Cancer rehabilitation (also called oncology rehab) is a field of medicine devoted to helping you stay active, diminish unpleasant side effects, and live independently during and after cancer and cancer treatment. It focuses on addressing common problems cancer patients face, like pain, fatigue, swelling, difficulty with movement, the mental fogginess of “chemo brain,” depression, anxiety and more.
A diverse set of specialists may work alone or in combination with each other to address these needs. Cancer rehab specialists can help you meet your own goals and participate more fully in activities that are important to you, like work, hobbies and family and social life.
Finding the right services
Because cancer rehabilitation includes many specialties, you’ll need to identify which types of services can best meet your needs. Your healthcare team can help by highlighting which aspects of your health and treatment will most benefit from additional attention. The hospital or your insurance company might assign a case manager to help you navigate your options and connect you with the right resources.
Talk openly with your care team throughout your treatment about any limitations you notice to what you can do. Include changes in your physical and mental capabilities (and don’t forget your emotions). Explain how these changes are impacting your everyday activities. For example, if you are having trouble getting dressed or showering, are feeling too tired or sad to spend time with people you care about, or if you find you’re too foggy to complete work tasks, let a member of your healthcare team know. Rehab services can help with many of these issues.
Here’s a more comprehensive list of the common problems cancer rehab services address:
- Tingling and numbness in fingers and toes (neuropathy)
- Sexual problems
- Difficulty swallowing or chewing
- Swelling (lymphedema)
- Balance problems
- Skin issues due to radiation treatment
- Reduced flexibility and range of motion
- Mobility issues, like trouble with walking, using stairs, getting in and out of bed or chairs, dressing
- Cognitive issues, like trouble thinking clearly and memory problems
- Emotional issues like depression, anxiety and PTSD
- Trouble with family or social relationships
Types of rehab services
There are many different specialists that may be involved in your cancer rehab care depending on your specific needs. Many of these specialists work with people with a variety of diagnoses. It’s usually best to find professionals experienced in working with people with cancer. They will be more familiar with the specific kinds of challenges you’re facing and how to address them.
Another factor to consider in choosing the right practitioner is location. If you will need to have regular appointments over an extended time period, finding someone to work with closer to your home can make getting to appointments much more convenient, and this can help you keep up your rehab routine and get the most out of treatment.
Here are some of the rehabilitation services available:
Physical therapists (PTs) focus on helping people with cancer maintain strength, mobility and balance, while decreasing pain and fatigue. Depending on your situation, you may need only a few appointments to learn basic exercises and movement techniques, or you may need to continue seeing a physical therapist for a longer time period as you rebuild your strength.
Physical therapy works best if you start as early as possible. Knowing what side effects or symptoms to expect and proactively managing them as they arise is much easier than waiting to rebuild strength and mobility after treatment. With this in mind, try to tell your physical therapist about any issues you have, however small or seemingly unimportant, as this will allow you to prevent them from worsening.
Physical medicine and rehabilitation specialists
Physical medicine and rehabilitation (PM&R) specialists, also called physiatrists, focus on nerve, muscle, and bone disorders that affect function and mobility. They often help with pain management. They address many of the same issues as physical therapists but have a broader scope of practice. You may see a PM&R specialist for evaluation and diagnosis, and that specialist may refer you for physical therapy as part of your treatment, along with other types of healthcare providers. A physiatrist can prescribe medication and give injections, while PTs cannot.
is a chronic condition in which a fluid called lymph collects under the skin, causing pain and swelling. It’s a common side effect of cancer treatment, especially in areas of the body near where lymph nodes have been removed. A certified lymphedema therapist (CLT) specializes in helping you manage and reduce these symptoms.
Occupational therapists (OTs) focus on equipping you to safely and comfortably perform activities necessary for daily life at home, work, school, and in your leisure time. This includes basic everyday tasks like dressing and bathing as well activities specific to your life and interests.
Occupational therapists can help you adapt your approach to activities so that you can continue participating even with some changes to your physical and cognitive abilities. They can recommend changes to your environment to reduce unnecessary effort and fatigue. OTs can also help you maintain or improve your abilities.
