Breast Cancer Rehabilitation
Breast cancer changes your life in many ways. Your body has changed because of surgeries, radiation, and or chemotherapy treatments. All of these changes can impact your physical, social, and psychological wellbeing. We offer services to help you feel the best you can feel as you travel throughout your cancer journey. Your medical team’s goal is to optimize your function so that you are best able to adjust to your new life.
Who is breast cancer rehabilitation for?
Patients can benefit from rehabilitation therapy from diagnosis, to treatment, to survivorship, or to end of life. When you are diagnosed with breast cancer, you should speak to your physician about your rehabilitation path.
Breast cancer rehabilitation is recommended for those who:
- have undergone lumpectomy with sentinel node biopsy, lumpectomy with axillary dissection, mastectomy, or breast reconstructive surgeries
- are undergoing radiation and or systemic chemotherapy
- have finished chemotherapy and radiation and are dealing with the after effects of treatments
- are experiencing decreased abilities to reach or use their arms to push, pull, carry; arm swelling; shoulder girdle pain
- have scar formation or radiation induced skin changes
- have lymphedema or have had lymph nodes removed
- have cognitive deficits such as memory or difficulty with executive planning
- have cancer induced fatigue or have decreased endurance
- are at risk for developing fractures from osteoporosis
- are at the end of life and their family members want to find easier ways to help care for them
What does breast cancer rehabilitation involve?
Every individual is unique and can be affected by cancer treatment differently. Rehabilitation therapists design individualized treatment plans to restore the patient to the highest level of functioning based on an comprehensive assessment. Therapists do a comprehensive evaluation of each patient focusing on functional abilities at present. They will design a program of therapeutic exercise and help you with progressing toward your functional goals.
What types of recovery/ outcomes can be expected from breast cancer rehabilitation?
Studies of breast cancer surgery patients have shown that a well-designed rehabilitation and exercise program has many benefits including:
- early functional use of the post surgical arm
- improved strength in upper and lower body
- greater flexibility in the shoulder joints
- reduced levels of fatigue
- better body image
- reduced anxiety levels
Cancer rehabilitation is a comprehensive, multi-disciplinary approach to the evaluation and treatment of patients diagnosed with various forms of cancer. Individualized therapy sessions, a variety of treatment techniques and evidence based practice are utilized in order to maximize the benefits of exercise throughout the disease process. Cancer rehabilitation can address functional issues such as weakness, soft tissue tightness, joint stiffness, fatigue and swelling or edema. Therapists are available in multiple treatment settings including: pre-operative, post-operative, acute care, home health, inpatient and outpatient rehabilitation. Therapy staff work in conjunction with the medical team to design components of a survivorship care plan in order to optimize overall functional outcomes.
Who would benefit from cancer rehabilitation?
Cancer rehabilitation is appropriate for individuals undergoing the following medical management:
- Radiation therapy and chemotherapy
Therapy services are also appropriate to address ongoing exercise and wellness needs as well as to provide recommendations for hospice needs/services.
What does cancer rehabilitation involve?
After a thorough evaluation and development of a plan of care, treatment often consists of:
- Survivorship care plan (exercise, wellness, bone health)
- Range of motion, strengthening and cardiovascular exercise
- Joint, soft tissue and scar mobilization
- Desensitization techniques
- Balance re-training/ falls risk reduction
- Breathing/relaxation, energy conservation and lifestyle modification techniques
- Lymphedema management including:
- Skin care
- Decongestive exercises
- Compression therapy including measurement and fitting of off the shelf and custom garments
- Manual lymph drainage
How long will cancer rehabilitation take?
The length of cancer rehabilitation varies depending on when therapy is initiated, the severity of symptoms and the patient’s goals for rehabilitation. Therapy services are often coordinated with the patient’s current treatment regimen in order to maximize tolerance and convenience as well as to improve function. A typical frequency may be one to two times per week and could last for several weeks or a few months in order to maximize progress and functional outcomes.
Lymphedema is an abnormal accumulation of lymph fluid that results in swelling, most often in the arms and/or legs, although it can affect other parts of the body as well. Lymphedema can develop when lymphatic vessels or nodes are missing, removed or not working properly. Left untreated, lymphedema not only causes an increase in the size of the limb, but also reduces oxygen to the skin, limits wound healing, and increases the chance of infection.
Who is lymphedema rehabilitation for?
Individuals with the following conditions are appropriate for lymphedema rehabilitation:
- Congenital lymphedema
- Oncologic lymphedema (after lymph node dissection, sentinel lymph node biopsy, radiation therapy)
- Vascular edema/lymphedema
- Face, neck, trunk, breast, genital and extremity swelling
What does lymphedema rehabilitation involve?
Physical and occupational therapists at the Cleveland Clinic are currently utilizing Complete Decongestive Therapy (CDT) as the standard of care to treat lymphedema. The treatment consists of four parts; manual lymph drainage, skin care guidelines, decongestive exercise and compression therapy (compression bandaging, garments and pumps). Typically there is an aggressive phase when the therapist customizes the above treatment approach (often including daily compression bandaging) during intense therapy in order to decrease swelling, improve tissue texture by reducing hardened or fibrotic tissue and improve the patient’s ability to function in order to achieve a successful outcome. During this phase, therapists emphasize patient/family education to ensure that the patient can self manage their lymphedema and continue the necessary techniques in the maintenance phase, which often includes daily wearing of a compression garment in addition to good compliance with all aspects of CDT on an ongoing basis.
How long will lymphedema rehabilitation take?
The length of lymphedema rehabilitation can vary depending on the extent of swelling present, the tissue texture of the skin, and other co-morbidities (such as diabetes, high blood pressure, etc.) as well as the patient’s compliance and ability to follow the recommendations provided. Typically therapy performed 1-3 days per with emphasis on patient education is optimal for reducing swelling. Duration varies based on a patients' response to treatment and active participation in the therapy.