Supportive Care Services

Physical therapy

People of any age who are diagnosed with cancer can improve strength, function, and independence during and after cancer treatment with the help of physical therapy. Physical therapists help with concerns related to weakness, balance, scar tissue, lymphedema, range of motion, and rehabilitation equipment.

To schedule a physical therapy appointment, Fred Hutchinson Cancer Center patients need to be referred by a Fred Hutch physician, physician assistant or nurse practitioner. Patients who have secondary lymphedema can be seen at the Fred Hutch clinic by one of our physical therapists specializing in oncology. Physical therapy is located on the fourth floor of the South Lake Union clinic.

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. Nurse practitioner A registered nurse who has additional education and training in how to diagnose and treat disease. In cancer care, a nurse practitioner may manage the primary care of patients and their families. A registered nurse who has additional education and training in how to diagnose and treat disease. Nurse practitioners are licensed at the state level and certified by national nursing organizations. In cancer care, a nurse practitioner may manage the primary care of patients and their families, based on a practice agreement with a physician. Physician assistant A health professional who is licensed to do certain medical procedures under the guidance of a physician. A health professional who is licensed to do certain medical procedures under the guidance of a physician. A physician assistant may take medical histories, do physical exams, take blood and urine samples, care for wounds and give injections and immunizations.

Contact

Fred Hutch Physical Therapy
phone (206) 606-6373
Hours: Monday–Friday, 8 am–5 pm

Benefits of physical therapy

Cancer may be treated by surgery, chemotherapy, radiation therapy, and other treatments. Each of these treatments has unique side effects, some of which may lead to physical impairments that make normal daily activities difficult. We have advanced training in oncology care and will skillfully evaluate and treat your condition and provide you with tools to continue managing symptoms on your own.

Comprehensive cancer institutes throughout the United States, as well as the National Coalition for Cancer Survivorship, endorse exercise for people with cancer.

Who can benefit from physical therapy?

People treated for these diseases are commonly referred for physical therapy:

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. Radiation therapy The use of high-energy radiation from X-rays, gamma rays, neutrons, protons and other sources to kill cancer cells and shrink tumors. The use of high-energy radiation from x-rays, gamma rays, neutrons, protons and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. 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. Symptom A physical or mental problem that a person experiences that may indicate a disease or condition. Symptoms cannot be seen and do not show up on medical tests. A physical or mental problem that a person experiences that may indicate a disease or condition. Symptoms cannot be seen and do not show up on medical tests. Some examples of symptoms are headache, fatigue, nausea and pain.
Bone marrow transplant

To maximize function and strength and decrease the possibility of complications, such as muscle atrophy, infections, falls, and depression.

Breast cancer

After mastectomy, axillary lymph node dissection, or both, to provide overall shoulder stretching, strengthening, and cardiovascular conditioning, lymphedema risk-reduction, and scar-tissue treatment.

Conditioning Treatments to prepare patients for stem cell transplantation. May include chemotherapy, monoclonal antibody therapy and radiation. The treatments used to prepare a patient for stem cell transplantation (a procedure in which a person receives blood stem cells, which make any type of blood cell). A conditioning regimen may include chemotherapy, monoclonal antibody therapy and radiation to the entire body. It helps make room in the patient’s bone marrow for new blood stem cells to grow; prevent the patient's body from rejecting the transplanted cells; and kill any cancer cells that are in the body. 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.
Gynecologic cancer

For lymphedema, muscle strengthening, scar-tissue treatment, and pain management.

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.
Head and neck cancer

For radiation precaution education, overall neck and shoulder stretching, strengthening, cardiovascular conditioning, lymphedema, and scar-tissue treatment.

Conditioning Treatments to prepare patients for stem cell transplantation. May include chemotherapy, monoclonal antibody therapy and radiation. The treatments used to prepare a patient for stem cell transplantation (a procedure in which a person receives blood stem cells, which make any type of blood cell). A conditioning regimen may include chemotherapy, monoclonal antibody therapy and radiation to the entire body. It helps make room in the patient’s bone marrow for new blood stem cells to grow; prevent the patient's body from rejecting the transplanted cells; and kill any cancer cells that are in the body. 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.
Leukemia/lymphoma

For weakness due to abnormal blood counts or cancer treatments.

Lung cancer

For scar-tissue treatment, cardiovascular, strength, and stretching training.

Melanoma

For overall shoulder stretching, strengthening, and cardiovascular conditioning, lymphedema risk-reduction, and scar-tissue treatment.

Conditioning Treatments to prepare patients for stem cell transplantation. May include chemotherapy, monoclonal antibody therapy and radiation. The treatments used to prepare a patient for stem cell transplantation (a procedure in which a person receives blood stem cells, which make any type of blood cell). A conditioning regimen may include chemotherapy, monoclonal antibody therapy and radiation to the entire body. It helps make room in the patient’s bone marrow for new blood stem cells to grow; prevent the patient's body from rejecting the transplanted cells; and kill any cancer cells that are in the body. 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.
Multiple myeloma

To maintain function and quality of life and gently enhance noncancerous portions of the bones.

Prostate cancer

For lymphedema, muscle strengthening, scar-tissue treatment, and pain management.

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.
Sarcoma

To decrease phantom-limb pain and to increase functional mobility in patients who have had a joint replacement, reconstruction, or an amputation. Other services include cardiovascular, strength, and stretching training, lymphedema, scar-tissue work, and limb desensitization after amputation.

