Supportive care services

Cancer rehabilitation

A cancer diagnosis doesn’t have to limit your life. Although cancer or cancer treatment might change your physical, emotional and mental abilities in ways that can make daily tasks harder, cancer rehabilitation can reduce or get rid of those side effects. Cancer Rehabilitation Services at Seattle Cancer Care Alliance (SCCA) can help you stay as independent as possible.       

Chemotherapy, surgery, radiation and other cancer therapies can cause changes in your body that make it harder to work, care for your family or do the activities that are important to you. Cancer rehabilitation deals with these changes by trying to reduce cancer therapy side effects like neuropathy, memory loss, depression, difficulty swallowing, weakness or lymphedema. We work to diagnose and treat these changes to help you keep your quality of life during and after cancer treatment.
 

Chemotherapy Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. It may be given alone or with other treatments. Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Chemotherapy may be given by mouth, injection, infusion or on the skin, depending on the type and stage of the cancer being treated. It may be given alone or with other treatments, such as surgery, radiation therapy or biologic therapy. Lymphedema A condition in which extra lymph fluid builds up in tissues and causes swelling. It may occur in an arm or leg if lymph vessels are blocked, damaged or removed by surgery. Neuropathy A numbness, tingling or pain from nerve damage caused by a tumor or by treatment. Side effects A problem that occurs when treatment affects healthy tissues or organs. Some side effects of cancer treatment are nausea, vomiting, fatigue, pain, decreased blood cell counts, hair loss and mouth sores.

What is cancer rehabilitation medicine?

Cancer rehabilitation medicine helps you stay as active as possible in work, family and other parts of your life. Rehabilitation medicine physicians prescribe medications, do joint and soft-tissue injections and can talk with you about exercises or adaptive equipment to help with the changes in your mobility. These steps can help you keep or improve your quality of life.

Who is cancer rehabilitation therapy for?

Anyone who is getting treatment at SCCA can have rehabilitation services. To decide if you need rehabilitation therapy, ask yourself these questions:

  • Have your daily routines become harder?
  • Are you in pain? If you are, what makes it better or worse?
  • What challenges are you having at home or work? 
  • Are you having trouble with tasks such as bathing, getting dressed or eating?
  • Are you able to do your hobbies as much as you used to?
  • Do you feel tired or weak? Is this making it harder for you to walk?
  • Are you having a hard time thinking clearly, doing several things at once or remembering things?

The changes in how you feel once you begin treatment can start small. For example, you may not feel quite "with it'' and decide to cancel plans with friends. Your hands may be a little sore and swollen, so you decide not to write in your journal. You might decide not to work in the garden because your joints, back or neck are a little stiff. It’s important to notice these little changes early, because if you don’t do something about them, they can get much worse. The sooner you start rehabilitation services, the faster you can recover and keep doing the things you love to do.

If you are worried about your quality of life during and after cancer treatment, you can begin rehabilitation therapy before you start cancer treatment. This is called “prehabilitation.” A rehabilitation therapist will check your strength and mobility and ask questions to understand how active you were before treatment. At each visit, we will check your strength and ask you if there are any activities that are getting harder for you to do. By dealing with side effects or limitations when they happen, we can help you continue to enjoy your work, family, activities and everything else that is important to you.
 

Side effects A problem that occurs when treatment affects healthy tissues or organs. Some side effects of cancer treatment are nausea, vomiting, fatigue, pain, decreased blood cell counts, hair loss and mouth sores.

How to request an appointment

If you are an SCCA patient and would like to talk to a rehabilitation medicine provider, you can ask your SCCA medical oncologist. Once you have an appointment scheduled, the Cancer Rehabilitation scheduling team will give you instructions on where to go and how to check in. 
 

Medical oncologist A physician who has special training in diagnosing and treating cancer in adults using chemotherapy, hormonal therapy, biological therapy and targeted therapy. A physician who has special training in diagnosing and treating cancer in adults using chemotherapy, hormonal therapy, biological therapy and targeted therapy. A medical oncologist is often the main health care provider for someone who has cancer. A medical oncologist also gives supportive care and may coordinate treatment given by other specialists.
Cancer Rehabilitation Services
email pttc@seattlecca.org
Hours: Monday–Friday, 8 am—5 pm
For more information, talk to someone from your care team or contact SCCA Rehabilitation Medicine Services.

What to expect

At your first rehabilitation care appointment, you will meet with our physiatrist (rehabilitation medicine physician) or a physical therapist, who will give you a physical exam and do a pre-treatment assessment. This may involve asking you questions about your cancer treatment and your daily activities as well as checking your strength and flexibility. This will give us a baseline that your practitioners will use to measure progress or notice changes. During your first appointment, your practitioner may ask you to stretch, bend, push or pull as far as you are comfortable. These practitioners are movement experts and will not ask you to do anything that causes pain.

Based on your strength and flexibility, your practitioner will make a treatment plan, which lets you know how often you should have rehabilitation therapy, what exercises you should do at the appointment (and maybe at home, too), and when you should be checked again to measure any changes in strength or mobility.

