Why You Should See a Physical Therapist Before You Start Cancer Treatment
Cancer survivors will often get referred to physical therapy after their cancer treatment has already been completed. However, this is a huge disservice to cancer survivors because many of the side effects of cancer treatment can be minimized or resolved with earlier interventions in physical therapy.
Cancer care has moved to a Prospective Surveillance Model, which seeks to monitor and intervene earlier in survivorship to lessen or eliminate physical impairments. This is a proactive rather than reactive approach to cancer care and has multiple benefits. Part of the Prospective Surveillance Model is having survivors see physical therapists before cancer treatment starts.
It may seem counterintuitive to see someone before you have problems, but here are three important reasons you should see a physical therapist who specializes in cancer rehabilitation before treatment.
Get baseline measurements
Lymphedema is a common side effect after radiation therapy and surgery involving lymph node removal. It’s a progressive condition involving abnormal accumulation of protein-rich fluid due to damage to the lymphatic system. To learn more about lymphedema and how it’s treated, check out this previous OncoPelvic PT blog post.
The key to addressing lymphedema is catching it early and treating it early. Before you start cancer treatment, you should see a lymphedema therapist to get circumferential measurements of your arms, legs, or head and neck area with a measuring tape. For example, if you were diagnosed with breast cancer and are going to have a right mastectomy with a lymph node biopsy, your right arm will be at risk for developing lymphedema. Using the pre-treatment measurements, you and your therapist will be able to track your arm measurements to see if there is an increase due to swelling.
Another way to get a baseline measurement of your limb volume is using bioimpedance spectroscopy (BIS). This involves you standing on a machine (see the ImpediMed device on right) that sends a low-level electrical signal through your body to get your body composition. Using BIS can catch lymphedema before it even shows up clinically. Ask your medical provider if they have a BIS unit, as they are not available at all clinics.
Learn what to expect during and after treatment
All cancer survivors will experience one or multiple side effects from their cancer treatment. Long-lasting side effects can include lymphedema, decreased mobility, balance difficulties, pain, fatigue, weakness, bowel and bladder issues, neuropathy, sexual dysfunction…the list goes on. Side effects can range from mild to debilitating, but if you know ahead of time what to expect, you can be better prepared.
Your physical therapist can educate you on different side effects to expect as well as strategies to either minimize or resolve the symptoms. Interventions can include exercises, balance training, lymphedema treatment, improving body mechanics, or even working with a pelvic health physical therapist.
Decrease the severity of treatment side effects
More and more research has shown the benefits of exercising before, during, and after cancer treatment to decrease side effects. Always work with a physical therapist or other qualified healthcare professional who has oncology rehabilitation training to assess your baseline function first and provide you an individualized, safe, and progressive program. Exercise has been shown to help:
Improve function and outcomes after surgery
Decrease fatigue
Strengthen your immune systems
Maintain a healthy weight
Improve strength and range of motion
Decrease risk of developing lymphedema
Decrease depression and anxiety
If you are a cancer survivor, regardless of if you were just diagnosed or if you are several years out from treatment, physical therapy can help. Managing the side effects of cancer treatment can be daunting and overwhelming on your own, but navigating them with a physical therapist can help you be more successful.
The national professional organization, American Physical Therapy Association (APTA), has a search tool to find someone with oncology rehabilitation training near you.