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.

Physical therapy solutions

People treated for a wide range of different cancers are referred to physical therapy. Physical therapists treat the following common problems related to cancer and its treatment:

Weakness

If you’re moving less due to fatigue from treatment and medications, such as steroids and chemotherapy, your muscles may atrophy and weaken. Physical therapists evaluate muscle strength and develop individualized exercise programs to restore strength. You will learn how to advance through a series of safe, appropriate exercises to meet your rehabilitation goals.

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. Steroid A type of drug used to relieve swelling and inflammation. Some steroid drugs may also have antitumor effects.
Swelling or lymphedema

Surgery and certain medications may cause temporary swelling. A more permanent condition called lymphedema can result if lymph nodes were removed during surgery. Radiation can also increase your risk of developing lymphedema. Physical therapists assess swelling, including evaluating your soft tissues and measuring the girth of your limbs, to determine which combination of compression therapy and manual techniques will be most effective for you. Manual lymphatic drainage techniques, along with compression therapy, promotes fluid clearance to reduce swelling so you can move more freely with greater comfort.

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.
Fatigue

Cancer treatment can have a significant and lasting effect on your energy level and endurance. Abnormal blood counts may contribute to feeling fatigued. Research supports exercise as a treatment for fatigue. Your physical therapist will help develop a graded and individualized exercise program to improve your energy level. You will receive coaching on how to conserve your energy and how to pace yourself during activities to get the best results.

View tips for dealing with fatigue

Poor balance

Generalized weakness from loss of muscle mass and strength can impair your balance and even lead to falls. Chemotherapy may cause a condition called neuropathy, which can result in numbness and tingling in the hands and feet. If you have neuropathy in your feet, you might be less aware of your position and lose agility and coordination. Physical therapists will test your balance to determine the extent of your problem and suggest activities to stimulate your sensory awareness and improve your stability. Strengthening your muscles and reducing swelling may also improve your balance and reduce your risk of falling.

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. Neuropathy A numbness, tingling or pain from nerve damage caused by a tumor or by treatment.
Decreased flexibility

Lack of activity can result in stiffness. After an allogeneic bone marrow transplant (using a donor’s cells), a condition called graft-versus-host disease can lead to tightening of the body’s connective tissues and loss of flexibility. Swelling and surgery may also limit the ability of a joint to move through its full range. A physical therapist will measure your range of motion and assess your tissue flexibility. Treatment may include manual techniques to loosen connective tissue restrictions and stretch muscles to improve flexibility in the most restricted joints.

Bone marrow The soft, spongy material in the center of your bones that produces all your blood cells, such as white blood cells, red blood cells and platelets. Graft-versus-host disease A condition that occurs when donated stem cells or bone marrow (the graft) see the healthy tissues in the patient’s body (the host) as foreign and attack them.
Reduced bone density

Chemotherapy, as well as the disease itself, can weaken and reduce the density of your bones. This condition is associated with an increased risk for fractures. Strengthening your muscles and doing weight-bearing exercises helps build bone mineral density. Physical therapists will teach you a safe and effective program to counteract a decline in bone density. And we’ll show you how to avoid excessive stress to vulnerable areas.

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.
Scar tissue

Radiation and surgery can create scar tissue that may be painful and decrease your flexibility or entrap nerves. Chronic swelling is also associated with the development of scar tissue. Physical therapists use targeted manual therapy and tissue techniques, as well as specific stretching and tissue and nerve mobilization, to help reduce pain associated with scar tissue and increase your mobility.

Diminished cardiovascular health and endurance

Lack of activity, loss of strength, and fatigue can diminish your cardiovascular health. If you experience shortness of breath or reduced endurance when walking or climbing stairs, these are signs of cardiovascular compromise. Physical therapists will develop a comprehensive, gradually progressive aerobic training program to improve your muscle metabolism, strengthen your muscles, and improve your endurance. We will teach you strategies to incorporate activities throughout your day to better manage your fatigue.

Sign In medicine, a sign is something found during a physical exam or from a laboratory test that shows that a person may have a condition or disease. In medicine, a sign is something found during a physical exam or from a laboratory test that shows that a person may have a condition or disease. Some examples of signs are fever, swelling, skin rash, high blood pressure and high blood glucose.
Other conditions

Physical therapists treat common conditions that may be unrelated to your cancer, such as joint and tissue sprains and strains, back pain, incontinence, shoulder problems, and more.

Meet our physical therapists

At Fred Hutch, physical therapists work as part of the care team with a patient's doctors, nurses and other specialists. Patients who have secondary lymphedema can be seen at the Fred Hutch clinic by one of our Certified Lymphedema Therapists. 

Carol Baltaxe, PT, MPT, CLT
Carol Baltaxe, PT, MPT, CLT
Courtney Bush, PT, DPT, CLT
Courtney Bush, PT, DPT, CLT
Adrienne DiLiberto, PT, MPT, CLT-LANA
Adrienne DiLiberto, PT, MPT, CLT-LANA
Amy Dock, PT, DPT, CLT-LANA
Amy Dock, PT, DPT, CLT-LANA
Melissa Federhar, PT, DPT, CLT, ATC
Melissa Federhar, PT, DPT, CLT, ATC
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