Physiotherapyis an essential part of cancer recovery and survivorship, focusing on restoring and improving physical function, reducing pain, and enhancing the overall quality of life for cancer patients. Physiotherapists play a critical role in the rehabilitation process by developing individualised treatment plans that address the specific physical challenges patients face during and after cancer treatment. These challenges may include fatigue, muscle weakness, joint stiffness, neuropathy, and movement limitations due to surgery, chemotherapy, radiation, or other cancer treatments.

Key Areas of Focus in Oncology Rehabilitation with your Specialist Physiotherapist:

1. Post-Surgical Recovery:
   • After surgeries like mastectomies, prostatectomies, or abdominal surgeries, physiotherapists work to restore mobility and strength.
   • They help patients regain muscle strength, joint flexibility, and proper movement patterns while minimising the risk of complications like scar tissue formation or joint stiffness.
   • Manual therapy, stretches, and strengthening exercises are often used to help with recovery.
2. Pain Management:
   • Physiotherapists use a variety of techniques to help manage both acute and chronic pain, which can result from surgery, radiation, chemotherapy, or nerve damage.
   • Techniques such as heat and cold therapy, TENS (transcutaneous electrical nerve stimulation), manual therapy, and specific exercises can help reduce discomfort and improve mobility.
3. Fatigue Management:
   • Fatigue is one of the most common and debilitating side effects of cancer treatment. Physiotherapists design gradual, paced exercise programs that help combat fatigue by improving cardiovascular health, muscle strength, and endurance.
   • They can also help with energy conservation techniques to manage daily activities more efficiently and reduce overall fatigue levels.
4. Neuropathy Management:
   • Chemotherapy-induced neuropathy (nerve damage, often affecting the hands and feet) can cause pain, numbness, and balance problems. Physiotherapists use specific strengthening exercises, sensory re-education, and balance training to help reduce the impact of neuropathy.
   • Techniques like nerve gliding exercises can help alleviate symptoms and prevent further nerve damage.
5. Balance and Gait Training:
   • Cancer treatment can affect coordination and balance, increasing the risk of falls. Physiotherapists help improve balance, posture, and gait through exercises that strengthen core muscles, improve stability, and enhance body awareness.
   • For example, dynamic balance exercises (e.g., standing on one leg, walking heel-to-toe) or working with assistive devices like walkers or canes may be necessary.
6. Lymphoedema Management:
   • Lymphoedema (swelling due to a blockage in the lymphatic system) can occur after surgeries like mastectomy or lymph node removal. Physiotherapists, often with additional lymphedema training, provide manual lymphatic drainage (MLD), compression garments, and specific exercises to reduce swelling, improve circulation, and promote fluid drainage.
   • Regular movement, especially low-impact aerobic exercises, can help keep the lymphatic system functioning and prevent fluid buildup.
7. Strengthening Exercises:
   • Cancer treatments can lead to significant muscle weakness, particularly in areas affected by surgery or radiation. Physiotherapists guide patients in progressive strength training exercises designed to rebuild muscle mass and improve function.
   • These exercises may involve low-resistance weight training, resistance bands, or body-weight exercises, customised to the patient’s strength level and physical limitations.
8. Flexibility and Range of Motion:
   • Physiotherapists work on improving flexibility and joint mobility through stretching routines and range-of-motion exercises, especially if surgery or radiation has caused stiffness or scar tissue formation.
   • For example, shoulder or chest stretches following a mastectomy or hip stretches after prostate cancer treatment can be key to improving function and reducing pain.
9. Postural Alignment:
   • Cancer survivors may develop poor posture due to fatigue, pain, or changes in muscle strength. Physiotherapists teach strategies for improving postural alignment, which can relieve tension, reduce pain, and prevent further injury or discomfort.
   • Core strengthening exercises can also help support better posture and overall spinal alignment.
10. Breathing and Cardiovascular Conditioning:
    • Some cancer treatments, particularly those affecting the chest, lungs, or heart, may lead to respiratory issues or reduced exercise capacity. Physiotherapists help with breathing exercises and cardiovascular conditioning to improve lung function and overall endurance.
    • Techniques like diaphragmatic breathing or pursed-lip breathing may help with shortness of breath and enhance overall stamina.

The Role of Physiotherapists in Oncology Rehabilitation:

1. Individualized Assessment and Treatment Plans:
   
   • Physiotherapists begin with a thorough assessment, which includes evaluating the patient’s medical history, cancer treatments, and any physical limitations or pain. Based on this assessment, they develop a personalised rehabilitation plan with specific goals.
2. Education and Empowerment:
   • Physiotherapists educate patients about their physical condition, including how to manage or prevent side effects of treatment and how to improve their physical function.
   • Patients are taught self-management strategies, such as home exercises, posture correction, and lifestyle modifications to promote long-term well-being.
3. Collaboration with Other Healthcare Providers:
   
   • Physiotherapists often work in collaboration with other members of the oncology care team, such as oncologists, occupational therapists, speech therapists, and psychologists, to ensure a holistic approach to recovery.
4. Motivation and Support:
   • Throughout rehabilitation, physiotherapists provide ongoing support and motivation. They offer encouragement to patients who may be struggling with the physical and emotional challenges of cancer recovery.
   • They help patients set achievable goals, celebrate progress, and adapt exercises as needed based on the patient’s evolving condition.

When to Start Physiotherapy in Oncology Rehabilitation:

• During treatment: Physiotherapy can be initiated during active cancer treatment to address symptoms like pain, fatigue, and muscle weakness, and help prepare for recovery.
• Post-treatment: Many cancer survivors begin physiotherapy after completing their treatments to address the long-term effects of surgery, radiation, or chemotherapy.
• Survivorship phase: Even after treatment ends, oncology rehabilitation with physiotherapists can continue to support long-term physical health, mobility, and well-being.

Benefits of Physiotherapy in Oncology Rehabilitation:

1. Improved physical function and mobility.
2. Reduced pain and inflammation.
3. Enhanced strength and muscle tone.
4. Reduced fatigue and increased stamina.
5. Better mental well-being and confidence in physical abilities.
6. Improved quality of life and independence in daily activities.

Conclusion:

Physiotherapy is a cornerstone of oncology rehabilitation, helping cancer survivors regain strength, improve movement, manage pain, and optimise their physical health after treatment. By working with a physiotherapist, individuals can achieve better physical recovery, minimise long-term complications, and return to a more active and fulfilling life.

Fiona Collins, MISCP, CORU PT066610

Fiona earned her degree in Physiotherapy from the Amsterdam University of Applied Sciences and further specialised in lymphoedema management, becoming certified in complete decongestive therapy. She has worked extensively with individuals managing lymphatic disorders, offering manual lymphatic drainage, compression therapy, and personalised exercise programs to reduce swelling, improve mobility, and enhance overall well-being.
Fiona expanded her practice to include oncology rehabilitation (PINC therapist), supporting cancer survivors through prehabilitation, treatment and recovery.