Cancer rehabilitation

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:

• 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