Oncology Rehabilitation

Overview of Rehabilitation

When you have been changed by a serious illness or injury, rehabilitation can help restore your physical ability and improve your quality of life. The scope of rehabilitation includes, but is not limited to, physical therapy, occupational therapy and speech-language pathology.

Physical therapy

Karen Gilbert, National Director of Oncology Rehabilitation at CTCA, guides a patient in lymphedema stretching exercises to help drain the patient's lymph nodes.

Aims to improve your quality of life and independence by improving your ability to be active and comfortable. The goals of physical therapy are to reduce your pain, improve your mobility (i.e., walking, going up stairs, getting in and out of bed), and restore your physical function/performance of everyday activities. Physical therapists evaluate movement potential and help establish agreed upon goals. Depending on your condition, you may focus on flexibility, strength, endurance, coordination and/or balance.

Occupational therapy

Aims to help you live as independently as possible. The goals of occupational therapy are to assist and train in performing Activities of Daily Living (ADLs), such as grooming, dressing, eating, playing with your children and interacting with family and friends in your community. Occupational therapists help you identify those activities, devices and tools that will improve strength, function and problem-solving. They partner with you to help you work smart, not hard, in your own environment.

Speech-language pathology

Aims to help you communicate your wants and needs with ease and clarity, and assist you with eating and swallowing. Speech-language pathologists help you with speech production, vocal production, language needs, swallowing problems, and other related disorders through speech therapy.

Oncology Rehabilitation

Rehabilitation can be your foundation for functioning before, during and after cancer treatment. Before treatment, rehabilitation can help you build strength and endurance. While you are undergoing treatment, it can help you maintain your physical well-being and functional independence and reduce pain and discomfort. After treatment, rehabilitation can help you regain function, improve strength and decrease fatigue. Overall, oncology rehabilitation is central to fitness and function and may help improve your quality of life.

Oncology Rehabilitation at CTCA

Stanislav Maravilla, Director of Rehabilitation Services at CTCA at Midwestern Regional Medical Center, helps a patient with resistance training exercises to improve physical function.

The Oncology Rehabilitation Program at Cancer Treatment Centers of America (CTCA) is dedicated to helping you achieve your highest level of physical and cognitive functioning. Our integrated rehabilitation team includes physical therapists (PTs), occupational therapists (OTs), speech and language pathologists, and massage therapists. Our therapists aim to help you reduce stress, regain your strength, energy and independence, and improve your overall quality of life.

Rehabilitation Assessment and Plan

As a patient at CTCA, you will meet with a rehabilitation therapist prior to cancer treatment for a thorough physical evaluation. Part of this initial evaluation consists of a functional assessment, in which your therapist measures your ability to perform activities of daily living (ADLs). Then, you and your therapist will work together to identify your physical and functional status, explore cancer treatment options and develop a cancer treatment plan tailored to your needs. This plan will be goal-oriented, with well-defined outcomes to help improve your safety, independence and satisfaction with your life activities.

Your rehabilitation plan may include therapeutic exercises and neuromuscular training, as well as cardiovascular, flexibility and strength training designed to meet your individual needs. The goal is to minimize cancer-related fatigue and to optimize your physical function and safety.

Throughout your treatment, your therapist will consult regularly with you and your care team to help improve your physical functioning and sense of well-being.

Our rehabilitation team also provides an educational component to help you understand the physical and psychological benefits of physical restoration, and to help prepare you and your family for continuing the program at home.

Oncology Rehabilitation Therapies at CTCA

We understand that your ability to function independently plays an important role in your comprehensive cancer treatment and your overall quality of life. The Oncology Rehabilitation Program at CTCA aims to help you maintain the energy you need to participate in activities that are important to you, and to find fulfillment in your level of independence.

Program highlights include:

Physical Therapy

Exercise—even minimal physical exertion—increases heart rate and muscle flexibility. For people living with cancer, exercise may boost your body’s tolerance to cancer treatments, including radiation therapy and chemotherapy.