Vocational counselors specialize in supporting you as you return to work. They can assess your needs, refer you out to other specialists to help prepare you for employment, and help you negotiate accommodations with an employer. If needed, they can help you find new work that best matches your needs, skills and interests.
Recreational therapists specialize in caring for clients’ physical, mental, and emotional health through leisure activities that build confidence and reduce anxiety and depression. This can include music, art, physical activity and skill-building exercises.
Home care services
Home care can allow you to receive necessary support while reducing time spent in a hospital setting. Differing needs will require greater or lesser care and expertise, so it’s important to find care that matches your situation. Typically, you will qualify for home care only if you are unable to leave your home unaided, or, put in other words, considered “homebound.”
Here are the common types of home care professionals:
- Registered nurses (RNs) provide direct medical care. They have a nursing degree and are qualified to provide services to people who require advanced care.
- Licensed practical nurses (LPNs) provide basic medical care, like administering medication, inserting catheters and monitoring health status.
- Certified nursing assistants (also called nurse aides or patient care assistants) look after basic care and needs, as supervised by an RN or LPN.
- Home care aides (or home health aides) help with daily tasks like bathing, dressing, moving and cooking. Even if you have loved ones who provide this kind of support, it can be helpful to hire a home care aide on occasion to give your family and friends a chance to rest.
Speech-language pathologists (SLPs), often called speech pathologists or speech therapists for short, help people who have difficulty communicating and swallowing. Issues with swallowing may be a side effect of treatment for cancer in the head or neck. Difficulty with speech may be related to swallowing problems or it may be related to cognitive issues, like memory loss. Speech pathology treatment can help people with all of these challenges.
Neuropsychologists, also called cognitive psychologists, can help you understand and manage changes to your cognition and brain function. This includes “chemo brain” symptoms, the impairments to thinking that can happen as a result of chemotherapy and other cancer treatments. A neuropsychologist can help you improve your memory and organizational skills, particularly if they’re not improving on their own several months after you finish chemotherapy.
Mental health professionals
Mental health professionals include cognitive behavioral therapists, psychiatrists, social workers and others. These specialists can help you handle emotional and relationship issues related to cancer. They can help with depression, anxiety, PTSD, sexuality, changes to family and work roles and social life and other issues. They can help you learn relaxation techniques and better manage stress and pain. A psychiatrist typically focuses on prescribing medication, while social workers, psychologists or other types of therapists provide counseling. They may also lead support groups.
Exercise physiologists can evaluate and help improve your general fitness and function. They may be able to help you return to sports or exercise activities you enjoyed before cancer or find a new exercise program to meet your goals and needs.
Massage therapy can help relieve muscle tension, ease stress and promote relaxation. It can be a helpful and enjoyable complementary therapy for people who have been through cancer treatment. A specialized form of massage therapy called lymphatic drainage can help ease swelling and pain from lymphedema.
A dietitian can help you manage your long-term health through nutrition. If you need to make dietary changes to support a healthy weight and reduce your risk of cancer recurrence, or manage side effects that impact what kinds of food you can eat, a dietitian can help you plan meals and find strategies to promote your overall health goals.
Working with rehabilitation services
As you can see, cancer rehabilitation is a big umbrella for many types of specialists. As part of a cancer rehab program at a hospital, these specialists may work collaboratively with you and the rest of your healthcare team to help you be as independent and active as possible and to reduce the side effects of cancer and its treatments.
You can also seek out specialists separately, but it’s best to find professionals accustomed to helping people who have been through cancer treatment. Connect them with your healthcare team so they can work together to provide the best care.
Be sure to share your goals for treatment and track your progress, as this will help your rehabilitation team build the best strategy and adjust it if needed. If you or your healthcare team feel a certain treatment isn’t working for you, your rehabilitation team can modify its approach accordingly.
Cancer recovery is a long process, but the right team can help you plan, prepare and move forward with confidence.