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 Fred Hutchinson Cancer Center 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.
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 Fred Hutch 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.
How to request an appointment
If you are a Fred Hutch patient and would like to talk to a rehabilitation medicine provider, you can ask your Fred Hutch 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.
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.
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:
- Weakness and loss of strength
- Range of motion and flexibility issues, spasticity (stiff or tight muscles)
- Less endurance
- Skin changes from radiation therapy
- Balance issues
- Sexual dysfunction
- Problems swallowing
- Problems chewing food
- Getting up off the floor
- Getting out of a chair
- Climbing stairs
- Getting dressed
- 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
After surviving four cancers in 18 years, Angela Kulp is no stranger to the side effects of cancer treatment, including nerve damage that requires her to use a leg brace and a cane. Her many health care team members were at a loss as to how to contend with the ways her body had been impacted by cancer treatment after her oncologists had done their job: she had survived two melanomas and two lymphomas and weathered a CAR T-cell treatment that had re-engineered her body’s own cells then reinfused them into her body to fight her disease.
Frequently asked questions (FAQs)
- 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.
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.
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.
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.
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.
Find care team profiles
Meet the caring, dedicated people who take care of your rehabilitation needs at Fred Hutch.
What each team member does
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 .
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.
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 Fred Hutch.