Our physical therapists team up with our occupational therapists to help you stay active during your cancer care. They deliver individualized exercise programs that combine range-of-motion training with other light activities, like resistance training. They try to treat cancer-related fatigue by helping you continue activity at the right level, and at the right time, so you still have energy to do the things you enjoy. Their goal is to improve safety and enhance your self satisfaction with your physical abilities.

Borg Rating of Perceived Exertion (RPE)

The Borg Rating of Perceived Exertion helps you identify the intensity of activity that will improve your fitness and, at the same time, give you a boost in energy. The scale was developed for anyone to use to determine how hard they are working when they do something physical.

By using either words or numbers on a scale, you rate your perceived exertion during activity. For instance, if you work somewhat hard (i.e., level 6 on the scale) without an increase in discomfort or shortness of breath, it usually corresponds to between 65 and 75 percent of your maximum heart rate. Research shows that working at this level will improve your physical performance status. Since the condition of each person is unique and varies from day to day, the Borg system is able to keep exercise and activity at the right level.

Flexibility Program

Our rehabilitation therapists recommend stretching, a beneficial activity to relieve joint stiffness and pain, and improve your overall mobility and range-of-motion. The benefits of stretching include:

• Enhancement of efficiency in everyday activities
• Improvement of mobility and independence
• Improvement and maintenance of posture and muscle balance
• Injury prevention
• Promotion of physical and mental relaxation

Occupational Therapy

Our occupational therapists aim to make your job easier and better. We define your “job” as anything you do to occupy your time, and which you feel is important to your quality of life.

Your therapist will assist you in the following ways: Help you identify your daily activities, rate your performance in these activities, rate your satisfaction in your performance, and prioritize these activities based on their importance to you. They will study you as you interact with your day-to-day surroundings, assess physical mobility, and teach you how to address, and adapt to, any physical limitations resultant from cancer treatment. This may include help with showering, dressing, eating and toileting.

Canadian Occupation Performance Measure (COPM)

This patient-driven, therapist-directed program takes the Borg rating system to a new level. It gives meaning and purpose to mobility and strength. As you move ahead with the COPM, our goal is to help you restore the “fun” in function—and discover self satisfaction in taking your own shower, playing with your kids, and chatting with friends—while you conserve your energy to fight the disease.

Speech and Language Pathology

The speech pathologists at CTCA provide a dual role in the Oncology Rehabilitation Department. They teach speech therapy, and they also help resolve any swallowing problems that may limit your ability to eat. If left untreated, improper swallowing can lead to aspiration, in which food falls into the lung. Our speech pathologists collaborate with our dietitians to thicken or puree food to a tolerable consistency. They also work with our surgical oncology and radiation departments to support head and neck cancer patients who undergo laryngectomies or receive TomoTherapy^® Highly Integrated Adaptive Radiotherapy (HI-ART).

Manual Therapy

Dorion Simmons, massage therapist at CTCA at Midwestern Regional Medical Center, provides manual therapy for a patient.

One means of manual muscle therapy is massage therapy. If it is indicated, your physical or occupational therapist will provide you with a referral to a massage therapist. The care team at CTCA provides various forms of manual therapies, including:

• Swedish Massage
• Reflexology
• Lymphedema Massage
• Myofascial Release

Lymphedema Prevention & Treatment

Up to 30 percent of mastectomy patients develop lymphedema, a collection of excess fluid and protein in affected extremities. Years after active treatment, all too many survivors have had to live with this daily reminder of a disease they have long since conquered. The Oncology Rehabilitation Department at CTCA has searched for innovative and user-friendly treatment options for this condition.

We offer traditional clinical interventions, such as compression, skin care, soft tissue body work and exercise, along with non-traditional therapies, such as dance, naturopathy, electrical modalities and "drainage" techniques. We also provide educational materials containing information about prevention and early detection.