After your first visit, you may feel tired later that day or the next day, and your muscles may be sore. If you are given exercises to do at home, it’s very important that you do them to help make sure your rehabilitation goes well.

Treatment plan A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A treatment plan may also include information about how much the treatment is likely to cost and about regular follow-up care after treatment ends.
“We work alongside patients throughout their cancer journey to help manage side effects that affect mobility, with the goal of optimizing quality of life.”
— Hanna Oh, MD, Medical Director, Cancer Rehabilitation Services

What can cancer rehabilitation help with?

Because cancer therapy affects people in different ways, side effects will be different for each patient. Here are some of the most common side effects that rehabilitation medicine can help with:

  • Pain 
  • Swelling 
  • Weakness and loss of strength
  • Range of motion and flexibility issues, spasticity (stiff or tight muscles)
  • Less endurance 
  • Skin changes from radiation therapy
  • Lymphedema 
  • Balance issues
  • Neuropathy 
  • Fatigue
  • Agility
  • Sexual dysfunction 
  • Problems swallowing
  • Problems chewing food
  • Getting up off the floor
  • Getting out of a chair 
  • Climbing stairs
  • Walking 
  • Getting dressed 
  • Showering
  • Difficulty multitasking 
  • Difficulty thinking clearly or mental fogginess
  • Memory trouble
  • Sequelae (a condition that is caused by an injury) from a spinal cord injury, such as bladder dysfunction
  • Amputee care
Lymphedema A condition in which extra lymph fluid builds up in tissues and causes swelling. It may occur in an arm or leg if lymph vessels are blocked, damaged or removed by surgery. Neuropathy A numbness, tingling or pain from nerve damage caused by a tumor or by treatment. Side effects A problem that occurs when treatment affects healthy tissues or organs. Some side effects of cancer treatment are nausea, vomiting, fatigue, pain, decreased blood cell counts, hair loss and mouth sores.

Frequently asked questions (FAQs)

What side effects or issues can rehabilitation services help with for my type of cancer?
  • Breast cancer: shoulder stretching and strengthening, joint pain, fatigue, scar tissue management, lymphedema risk reduction and management, peripheral neuropathy, post-mastectomy pain and exercise prescription.
  • Lung cancer: scar tissue management, fatigue, exercise prescription and maximizing function and strength.
  • Prostate cancer: pelvic floor rehabilitation, lymphedema prevention and management, and exercise prescription.
  • Head and neck cancer: neck range of motion, jaw mobility, shoulder strengthening, speech or swallowing difficulties, scar tissue management, lymphedema management, fatigue and exercise prescription.
  • Stem cell transplant: maximizing function and strength, staying independent with daily activities, exercise prescription and reducing fall risk.
  • Sarcoma: mobility needs, muscle strengthening, lymphedema risk reduction and management, and scar tissue management.
  • Gastrointestinal cancer: peripheral neuropathy, muscle strengthening, fatigue and exercise prescription.
  • Gynecologic cancer: peripheral neuropathy, lymphedema risk reduction and management, scar tissue management and muscle strengthening.
  • Brain cancer: maximizing strength and function, mobility needs, speech or swallowing difficulties and staying independent with daily activities.
Bone marrow transplant The process of treating disease with high doses of chemotherapy, radiation therapy or both. Bone marrow or peripheral blood stem cells are given after treatment to help the body make more blood cells. The process of treating disease with high doses of chemotherapy, radiation therapy or both. Because this treatment destroys the bone marrow’s ability to produce blood cells, bone marrow or peripheral blood stem cells are given after treatment to help the body make more blood cells. Gastrointestinal Refers to the stomach and intestines. Also called GI. Lymphedema A condition in which extra lymph fluid builds up in tissues and causes swelling. It may occur in an arm or leg if lymph vessels are blocked, damaged or removed by surgery. Neuropathy A numbness, tingling or pain from nerve damage caused by a tumor or by treatment. Stem cell A cell from which other types of cells develop. For example, blood cells develop from blood-forming stem cells.
Do I need a referral to this clinic?

If you are a current SCCA patient and would like to be seen by one of our rehabilitation providers, please ask for a referral from your medical team.

How often would I need to go to this clinic?

This is different for each patient, and it is part of the treatment plan set up by your physiatrist or physical therapist at your first appointment. Therapy visits are often scheduled weekly, but that can change based on your treatment.

Treatment plan A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A treatment plan may also include information about how much the treatment is likely to cost and about regular follow-up care after treatment ends.
Can I do cancer rehabilitation therapy while I am having chemotherapy or radiation?

Yes. Based on several studies, cancer patients can safely do rehab therapy while going through treatment. Our therapists will keep your cancer treatment in mind and make changes to your rehab treatment plan if they are needed.

Treatment plan A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A treatment plan may also include information about how much the treatment is likely to cost and about regular follow-up care after treatment ends.
Does insurance cover cancer rehabilitation visits?

