Breast Cancer Rehabilitation

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’re best able to adjust to your new life.

Who is breast cancer rehabilitation for?

People can benefit from breast cancer rehabilitation therapy from diagnosis, to treatment, to survivorship or to end of life. When you’re diagnosed with breast cancer, you should speak to your healthcare provider 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 aftereffects of treatments.
  • Are experiencing a decreased ability to reach or use their arms to push, pull and carry, or who are experiencing arm swelling or shoulder girdle pain.
  • Have scar formation or radiation-induced skin changes.
  • Have lymphedema (swelling, typically in your arms and legs, which can happen after certain cancer treatments) or have had lymph nodes removed.
  • Have cognitive disorders such as memory problems 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 person is unique and can be affected by cancer treatment differently. Rehabilitation therapists design individualized treatment plans to restore you to the highest level of functioning based on a comprehensive assessment that focuses on your current functional abilities. Treatment plans may include therapeutic exercise and manual therapy to help with progressing toward functional and personal 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 postsurgical arm.
  • Improved strength in the upper and lower body.
  • Greater flexibility in the shoulder joints.
  • Reduced levels of fatigue.
  • Better body image.
  • Reduced anxiety levels.

How long will breast cancer rehabilitation take?

The length of cancer rehabilitation varies depending on when you start therapy, the severity of your symptoms and your goals for rehabilitation. We’ll often coordinate your therapy services with your current treatment regimen in order to maximize tolerance and convenience, as well as to improve function. Typically, you’ll visit one to two times per week for several weeks or a few months in order to boost your progress and overall outcome.

Cancer Rehabilitation

Cancer Rehabilitation

Cleveland Clinic cancer rehabilitation is a comprehensive, team-based approach to the evaluation and treatment of people 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 (edema). Outpatient therapy staff works with the medical team to design components of a survivorship care plan in order to enhance overall functional outcomes.

Who would benefit from cancer rehabilitation?

Cancer rehabilitation is appropriate for people undergoing the following medical management:

  • Postsurgical treatment for prostatectomy, hysterectomy, oophorectomy and head and neck cancer.
  • Radiation therapy and chemotherapy.

Therapy services can also address ongoing exercise and wellness needs, as well as provide recommendations for hospice needs or services.

What does cancer rehabilitation involve?

After a thorough evaluation and development of a care plan, treatment often consists of:

  • A survivorship care plan (exercise, wellness, bone health).
  • Range-of-motion, strengthening and cardiovascular exercise.
  • Joint, soft tissue and scar mobilization.
  • Desensitization techniques.
  • Balance retraining and falls risk reduction.
  • Breathing and relaxation, energy conservation and lifestyle modification techniques.

Lymphedema management treatment methods include:

  • 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 you start therapy, the severity of your symptoms and your goals for rehabilitation. Your care team will often coordinate your therapy services with your current treatment regimen in order to maximize tolerance and convenience, as well as to improve function. Typically, you may visit one to two times per week for several weeks or a few months in order to boost your progress and overall outcome.

Lymphedema Rehabilitation

Lymphedema Rehabilitation

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?

People with the following conditions can benefit from 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.
  • Lipedema (an irregular accumulation of fat in your legs and buttocks, or, potentially, your upper arms).

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’s an aggressive phase when the therapist customizes the above treatment approach (often including daily compression bandaging) during intense therapy. They do this in order to decrease swelling, improve tissue texture (by reducing hardened or fibrotic tissue) and your ability to function in order to achieve a successful outcome.

During this phase, therapists emphasize patient/family education to ensure that that you can self-manage your lymphedema and continue the necessary techniques in the maintenance phase, which often includes wearing a compression garment every day while also maintaining all other 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 comorbidities (such as having diabetes, high blood pressure, etc.), as well as your ability continue to follow the recommendations provided. Typically, therapy performed one to three days per week with emphasis on patient education is best for reducing swelling. Duration varies based on your response to treatment and active participation in the therapy.