Physical Therapy for Cancer Patients: 12 Benefits

Cancer takes a toll, regardless of where it appears in the body. The disease itself, combined with treatments, such as radiation therapy, that can cause additional damage means that cancer patients undergo physical changes that often impair their functionality.

This is where PT comes in—physical therapy for cancer patients is key to helping patients regain strength, deal with pain and fatigue, and eventually return to full functionality and quality of life. Rehabilitation medicine strategies designed for each individual will enhance patient recovery.

Do Cancer Patients Need Physical Therapy?

Most of the time, the answer is yes. While different cancers affect different parts of the body, the damage that both the disease and its aggressive treatment cause typically means that physical therapy will be part of the recovery plan.

The population of cancer survivors has grown worldwide in response to advances in diagnosis and treatment—and survivors are living longer, which means there’s more time to regain quality of life. However, this also means there’s more time to experience late-blooming side effects.^1,2

Cancer treatment side effects can be acute and long-term, and they may occur at different stages of treatment, including well after completion. Survivors may experience:

• Pain
• Depression, anxiety, and fear
• Impaired balance, flexibility, and range of motion
• Chemotherapy-induced peripheral neuropathy (CIPN)
• Cancer-related fatigue (CRF) and weakness
• Chemotherapy-induced cognitive impairment (CICI)
• Radiation fibrosis and lymphedema
• Cardiotoxicity
• Pelvic floor dysfunction
• Impaired speech
• Difficulty swallowing or chewing food

Symptoms can damage or lower:

• Quality of life
• Personal safety
• Independence with bathing, toileting, dressing, etc.
• Ability to participate in activities and hobbies previously enjoyed
• Social engagement
• Relationships
• Ability to be employed or engaged in business at a pre-cancer level
• Professional momentum and investment

Plus, the symptoms and their effects can become a chicken-and-egg situation. For instance, fatigue leads to inactivity and loss of social life. This can, in turn, lead to depression, which can lead to the inability to invest in professional life, and so on.

How Do Physical Therapists Help Cancer Patients?

Physical therapists provide many benefits, but it starts with the title: they’re movement experts, with expertise ranging from the smallest curl of a toe to pro-athlete conditioning. They blend education, prescribed movement, and hands-on care to help patients engage in desired activities with better functionality and health.

Including a physical therapist in your care team and support groups can supplement your cancer care and daily activities. When it comes to physical therapy for cancer patients, 12 benefits stand out:

#1 Assessments

Physical therapists can provide prehabilitation assessments immediately after a cancer diagnosis to document baseline capabilities that will be useful in planning recovery goals. These include:

• Mobility and balance
• Range of motion
• Fitness level

Their assessments can also be useful (and sometimes required) in relation to:

• Work leaves and absences
• Workplace accommodations
• Disability coverage

#2 Pain Management

Adding physical therapy rather than relying solely on medication for pain management can improve outcomes, reduce side effects, and boost quality of life. Cancer rehabilitation will help reduce pain and enhance daily activities. Physical therapists can help lower pain levels through:

• Targeted massage
• Ice packs to calm inflammation
• Heat application to warm up muscles
• Exercises to reduce stiffness and weakness contributing to pain
• Electrical stimulation
• Ultrasound

#3 Strengthening

Physical therapy often focuses on building muscle strength by gradual, targeted, and supervised resistance training. This can include hands-on manipulation of the body (manual therapy) before patients move on to working with independent movement, resistance, or machines. However, this cancer rehabilitation method may prove difficult for those still undergoing radiation therapy since physical strengthening can worsen dizziness.

#4 Balance

Physical therapists can identify which muscles, joints, or bones are involved in balance issues and help their cancer patient through:

• Teaching alternate ways to rise, stand, or walk safely
• Providing guidance on fall prevention
• Helping improve posture
• Training to use assistive devices

#5 Mobility

Similar to strength training and balance, improving mobility typically involves an individualized plan of progressive steps. An example might be:

1. Manipulation of the patient’s muscles and joints
2. Physical therapist-assisted resistance exercises
3. Movement using walking rails and resistance training
4. Walking with assistive devices
5. Walking increasing distances to full mobility

#6 Range of Motion

Surgeries, fatigue, or joint swelling and pain may temporarily or permanently limit a patient’s range of motion. A physical therapist can help work toward realistic goals through four types of exercises:

• Active with movement by the patient
• Active assistive with limited help
• Passive where the patient needs complete help
• Resistive that employs resistance mechanisms

Completing the specialized exercises to increase their range of motion can enable cancer survivors to:

• Rise, sit, and walk
• Use their arms to feed, dress, bathe, and groom themselves
• Hug a family member

#7 ADLs Functionality

Physical therapy is essential when the activities of daily living (ADLs) that the patient is typically able to complete are unattainable. Basic ADLs include:

• Ambulating – Moving positions and walking independently
• Feeding – Eating typical foods while seated and using regular tableware
• Dressing – Selecting appropriate clothes and putting them on
• Personal hygiene – Bathing and grooming, including dental, nail, and hair care
• Continence – Control over bladder and bowel functions
• Toileting – Getting to and from the toilet, using it, and cleaning oneself

ADL functionality training may include:

• Building the strength, balance, and movement needed to complete these functions
• Learning new methods (i.e., safer ways to gently  move from floor-sitting to standing)
• Prescription and training on assistive devices and equipment

#8 Skin and Wound Care

Physical therapists can assist with skin damage, wounds, and incisions by changing dressings, checking conditions, and advising at-home care. They also employ techniques to reduce swelling, increase circulation, and promote tissue healing such as:

• Manual therapy
• Electrical muscle stimulation (TENS, Alpha-Stim, or Iontophoresis)
• Therapeutic exercise

#9 Lymphedema Treatment

Edema is swelling caused by fluid trapped in the body, and it’s defined as lymphedema when it persists for more than three months. Due to an overloaded or disrupted lymphatic system, lymphedema is chronic and severe. It can be caused by certain types of cancers and some types of chemotherapy.

