5 Things You Didn’t Know Physical Therapy Could Help With After Breast Cancer Treatment
You did it! You made it through breast cancer treatment! But what about life after breast cancer treatment?
Many people will experience side effects that will last a short or long time, or sometimes not even present until months or years later.
Breast cancer treatment may involve surgery, chemotherapy, radiation therapy, and/or hormone therapy. Specially trained physical therapists are key to have as part of your Survivorship Care Plan to address the commonly known, and not well known, side effects of these breast cancer treatments. As an oncologic, lymphedema, and pelvic health physical therapist, I find that a lot of breast cancer survivors I work with are dealing with some of these side effects without knowing that they can actually do something about them.
Cancer-Related Fatigue
This type of fatigue is different from “typical” tiredness because it is related to cancer or cancer treatment, does not resolve with sleep, is caused by multiple factors, and impedes usual functioning. One of the best ways to treat cancer-related fatigue is with moderate to vigorous physical activity. It may seem easier to just sleep more, but studies show physical activity can counteract and improve cancer-related fatigue. Working with an oncologic physical therapist will ensure that you are performing the best program for you. Your physical therapist will assess your balance, posture, gait, strength, range of motion, flexibility, reflexes, and sensation, as well as what your goals are. Based on all of this information, they will provide you with a safe and progressive exercise routine to get you feeling better. To learn more about what to expect with oncology physical therapy, check out my blog post, “What is Oncology Physical Therapy?”.
Sex
Yup, you read that right! Although hormone therapy is great at reducing the amount of estrogen and progesterone in the body or stopping these hormones from acting on cancer cells, one of the major side effects is menopause. Some of the effects of menopause include vaginal dryness, vaginal tissue thinning, less elasticity of the vaginal tissues, and narrowing and shortening of the vagina. All of these factors combined can lead to painful vaginal intercourse. Most people will have superficial pain, but some may experience pain with deeper thrusting as well. So how can physical therapy help?
A pelvic health physical therapist will ask you questions about your symptoms and perform a pelvic exam. The pelvic exam will assess the tissue health, reflexes, any muscle tension at the pelvic floor, and how your pelvic floor muscles are functioning, including their strength, coordination, and endurance. Based on the exam findings and your symptoms, your pelvic health physical therapist will provide different types of interventions. These may include instruction in vaginal moisturizing, training you how to use trainers (dilators), giving you stretches and other exercises to do at home, and manual therapy in the clinic. To learn more about pelvic health physical therapy, check out my blog post, “Pelvic Health Physical Therapy 101”.
Axillary Web Syndrome (AWS)
Upwards of 86% of people will develop AWS, also called cording, after breast cancer surgery. AWS is a thin line of a clotted lymphatic vessel within connective tissue and feels like a guitar chord. It’s most often in the axilla (armpit) and can travel down the arm. It can be very painful and make raising your arm difficult. Although most AWS will resolve on its own, working with a physical therapist can potentially help resolve it quicker and also decrease the risk of further shoulder dysfunction. Check out my video to learn how to do a quick screen for AWS.
Lymphedema
Certified Lymphedema Therapists (CLT) should be your best friend even before your treatment starts. Before you start treatment, you should see a CLT to get pre-treatment measurements of your arms as a baseline to monitor for any swelling or lymphedema as you move on from treatment. If you do develop lymphedema after breast cancer treatment, your CLT will work with you to reduce and manage the swelling. The sooner lymphedema is diagnosed and the earlier the stage of lymphedema at diagnosis, the better the outcomes. To learn more about lymphedema, how it’s assessed, and what treatment involves, check out my blog post, “What is Lymphedema?”.
Pain
Pain can be experienced after surgery, radiation treatment, hormone therapy, or chemotherapy. Often, the chest and shoulder muscles are tight after surgery and radiation, which can cause pain and difficulty using your arm. This can be improved with exercises and manual therapy techniques provided by your physical therapist. Joint pain, chemotherapy-induced peripheral neuropathy (CIPN), and post-mastectomy pain syndrome are other conditions that can be successfully treated in physical therapy. Understanding the “why” of your pain is very important, and working with a physical therapist can help you put the puzzle pieces together and give you a home program.
There are many types of physical therapists, so depending on your needs, make sure you are working with someone who is a CLT, has a background in cancer rehabilitation, and/or is a pelvic health physical therapist. To find a physical therapist near you, head to the American Physical Therapy Association (APTA) Find a PT resource, or to find a CLT, head to Lymphology Association of North America (LANA).
