By any measure, cancer is one of the most prevalent and lethal diseases today. According to the American Cancer Society’s Statistics Center, in 2018 alone more than 1.7 million people will be diagnosed with cancer — 4,750 new cases every day.
While the statistics can be daunting, there is good news and hope for those who receive a cancer diagnosis. Death rates across multiple types of cancer are holding steady or decreasing. But what does that mean for cancer survivors?
Cancer (and the treatments for it) can affect balance and movement, cause pain and swelling, and create mental and physical fatigue. As musculoskeletal experts, physical therapists can help cancer patients move and feel better, explains Mitch Kaye, a physical therapist and the Director of Quality Assurance for PTPN, the parent company of Physiquality.
There are many conditions caused by cancer and its treatments, but the Academy of Oncologic Physical Therapy, a subset of the American Physical Therapy Association that focuses on treatment of patients with cancer and HIV, emphasizes four specific issues where PTs can especially help:
The most common side effect of cancer and its treatment is cancer-related fatigue, or CRF. Up to 80% of cancer survivors report some type of debilitating fatigue during or after cancer treatment, sometimes years after their initial diagnosis and treatment. While it may seem counter-intuitive, studies have shown that exercise reduces the effects of CRF. As healthcare practitioners who create exercise programs for patients every day, PTs are ideally situated to work with cancer survivors to improve their mobility, Mitch notes.
Edema is the clinical name for swelling, when blood and bodily fluids rush to a body part to facilitate healing, like in a sprained ankle. Lymphedema occurs when there are disruptions to the lymphatic system, which transfers fluids throughout our body. Lymphedema can be primary and related to a hereditary condition, or secondary, as a result of trauma, which can be caused by a variety of treatments used for cancer, like radiation therapy or the removal of lymph nodes.
Lymphedema is not just swelling that goes away on its own. It can cause limbs to feel heavy and even become infected. Trained physical therapists can help relieve lymphedema for cancer patients, reducing their risks of infection. PTs can even teach them how to manage their symptoms at home through a variety of methods, from ice and compression, to the use of pumps and massage methods to prompt the lymphatic system to push fluids away from the swollen area.
Doctors call it chemotherapy-induced cognitive impairment. Patients often call it “chemo brain.” In any case, it means that patients who have undergone chemotherapy are often not only more forgetful, but they also have problems paying attention and processing information. For anyone trying to resume daily activities, not to mention returning to work, this can be a huge problem. In addition to doing mental activities like crossword puzzles or learning a new language, Mitch says, physical activity has been shown to improve mental focus and help patients feel more alert.
Radiation Fibrosis Syndrome, or RFS, is often a side effect of the use of radiation on cancerous cells. Like cancer-related fatigue, it can occur months or even years after radiation treatment has been given. Radiation can affect muscles and soft tissue, nerves and bones, the heart, and especially the skin. Physical therapy can help with many of these side effects, explains Mitch, through aerobic exercises to strengthen the heart, weight-bearing activities to strengthen bones, stretches and strengthening exercises for the muscles, and soft tissue mobilization for the skin.
Patients should consult with their oncologist or doctor to make sure that physical therapy is appropriate at their particular point of care and should continue to communicate with their physician and physical therapist throughout the process. PTs will monitor how a patient responds to treatment and exercise, and they may refer a patient back to their oncologist if they see signs that the patient may need more rest and recuperation before physical activity.
Physical therapists are an excellent resource for health and wellness throughout the continuum of cancer treatment, from initial diagnosis to remission. Use our therapist finder below to locate the Physiquality professional nearest you.
Thank you to our contributors:
Mitch Kaye, PT, is the Director of Quality Assurance for PTPN, the parent company of Physiquality. He oversees all aspects of utilization review and case management for the entire PTPN network, and trains and supervises PTPN’s Quality Assurance and Utilization Management staff. In addition, he is responsible for creating and updating case management, utilization management, quality assurance, clinical integration and outcomes guidelines for the network. Mitch’s previous positions include director of physical therapy and imaging services for a community hospital and owner of a private physical therapy practice.
American Cancer Society.
Academy of Oncologic Physical Therapy.
- Doherty, Deb and Kodie Krzys. Chemotherapy-induced cognitive impairment. December 2017.
- Lymphedema: How physical therapy can help. December 2017.
- Calvet, Marie, Jessica Curran and Kimiko Yamada. Cancer-related fatigue fact sheet for consumers. December 11, 2015.
- Johnson, Brandis. Radiation fibrosis fact sheet. November 2014.
Diseases and conditions: Lymphedema. Mayo Clinic, December 21, 2017.
American Physical Therapy Association.
- Physical therapist’s guide to cancer. February 1, 2017.
- Physical therapist’s guide to lymphedema. October 13, 2011.
Mustian, Karen M., Lisa K. Sprod, Michelle Janelsins, Luke J. Peppone, and Supriya Mohile. Exercise recommendations for cancer-related fatigue, cognitive impairment, sleep problems, depression, pain, anxiety, and physical dysfunction: a review. Oncology and Hematology Review, 2012.
Cancer survivorship graph created with data from the American Cancer Society and Cancer Facts and Figures, 2018.