Role of the Physiotherapist in Oncology Care:
Physiotherapy plays an important role in the holistic care of the cancer patient. Research has shown the importance of exercise and activity through treatment for cancer. Some cancer treatments and surgeries are accompanied by side affects such as fatigue, decreased activity and in some cases mobility. Specific side effects such as joint stiffness, muscle weakness and lymphoedema can also be experienced. Physiotherapy has been shown to play an important role in the management of these side effects. We aim to
- Optimise activity levels prior to and during cancer treatment.
- Maintain joint flexibility and muscle strength
- Treat specific side effects such as lymphoedema
- Assist and advise on recovery to a healthy lifestyle including exercise following a cancer experience.
Beacon Physiotherapists are in constant communication with the Oncology team including consultant oncologists, radiation oncologists, radiation therapists and specialised nursing staff to ensure a holistic multi disciplinary approach to your care is provided. For more information about Beacon Cancer Centre please click here.
(1) Post operative care
Comprehensive rehabilitation service to oncology in patients including post operative care and inpatient based rehabilitation. Early rehabilitation and mobility plays an important part of recovery post surgery. Your surgeon will refer you for physiotherapy as needed following procedure. Your physiotherapist will advise you on breathing techniques to help prevent chest infection post surgery. She will also assist you in mobilising following your surgery to aim for recovery of independence as soon as possible following your operation. Your physiotherapist will advise you on specific exercises to help recover joint range of movement and muscle strength following surgery. Prior to your discharge home your physiotherapist will advise you on an activity / exercise programme aimed at helping you recover to your pre surgery activity levels.
(2) Advice on exercise prescription for inpatients and outpatients.
In the past people being treated for cancer were often told to rest and avoid too much physical activity. Alot of people with cancer were unsure if it was safe to exercise or not. There is growing evidence to suggest that taking part in moderate levels of exercise plays an important role in living through a cancer diagnosis and its treatments. Research has shown that regular moderate levels of exercise can help with the following
- Maintain energy levels and lessen the symptom of fatigue
- Maintain general function and muscle strength
- Keep the bones strong, reduce the risk of osteoporosis
- Improve balance and reduce the risk of falls and broken bones
- Improve weight control
- Improve circulation to the legs and therefore reduce the risk of blood clots
- Exercise has also been shown to reduce levels of anxiety and depression through cancer treatment
Your physiotherapist will advise you on an exercise and activity programme specific for you. This may include use of an activity diary, one on one physiotherapy gym sessions and referral to one of our group based exercise programmes such as circuit training or Pilates. Important to know about planning an exercise programme
- Your exercise programme should include activities that you enjoy.
- If you have previously been prescribed exercises by your doctor or physiotherapist, these exercises should be included in your exercise programme
- Find somebody to exercise with. This will make the sessions more enjoyable.
- Set yourself some goals for each week.
- An exercise programme should include a warm up period, fitness training, some strengthening exercises and stretches.
How do I know if I am doing too much or too little?
- The level of exercise you will manage will vary from day to day depending on your treatment. The trick is getting the balance right between exercise and rest.
- The easiest way to know if you are exercising to the right level is to monitor the effect the activity is having on your breathing.
- Too little: If you feel no effect on your breathing at all – you are able to sing.
- Too much: If you are unable to catch your breath – you are unable to hold a conversation with your training partner
- Just right: You feel slightly to moderately breathless while exercising but are able to maintain a conversation with your training partner.
Some patients undergoing surgery or treatment for cancer are at risk of developing lymphoedema.
What is Lymphoedema?
If a lymph vessel or node becomes blocked, the lymph fluid is unable to pass along it. Because the excess tissue fluid cannot drain away normally, it builds up and causes swelling. The medical name for swelling is oedema. When the swelling is due to a problem in the lymph system, it is called lymphoedema.
Primary lymphoedema because the lymphatic system has not formed properly, but this is rare. It can also be caused by other medical conditions that affect the lymphatic system.
Secondary lymphoedema can be caused by cancer or its treatment. It can occur if the lymph nodes are blocked with cancer or if they have been removed by surgery. Radiotherapy can also cause lymphoedema by causing a build-up of scar tissue within the lymph nodes.
Not everyone who has radiotherapy or surgery to the lymph nodes will get lymphoedema. But everyone who has undergone these procedures is at risk of developing lymphoedema.
The Lymphoedema Service
In Beacon Hospital, our Clinical Specialist Physiotherapist in Oncology Care is also a fully qualified and registered Manual Lymphatic Drainage Therapist. She can assess your risk of developing lymphoedema, assess the severity of lymphoedema if present and also provide necessary treatment. The aim of our service is to raise lymphoedema awareness and offer early intervention to prevent progression of symptoms. For more information about the Beacon Breast Care Centre please click here.
Limb volume measurements are taken and volume differences calculated. Skin condition is examined as well as limb function. Treatment goals are then agreed between the therapist and client.
Very often lymphoedema can be prevented and in some cases managed by abiding by simple “Do’s and Don’ts”. Your therapist will provide you with all necessary information on how to help prevent lymphoedema from occurring and what to do if you suspect you may be developing symptoms. Your therapist will also advise you on decongestive exercises and skin care. A compression garment will be provided when necessary. A specialist type of massage called Manual Lymphatic Drainage is an important part of treating lymphoedema.
Manual Lymphatic Drainage is a specialized form of skin massage provided by a trained therapist. It involves a sequence of hand movements which redirect excess fluid away from areas which are swollen towards areas with normal lymphatic drainage. Intensive sessions will be arranged when appropriate.
Should you require any further information about Beacon Hospital Physiotherapy Department please contact us on 01-293 6692 or email oncology firstname.lastname@example.org
Referrals and Appointments:
Your consultant can refer you for physiotherapy. Patients can be seen as an inpatient during a hospital stay. Alternatively patients can be seen in the out patient physiotherapy department. Out patient appointments can be made to coincide with other hospital appointments as necessary.
The different health insurance companies reimburse varying amounts for physiotherapy treatments. There is also variability in the limit of physiotherapy sessions per annum that can be reimbursed. We advise you to consult your individual health insurance company to find out how much you can claim with each physiotherapy visit. Physiotherapy costs can also be claimed against Tax using your MED 1 form. Please ask at physiotherapy reception for further details.