Historically, clinicians have advised cancer patients to rest and avoid activity, but newer research has shown that exercise is not only safe and possible during cancer treatment, but can improve how a patient functions physically, as well as his or her quality of life.
"A lot of people think that they have cancer so they're tired and should go home and rest, but that's not what the current research is showing, says Dr. Felicia Adderley, a physiotherapist at Doctors Hospital Rehabilitation Centre. "Cancer survivors who took part in a high-intensity exercise program had better muscle strength, cardiopulmonary function, quality of life and less fatigue than those in the control group up to a year later," she said.
"Another study showed that individuals taking part in an 18-week high-intensity rehab program were able to return to work faster and at pre-diagnosis level of working hours as compared to the control group that received only standard medical care, without incorporating any cancer rehab or exercise into their regimen or treatment. Another study shows that physical training has significant, beneficial effects on fatigue, compared with no intervention at all. So exercise doesn't make you more tired; it gives you more energy," said the doctor who spoke at the recent Doctors Hospital Distinguished Lecture Series, at which the topic cancer rehabilitation and wellness was addressed.
The American College of Sports Medicine (ACSM) recommends that, to the extent they are able, cancer patients and survivors should engage in at least 150 minutes of moderate intensity aerobic exercise weekly. It adds that clinicians should advise cancer survivors to avoid inactivity, even for patients with existing disease or who are undergoing difficult treatments. The exercise recommendations should be tailored to the individual cancer survivor to account for exercise tolerance and specific diagnosis.
"The ACSM says exercise results in better physical function, quality of life and less fatigue," said Dr. Adderley. "Even persons that are undergoing chemotherapy or radiation can still benefit from cancer rehabilitation."
According to the doctor, cancer rehab includes exercise prescription in the clinic and at home.
"We don't have people come in two to three times per week; we ask them to incorporate exercise on the days they don't come in to see us as well. What is recommended is 150 minutes of moderate intensity exercise per week, and that can be broken up into 30 minutes per day, so that means exercising five days a week."

Cancer rehabilitation
Cancer rehabilitation is a multidisciplinary care designed to treat physical impairments and improve function and quality of life for cancer survivors as well as cancer patients who are currently undergoing treatment.
Members of this multidisciplinary team can include radiologists, oncologists, physical and occupational therapists, nutritionists, plastic surgeon, podiatrist, exercise physiologist and, in some, cases speech therapists, if there is any kind of neck cancer.
And cancer rehab is important, because cancer treatment is necessary and has numerous negative effects, according to Dr. Adderley. She said cancer rehab can help to lessen the negative effects and improve the patient's quality of life.

Who benefits
"The people that benefit from cancer rehab include people with any type of cancer; people that are at any stage -- whether early stage or late stage -- can all benefit from cancer rehab. Also those people that are currently going through chemotherapy or radiation and those that have remaining deficits up to years after being in remission can benefit," she said.
The physiotherapist said cancer rehabilitation came about because of the increase in early detection and better screening. As a result, with many more cancer survivors than there used to be, there came a new population of people living with deficits who did not realize that they could do something about it. In the United States, there are approximately 12 million cancer survivors, according to Dr. Adderley.

Common issues
Common issues that can occur due to cancer treatments include development of scar tissue, fascial cording (a band of tissue that can occur and decrease the range of motion at particular joints), fibrosis, decreased range of motion, lymphedema (an abnormal accumulation of protein-rich fluid), cancer-related fatigue, muscle weakness and imbalance, fracture secondary to bone metastasis.
"Some of the things we [physiotherapists] can do for them include mobilizing and massaging the scars, doing deep tissue work, myofascial release and manual stretching. For the lymphedema, there is decongestive therapy, which can include manual lymph drainage, compression bandages, skin care, exercise and use of compression garments. Also we can use walking programs, aerobic and strength training exercise to help decrease the likelihood of fracture, because doing the activities will help to build and strengthen the bone for weight-bearing."
Lymphedmea is an abnormal accumulation of protein-rich fluid due to mechanical insufficiency of the lymphatic system and it can develop overtime, and can occur many years after cancer treatment. According to the physiotherapist, lymphedema can occur as a result of surgery from the lymph nodes being removed. The lymph nodes help to filter out the fluid from the extremity. Dr. Adderley said that, over time, the remaining lymph nodes tend to burn out because they're overworked and unable to handle the load; the sufferer gets the swelling under the skin of the extremity.
Treatment for lymphedema can include medication, complete decongestive therapy and surgery; bandaging, fitting for compression garments, manual lymph drainage and kinesiotaping that are all offered at Doctors Hospital.
According to the physician, patient education is also very important so that persons can know what to expect from their cancer treatments, understand the precautions they should take with their treatments, learn how to monitor for signs of infection and lymphedema, and teach them ways to prevent themselves from getting lymphedema.

Benefits of cancer rehabilitation
"We would like to improve the quality of life for persons that are living with cancer, those that are undergoing treatment and those that are in remission," said the physiotherapist. "Persons will know that they will have increased endurance, increased strength, increased range of motion, prevention and control of lymphedema and, overall, what we would like to do is empower cancer patients and survivors to take control back of their lives and not just feel so helpless."
With respect to the social aspect to the disease, Dr. Adderley said it can help patients to hear stories from fellow individuals living with cancer and socialize with people who have gone through similar experiences.

Click here to read more at The Nassau Guardian