Getting well: Cancer rehab

CURE invited Julie Silver, MD, cancer survivor and rehabilitation specialist, to offer suggestions on healing physically after cancer.

One of the questions I am often asked is, "What exactly is cancer rehab?"

Since rehab has not traditionally been part of the cancer care continuum, it's not surprising that many people are confused about what it might involve. However, if someone has a stroke, then most people understand that rehab involves doctors who can order tests and prescribe medications and other treatments. Rehab also usually involves physical therapy and may involve occupational and speech therapy as well. An individual with a hip replacement usually requires orthopedic rehab with physician involvement and physical therapy at a minimum. Cancer rehab is very similar to all other kinds of rehab. The goals are the same--help someone function at the highest possible level by building up their strength and stamina, reducing pain and fatigue, improving problems with balance, gait swallowing, joint range of motion and a host of other problems.

In short, rehab is a critical part of cancer care. But, few survivors ever get it. Why?

There are probably a lot of reasons why cancer survivors don't get rehab, but the one that people often cite (which simply isn't true) is that in the past there weren't survivors to treat. That hasn't been an issue for more than half a century. Sure, every year acute cancer treatments get better and better, but surviving cancer is not a new phenomenon. Unfortunately, offering cancer rehab to survivors is. Even though cancer rehab has been around for a long time, it is not usually part of the care continuum, so few survivors ever get it.

Indeed, developments in and acceptance of cardiac rehab and other forms of physical retaliation are many decades ahead of cancer rehab. And, cancer survivors are needlessly suffering. Being told over and over again to "accept a new normal" when instead they should be referred for appropriate rehabilitation interventions and offered the opportunity to heal as well as possible.

So, the next time someone tells you to accept a new normal, try asking them if they've heard about the growing movement in cancer care--cancer rehab. If they need more information, here are some quick facts:

Who are the main cancer rehab experts?

Physiatrists (doctors in physical medicine and rehabilitation or PM&R) and physical/occupational/speech therapists. There are many others who contribute to rehabilitation care, but start your rehab with these experts.

What are the benefits of cancer rehab?

Improving your physical--and emotional--function.

Why is cancer rehab needed?

Because it's not fair to survivors to tell them to accept a new normal when there is proven medical care that can help.

How do I know if cancer rehab will help me?

If you would benefit from one or more of the things on this list, talk to your doctor about cancer rehab:

> Improve endurance and cardiovascular conditioning

> Increase muscular strength

> Improve joint range of motion

> Decrease pain

> Lessen fatigue

> Improve swallowing

> Improve speech

> Assist with surgical recovery

> Improve immune function

> Increase bone density

> Manage lymphedema

> Improve physical function

> Improve balance and coordination

> Improve quality of life

> Decrease psychological distress

Why isn't cancer rehab part of my cancer center or hospital?

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