The course of treatment managed by physical therapists is known as complete decongestive therapy (CDT) which includes:

• Manual lymphatic drainage (MLD) through gentle stretching and massage
• Compression garments and bandages
• Proving at-home exercises and education to prevent complications
• Caring for damaged skin and wounds related to lymphedema

#10 Neuropathy Treatment

Patients with nerve damage have a range of symptoms which are collectively referred to as neuropathy. Physical therapists help patients with chemotherapy-induced peripheral neuropathy (CIPN) to reduce pain and speed the recovery of damaged nerves through:

• Nerve-gliding activities
• Bracing for nerve injuries
• Teaching alternative ways to complete stressful tasks

#11 Family Education

Physical therapists coordinate with the patient’s medical team and daily caregivers or support system including involved friends and family members. They can help caregivers understand patient needs, limitations, at-home exercises, and how to best support them.

#12 Exercise

There have been many connections to exercise and cancer throughout this article, covering a range of assisted and independent activities and movements beyond the realm of standard physical fitness. However, physical therapists are experts on the body and its movements, and consulting on exercise programs for patients ranging from Hall-of-Fame athletes to movement newbies is a core function of the profession.

In addition to the benefits listed above, such as strength, range of motion, and mobility, an exercise regimen can improve:

• Cardiovascular function
• Stress levels
• Circulation
• Endurance
• Pelvic floor function

What Is an Oncology Physical Therapist?

Oncology physical therapists receive specialist training and gain experience and skills to complete assessments for and treat cancer-related impairments. These include:

• Lymphedema
• Peripheral neuropathy
• Cancer-related fatigue

In addition to treatments specific to cancer survivors’ needs, they can provide general physical therapy treatments as well, such as:

• Improving range of motion, strength, and balance
• Relieving pain
• ADL training and restoration
• Designing an appropriate at-home PT exercise plan

What Is the Best Physical Activity for Cancer Patients?

There are countless studies on the benefits of exercise to health in general, cancer specifically, and individual types of cancer at a targeted level.³ However, different cancer types require unique treatments. For example, the rehabilitation service for neck cancer will involve different therapy than brain cancer rehab. In addition to reducing the risk of developing cancer in the first place, physical activity has been found to influence cancer development and outcomes in multiple ways.⁴ It can reduce:

• The rate of malignant tumor growth and spread to new sites
• The risk of cancer relapse and recurrence
• The mortality risk, particularly for patients with breast, colon, or prostate cancer

Plus, it reduces the severity of cancer-related health outcomes including:

• Fatigue
• Quality of life
• Physical function
• Anxiety
• Depressive symptoms

Physical therapists can help design a safe course of exercise that provides the most benefit for each patient. In general, according to the 2018 ACSM Roundtable on Exercise and Cancer Prevention and Control, cancer survivors should complete⁴:

1. Aerobic activity for 30 minutes three times per week
2. Resistance exercise twice weekly, with one exercise per major muscle group, 8 – 15 repetitions per set, two sets per exercise, progressing with small increments

Resistance sessions can be completed with a mix of gym or at-home exercises using:

• Weight machines
• Free weights
• Resistance bands
• Bodyweight (i.e., sit-ups, squats, pull-ups)

Aerobic activity is any movement that increases the heart rate and the body’s use of oxygen. When it comes to aerobic activity, cancer patients should opt for low-impact exercises such as:

• Walking briskly
• Swimming or water aerobics
• Biking or indoor cycling
• Rowing or rowing machines
• Elliptical machines
• Dancing
• Active types of yoga such as Hatha or Vinyasa yoga
• Pilates with a cardio focus

Ivy Rehab Can Help

Ivy Rehab is proud to offer state-of-the-art, compassionate care from highly qualified clinicians, with a network of more than 560 clinics in the Midwest and Eastern states.

We specialize in helping patients from immediately after diagnosis until they reach their goals in post-treatment recovery. In addition to a wide range of oncology rehabilitation services, we offer a full suite of physical therapy treatments, from athlete training to vestibular rehab.

We’ll work with you on a personalized plan to improve your health and comfort during and after your cancer treatment. When you’re ready to connect, find a location near you to schedule your free screening.

Sources: 

1. National Library of Medicine PubMed. Recent Trends in Rehabilitation for Cancer Patients. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9263325/
2. National Library of Medicine PubMed. Physical Therapists in Oncology Settings: Experiences in Delivering Cancer Rehabilitation Services, Barriers to Care, and Service Development Needs. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8887570/
3. National Library of Medicine PubMed. Exercise and cancer: a position statement from the Spanish Society of Medical Oncology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7423809/
4. National Library of Medicine PubMed. Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7896280/