Most insurance providers, including Medicare and Medicaid, provide benefits for rehabilitation services. To find out your specific coverage, you will need to ask your medical insurance company. Coverage and benefits depend on your medical insurance company and the plan you have. It is your responsibility to know what is covered by insurance and what you will be responsible for paying.  

What is different about the rehabilitation team at SCCA/UW? Why can’t I just see someone closer to my home?

Because cancer patients have unique needs and situations, your physiatrists and therapists need to have specialized skills to provide the best evidence-based care. Our team has advanced training in lymphedema and oncology rehabilitation, and we focus completely on the rehabilitation needs of cancer patients. After you have started care with our team, we may be able to help you switch to rehab providers in your community for your ongoing needs.

Lymphedema A condition in which extra lymph fluid builds up in tissues and causes swelling. It may occur in an arm or leg if lymph vessels are blocked, damaged or removed by surgery.

Find care team profiles

Meet the caring, dedicated people who take care of your rehabilitation needs at SCCA.

Hanna  Oh, MD
Hanna Oh, MD
Physician
Rehabilitation Medicine

Physical therapists

Carol Baltaxe, PT, MPT, CLT
Carol Baltaxe, PT, MPT, CLT
Courtney Bush, PT, DPT
Courtney Bush, PT, DPT
Adrienne DiLiberto, PT, MPT, CLT-LANA
Adrienne DiLiberto, PT, MPT, CLT-LANA
Amy Dock, PT, DPT, CLT-LANA
Amy Dock, PT, DPT, CLT-LANA
Rachel Douglas, PT, MPT, CLT, APTA
Rachel Douglas, PT, MPT, CLT, APTA
Melissa Federhar, PT, DPT, CLT, ATC
Melissa Federhar, PT, DPT, CLT, ATC
Sue Frohreich, PT, MPT, CLT-LANA
Sue Frohreich, PT, MPT, CLT-LANA
Hannah Gaba, PT, DPT, CLT-LANA
Hannah Gaba, PT, DPT, CLT-LANA
Lexi Harlow, PT, DPT, CLT
Lexi Harlow, PT, DPT, CLT
Jenica Holt-Melnick, PT, DPT, CLT
Jenica Holt-Melnick, PT, DPT, CLT
Rette Loera, PT, MS
Rette Loera, PT, MS
Rachel Trussell, PT, MPT, CLT, CWS
Rachel Trussell, PT, MPT, CLT, CWS

What each team member does

Lymphedema therapist

A lymphedema therapist tests and treats lymphedema, which is the buildup of fluid in your soft body tissues when your lymph system is damaged or blocked .

Lymphedema A condition in which extra lymph fluid builds up in tissues and causes swelling. It may occur in an arm or leg if lymph vessels are blocked, damaged or removed by surgery. Lymph system The tissues and organs that produce, store and carry white blood cells that fight infections and other diseases. The tissues and organs that produce, store and carry white blood cells that fight infections and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes and lymphatic vessels (a network of thin tubes that carry lymph and white blood cells). Lymphatic vessels branch, like blood vessels, into all the tissues of the body.
Occupational therapist (OT)

An occupational therapist helps improve the function, comfort and safety of patients living their everyday lives, including things like showering, cooking, commuting or caring for family. 

Physiatrist, or physical medicine and rehabilitation specialist

Physiatrists are physical medicine and rehabilitation physicians who specialize in oncology. They diagnose and treat conditions involving nerves, muscle and bone that are caused by cancer or cancer treatment and can change how you move and function.

Physical therapist (PT)

A physical therapist specializes in helping you improve or restore your mobility and helping you reduce or get rid of pain. 

Prosthetist/orthotist

Prosthetists and orthotists specialize in fitting and making braces, splints and prostheses to help you recover from limb loss, neurologic injury or other mobility problems. 

Registered nurse (RN)

Your nurse manages your care with your physician. They also help with procedures and treatments. Nurses are resources for you and your caregiver. They can answer questions and help with a wide range of topics, like how to cope with side effects or how to get other services you need at SCCA.

Caregiver A person who gives care to people who need help, such as children, older people or patients who have chronic illnesses or disabilities. A person who gives care to people who need help taking care of themselves, such as children, older people or patients who have chronic illnesses or disabilities. Caregivers may be health professionals, family members, friends, social workers or members of the clergy. They may give care at home, in a hospital or in another health care setting. Side effects A problem that occurs when treatment affects healthy tissues or organs. Some side effects of cancer treatment are nausea, vomiting, fatigue, pain, decreased blood cell counts, hair loss and mouth sores.
Speech pathologist (SLP)

Speech pathologists specialize in helping patients who are having trouble communicating, swallowing or eating. 

Pathologist A physician who has special training in identifying diseases by studying cells and tissues under a microscope.
Team coordinator

Your team coordinator will likely be one of the first people you meet when you come to SCCA. They will schedule your first appointment and any recommended follow-up appointments for all rehabilitation services. They are also your main point of contact during business hours.