Physical Therapy & Breast Cancer
At first glance, it wouldn’t seem natural to corrolate breast cancer with physical or occupational therapy; however, pt/ot can play a beneficial role in the plan of care for breast cancer patients.
Even BEFORE a patient even begins any type of intensive treatment, physical therapy can during prehabilitation. Prehabilitation is defined as, “physical and/or lifestyle preparation designed to improve recovery time following surgery”. This period is the time between receiving a diagnosis and beginning cancer treatment (e.g. surgery, chemo, radiation).
Physical therapy prehabilitation for cancer patients can improve both patients’ psychological and physical treatment results by:
- Obtaining baseline measurements including range of motion
- Identify patients’ daily activities of living (ADLs) including work requirements in order to better enable therapists to build post-treatment plans of care to get patients back to normal ADLs
- Identifying already weak areas of the body including certain muscle groups, postural deficiencies and/or pre-existing pain
- Educating patients in the expectations of life post-treatment including complications which could occur and how to reduce risks from common complications
- Developing an exercise plan for patients both prior to and after treatment. A healthy body going into treatment provides a more stable foundation from which the body can recover. Having a set plan for post-treatment can also provide patients a goal to work towards and something to look forward to.
While the benefits physical and occupational therapy are strengthened when utilized both pre and post-cancer treatment, the care received after standard cancer treatments is slightly more familiar. Common cancer treatments often include biopsies, lumpectomies, mastectomies, reconstruction, radiation and chemotherapy. These treatments generally leave patients with challenging physical and emotional side effects such as:
- Decreased range of motion
- Weakness and fatigue
- Scar tissue adhesions
Physical and occupational therapists can assist patients recuperating from cancer treatments with the goal of eliminating/diminishing side effects and enhancing function. Post-treatments, physical and occupational therapists will create plans of care that include, but are certainly not limited to:
- Increase range of motion (ROM) through exercises and stretches
- Provide hands-on manual therapy (massage) to patients’ joints, muscles, fascia and scarred areas with the goal of increasing ROM and decreasing pain and swelling
- Identify patients’ likelihood of developing lymphedema (swelling due to extra fluid build up in tissue because of removed or damaged lymph nodes as part of cancer treatment) and assisting with management of lymphedema treatments including drainage, bandaging areas as needed, identification of appropriate garments, and instruction in self-care at home
- Re-training patients to maintain proper posture post surgery including creation of specific exercise plans and ergonomic assessments
- Identification of special needs patients may have in accomplishing daily activities (e.g. cooking, dressing, bathing, getting back to work, etc.) and subsequent creation of tools to accomplish ADLs on a modified scale.
In short, getting back to “normal” after surviving a breast cancer diagnosis can be complicated and daunting. When utilized both before and after cancer treatments, physical and occupational therapists can help patients get back to “normal” or a modified version of what the new normal will be. Physical and occupational therapy strives to provide patients with the quality of life deserved after experiencing the trauma that is breast cancer.