It’s common for people to expect physical therapy after injury or surgery on a hip, leg or shoulder. It’s somewhat unexpected for cancer patients. At the Providence Roy and Patricia Disney Family Cancer Center (DFCC), patients often are surprised when they receive a full program of physical therapy after their treatment begins, and sometimes even before.
The human body experiences many changes during the cancer treatment journey. Physical therapy provides many benefits, according to the National Cancer Institute, including helping your body and brain work better, reducing fatigue, helping to alleviate depression and anxiety and improving sleep, muscle strength, bone health and range of motion—all while strengthening your immune system and reducing treatment side effects.
“Patient-specific exercise programs are a key component in preventing and restoring movement, strength and function,” says Cheryl Pranskevich, a physical therapist and leader of the DFCC’s Oncology Rehabilitation department at Providence Saint Joseph Medical Center in Burbank. “Physical therapy services can safely provide rehabilitation for cancer survivors from the time of diagnosis, during cancer treatment and throughout life,” she adds. “The Commission on Cancer, the American College of Sports Medicine and the American Cancer Society all recognize the safety and benefits of exercise for cancer patients.”
HOW IT WORKS
Pranskevich explains that patients are evaluated and given customized therapeutic exercises and activities to address range of motion, strength, and balance deficits specific to their cancer treatment and that rehab services can be preventive, restorative and/or supportive. She and her team consider all aspects of a patient’s life when creating exercise programs. “When we establish a plan of care, it is essential that we have knowledge of our patient’s cancer history—diagnosis, prognosis, surgery, chemotherapy, radiation therapy, targeted therapy—as well as their preexisting medical history, living situation, social/emotional support and vocation, and their specific goals.”
Sometimes Pranskevich meets patients before they begin treatment. She points out that “there is evidence that supports the benefits of PT interventions before cancer treatment.” This is sometimes referred to as prehabilitation.
The PT Breast Cancer services at the Disney Family Cancer Center offer prehabilitation care. A very common concern with breast cancer is the risk of lymphedema, which is swelling beneath the skin caused by a buildup of lymph fluid. The American Cancer Society identifies cancer and its treatment as possible causes of lymphedema. Pranskevich emphasizes that early intervention and surveillance can optimize lymphedema management and outcomes, allowing for the identification and implementation of patient-specific needs for manual lymphatic drainage, compression garments and exercise/activities as well as any needs for further manual therapy for scar management, fibrosis and cording.
Helping patients regain their health is meaningful work for Pranskevich and her colleagues. That’s why they encourage them to keep exercising long after they have recovered. “When I think of the rewards of my role at the DFCC, I think of two things,” she says. “I am part of a team of amazing individuals working to provide the best care for cancer patients. And these cancer patients, who have a heightened awareness and appreciation of their time, not only share their time with me but are forever grateful for their care and outcomes.”