By Casey White, DPT, Clinic Director of STAR Physical Therapy
Cancer treatments such as radiation, chemotherapy, and surgery typically leave patients with several musculoskeletal limitations such as limited range of motion, strength, and balance. Physical therapy (PT) can help restore these limitations. Treatment can vary in intensity and quality based off of each patient’s needs. A treatment can be as specific as working on one joint and as broad as balance work to improve quality of life. Goals for therapy include decreasing dependence on family members and assistive devices, and returning to prior level of function.
PT While Undergoing Cancer Treatment
Physical therapy will decrease side effects such as stiffness in joints, loss of strength and muscle mass, and provide education on use of assistive devices as needed. Physical therapy can help assist a patient in maintaining quality of life along with guiding a patient in a long term program. For safety, patients should speak with their medical doctor prior to partaking in exercise. Patients should avoid exercise if they are experiencing anemia or low blood counts in their white or red blood cells. Appropriate level of treatment will be determined using blood pressure, heart rate, and oxygen saturation monitors along with patient perceived exertion.
PT after Cancer Treatment
Once a patient’s health has stabilized, physical therapy will help to identify and target any negative changes of the musculoskeletal nature brought on by treatment. Radiation can lead to a multitude of symptoms such as joint restrictions and swelling. Patients will also develop scarring around areas of radiation. Breast cancer patients can develop axillary web syndrome or thickening of connective tissue that hardens along the nerves, arteries, and veins as they travel the length of the arm with lymph node biopsies or removal. This thickening may limit arm range of motion and the ability to reach forward and behind the back. Chemotherapy typically leads to neuropathy, muscle wasting, and weakness. Physical therapy uses an individualized program to gradually increase range of motion and progress strengthening exercises.
Spending weeks immobile or in bed can lead to an increased fall risk among patients. Neuropathy could also lead to decreased balance with walking. Physical therapy would treat these balance and strength limitations to ensure a safe return to function inside a patient’s home and in the community. Lastly, surgery to remove tumors and organs associated with cancer can lead to swelling, decreased joint mobility, and scarring. The use of manual therapy along with exercises for loss of range of motion and strength will help target limitations and restore quality of movement and decrease pain.
Deconditioning is a common post cancer treatment diagnosis. Physical Therapists are best educated to assist with reconditioning. Through the use of an individually developed plan, patients can return to higher levels of independence, decreased dependence on assistive devices, and return to community activities.
What to expect in PT
A typical physical therapy program will begin with an evaluation to identify limitations. Then, a combination or flexibility exercises, aerobic activities, and resistance training will be utilized and progressed as appropriate. Every patient’s situation and diagnosis is different and every patient should consult their medical doctor prior to starting an exercise program.
Casey White, DPT
Casey White, DPT, Clinic Director for STAR Physical Therapy at the White Bridge Road Location in Nashville, TN, hails from the University of Kentucky. She was a member of the Swim Team and remains active with the swimming community in Nashville as the Physical Therapist to the Nashville Aquatic Club. Casey has continued her education while at STAR earning her manual therapy certifications in the McKenzie Method. Casey is married to Tony White, a realtor and professional Triathlete. She is also the proud new mother to her daughter Kylie.
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