PT should be considered a necessary part of cancer treatment.
Physical therapy has been working its way into the world of Oncology and has made large strides in improving patient quality of life and outcomes. “Although cancer is the second leading cause of death in the United States, advances in treatment and hospital care have improved survival such that 67.1% will survive 5 years after diagnosis.” Due to the detrimental effects that treatment has at the cellular and organ level, curing cancer still has its consequences. Physical therapy has been shown to improve many of the problems resulting from chemotherapy, radiation, and unavoidable lifestyle and activity level changes; the Institute of Medicine highly recommends rehabilitation for all individuals with a diagnosis of cancer.
Studies show that physical activity and exercise are proven protective behaviors against both cardiovascular diseases and cancer. Cardiovascular disease and cancer have a bidirectional relationship, meaning that cardiovascular disease increases the likelihood of getting cancer and vise versa. Studies suggest potential biological mechanisms underlying the protective effect of exercise on cancer progression —>exercise has an anti-inflammatory effect by reducing the circulating levels of a specific nuclear protein (HMGB1) that is responsible for cell differentiation, cell migration, and tumor metastasis. Additionally, studies show that exercising before or during primary adjuvant therapy(chemotherapy, radiation therapy, hormone therapy, immunotherapy, or targeted therapy) can lessen the potential therapy-induced toxicity.
Researchers are attributing physical therapy’s lack of prevalence within the treatment for this population to lack of sufficient published evidence-literature surrounding this topic is still in its infancy. There are so many areas that physical therapy can address—> lymphedema, loss of extremity strength, osteonecrosis, fatigue and deconditioning, education regarding proper movement patterns and restrictions such as spinal precautions for those with spinal metastasis, etc. Exercise can positively impact fatigue, anxiety, cardio-respiratory fitness, quality of life, and psychological well-being, and it can also counteract the toxic effects of cancer. Supervised exercise programs have been shown to improve quality of life and physical function in cancer patients with different demographic and clinical characteristics, especially for those with high fatigue and low physical function such as with childhood cancer. The ability for Physical Therapists to positively impact the lives of those currently battling cancer and those in remission is substantial yet often overlooked….let’s work to change that.
o References
Ness K.K., Gilchrist L. (March 2020). Innovations in Rehabilitation for People Who Have Cancer or Who Have Survived Cancer. Physical Therapy, 100(3), Pages 361-362.
Venturini E., et al. (May 2020). Oncology and Cardiac Rehabilitation: An Underrates Relationship. J. Clin. Med., 9(6), 1810.
