Cancer Rehabilitation

Introduction

Cancer rehabilitation is the care that should be integrated throughout the oncology care continuum to treat the patient’s physical, psychological, and cognitive impairments in an effort to maintain or restore function, reduce symptom burden, maximize independence, and improve quality of life.

Definition

Cancer rehabilitation includes a wide range of therapies that are designed to help a person maximize his or her functioning physically, emotionally, spiritually, socially, and financially.

Objectives

• Prevention of the loss of function.
• Slowing the rate of loss of function.
• Improvement or restoration of function.
• Compensation for loss of function (compensatory strategies).
• Maintenance of the current function.

Purposes

• Improve the endurance, strength, and mobility.
• Increase the confidence and self-esteem.
• Make the activities of daily living and caring easier for the patient.
• Help to cope with anxiety, distress, or other emotional issues.
• Reduce fatigue, pain, and other lingering side effects.
• Formulate a long-term plan for cancer survivorship.

Elements of Rehabilitation

Cancer rehabilitation is a multidisciplinary approach designed to help patients manage the physical, emotional, and cognitive effects of cancer and its treatment. Here are the key elements:

1. Physical Rehabilitation

• Pain Management – Using medications and techniques to reduce discomfort.
• Exercise Programs – Strength-building exercises to improve endurance and mobility.
• Lymphedema Therapy – Specialized care to reduce swelling and improve circulation.

2. Functional & Daily Living Support

• Mobility Assistance – Helping patients regain movement and independence.
• Activities of Daily Living (ADLs) – Support with eating, dressing, bathing, and other essential tasks.

3. Psychological & Emotional Support

• Counseling & Therapy – Addressing anxiety, depression, and emotional distress.
• Cognitive Rehabilitation – Helping patients manage memory issues and brain fog.

4. Social & Vocational Rehabilitation

• Patient & Family Education – Providing guidance on coping strategies and long-term care.
• Work & Social Reintegration – Helping patients return to work and social activities.

5. Nutritional & Lifestyle Support

• Dietary Counseling – Ensuring proper nutrition to support recovery.
• Smoking Cessation & Wellness Programs – Encouraging healthy habits to improve overall well-being.

Types

1.Physiotherapy

Physiotherapy plays a significant role in restoring and maintaining the highest possible level of function, independence, and quality of life among patients with cancer and survivors.

2.Speech and Swallow Therapy

Highly qualified speech-language during the evaluation and treatment of articulation, language, stuttering, voice, cognition, and swallowing disorders.

3.Psycho-Oncology

Psycho-oncology focuses on the psychological, behavioral, and social aspects of cancer management.

4.Cognitive Behavioral Therapy (CBT)
It benefits the patients in the following ways:

• Assists in the effective management of key symptoms of stress, anxiety, and depression.
• Helps patients explore ways to make their family understand their condition and adjust to the new routine.

5.Yoga

Practicing yoga develops a positive impact on physical health by supporting the enhanced circulation of oxygenated blood in the body.
Yoga techniques, such as breathing exercises, breath training, modified postures (asana), regulation of breath (pranayama), and meditation techniques, can help the patients cope with their distress.

6.Onco-Dietetics
This includes diet modification, counseling and education, intake of dietary supplements, and, lastly, tube feeding or IV feeding.

7.Onco-Dermatology
It focuses on controlling the side effects of cancer treatments on the skin, hair, and nails.

8.Occupational Therapy (OT)
It helps to maximize the function, comfort, and safety of patients during everyday living situations. This includes managing daily tasks, such as bathing and dressing.

9.Lymphedema Therapy
This includes the techniques such as compression garments, specialized massages, bandaging methods, and exercises.

10.Vocational Therapy
Vocational counselors support people in returning to work during or after cancer treatment.

11.Trigger-Point (Functional) Dry Needling
Trigger-point dry needling, also known as functional dry needling, is a treatment for muscular tightness and spasm which commonly follows an injury due to repetitive stress, trauma, or surgery.

Advantages

• This helps patients stay as active as possible and enables them to participate in work and domestic activities, and fulfill other life roles.
• This will reduce the severity of the ill impact caused by side effects and symptoms that come along with the cancer treatment.
• Multidisciplinary aftercare plays a critical role in ensuring that patients gradually become independent after the treatment.
• A well-planned rehabilitation program will also have a positive impact on the quality of life in patients.

Role of Nurse

• Maintaining tissue integrity.
• Promoting nutrition.
• Relieving pain.
• Decreasing fatigue.
• Improving body image and self-esteem.
• Assisting in the grieving process.
• Monitoring and managing potential complications.
• Promoting home and community-based care.

Special Consideration

Cancer rehabilitation requires special considerations to ensure safe and effective recovery. Here are key factors to keep in mind:

• Each patient has unique needs based on cancer type, treatment history, and overall health.
• Rehabilitation should be tailored to address specific impairments like pain, fatigue, or mobility issues.
• Cancer treatments can cause multi-organ complications, requiring careful monitoring.
• Exercise prescriptions should be adjusted based on treatment side effects and patient tolerance.
• Rehabilitation should include memory and concentration exercises.
• Addressing anxiety, depression, and body image concerns is crucial.
• Collaboration between oncologists, physical therapists, nutritionists, and mental health professionals ensures comprehensive care.
• Early intervention can prevent long-term disability and improve quality of life.
• May require modified rehabilitation techniques due to age-related limitations.
• Need developmentally appropriate therapy to support growth and recovery.

REFERENCES

1. Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
2. Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
3. Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwers, ISBN-13:978-9388313285
4. Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
5. Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
6. Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
7. AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884

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