: All types of cancers beginning before, during, or after cancer treatment

Why performed: The specific goals of rehabilitation are different for each individual. In general, the goal of rehabilitation is to allow the individual to function as fully and independently as possible. The rehabilitation team will include different allied health professionals depending on the goals and needs of the individual. Often the rehabilitation team will include many health professionals, such as a physical therapist, an occupational therapist, a rehabilitation nurse, a psychologist or psychiatrist, a nutritionist or registered dietician, the individual’s physician or oncologist, pain management specialists, a case manager, and home health workers.

The rehabilitation team will work together with the patient and the patient’s family and loved ones to help the patient regain as high a degree of functioning as possible. The specific activities included in the rehabilitation plan usually comprise dressing, bathing, cooking, eating, and other activities of daily living. Some individuals may receive help recovering the ability to drive, take public transportation, or other aspects of mobility.

For individuals whose job skills were affected by cancer or cancer treatment, regaining the skills necessary to return to a job is usually considered a high priority. An occupational therapist or other member of the rehabilitation team may help the individual determine what skills are required, work to improve those skills, and seek ways to modify the employment environment so that the individual may return to work sooner.

The individual may have goals in addition to those necessary for return to employment or for daily living. Many recreation and leisure activities that were formerly pleasurable may become difficult or impossible because of cancer or cancer treatment. Rehabilitation therapists listen to the patient to address additional goals, such as the ability to go camping or sailing, play sports, or play music.

Patient preparation: Before beginning to meet with a rehabilitation specialist, it may help the patient to consider specific goals for rehabilitation. Making a list of activities or skills on which the patient would like to work can help the rehabilitation therapist look beyond the activities of daily living to other activities important in that individual’s life. Goals can be very specific, such as being able to knit or type again, or more general, such as being able to play with children or grandchildren.

The patient preparation required before the individual rehabilitation sessions will vary depending on the type of therapy. The rehabilitation specialist will give the patient specific information about what steps to take before a session, which may include things such as doing gentle stretches to warm up or even mentally preparing to meet the challenges that rehabilitation therapy provides.

Steps of the procedure: The steps of rehabilitation are very individualized. They depend on the type of therapy that is being done and on the specific needs and goals of the patient. Rehabilitation therapy often breaks down the goal activity or skill into smaller parts or steps and then works on one step at a time. For example, an occupational therapist who is helping a cancer patient regain the ability to feed himself may work on the action of bringing the food to the mouth as one activity, the act of using a spoon or fork to scoop food as a separate activity, and the act of cutting food as yet a separate skill. As these different aspects of the skill of feeding oneself are mastered, they can be combined into more complex sequences of actions.

Another way of approaching rehabilitation can be from the standpoint of increasing the day-to-day abilities of the patient in the affected areas. In this case, the rehabilitation therapist might focus on getting food from the plate or bowl and into the mouth using the hands and then slowly add skills, such as beginning to help the patient use a spoon, then a fork, and then working on cutting food.

Rehabilitation also often helps to identify assistive devices that individuals can use to help them accomplish various tasks. In some cases, these devices are only necessary for a short time; in other cases, they will be used by the individual for the rest of his or her life. For instance, a rehabilitation specialist may help an individual regain the ability to walk using a walker, or may help an individual who had a leg amputated master the use of a prosthetic leg.

After the procedure: The steps after rehabilitation will vary depending on the type of therapy performed. After therapy that involves physical activity or exercise, a series of stretches and cooldown activities is usually performed. Often the rehabilitation therapist will assign the individual exercises or activities to practice each day, sometimes several times a day, before the next session. This approach can help to ensure that the progress made during the session is maintained until the next session. The patient’s family members or caregivers may be shown how to help the individual complete these exercises.

Rehabilitation therapy may be continued for weeks, months, or even longer. When the therapy has ended, the therapist may give the patient a list or set of exercises or activities to continue to do to help keep up the skills that were gained during therapy, or to help the patient continue to make improvements.

Risks: The risks associated with rehabilitation are generally mild but are different for different forms of rehabilitation therapy. There are some risks that during physical therapy individuals may strain or pull muscles, or otherwise overextend or injure themselves, especially if the proper stretching and warmup routine is not followed before the therapy. Risks of occupational therapy and other forms of rehabilitation therapy that involve the patient working to perform certain actions or movements, such as the movements of dressing or bathing, may also result in strain or injury if the individual pushes too hard to accomplish the task before his or her body is ready. An individual working on regaining the ability to walk may fall if not carefully monitored. Generally, these and other physical risks from rehabilitation are very low if the therapy is overseen by a qualified health professional.

There may also be some emotional risks relating to rehabilitation. The issues discussed with a psychologist or psychiatrist can often be painful or upsetting as they help the individual with cancer work through the fear, uncertainty, and feelings of hopelessness that often accompany cancer diagnosis and treatment. Although discussions with a psychologist or therapist can often be very upsetting, they can usually help the patient deal effectively with these new emotions.

Results: The results of rehabilitation are usually very positive. With consistent effort by the patient and the rehabilitation team, many skills and abilities that have been lost can be regained. Many people can return to jobs and activities in which they would not have been able to participate without rehabilitation. Psychological and emotional rehabilitation is usually effective at helping the individual regain a positive outlook and overcome the fear and unhappiness often associated with cancer and cancer treatment. A comprehensive rehabilitation plan that involves many different allied health professionals, as well as family, friends, or other caregivers, is often especially effective.

It is important for the rehabilitation team to help the patient develop a realistic view of the amount of work required by rehabilitation, the length of time that it will take to reach rehabilitation goals, and what rehabilitation goals are likely to be realistic overall. Having realistic expectations can help reduce frustrations and negative feelings that may occur during the rehabilitation process as hurdles are met and overcome.

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