by Jarrod Bowan – Allied Health Assistant

Physical activity can reduce the risk of many cancers

There is strong evidence that shows leading an active lifestyle can reduce the risk of breast, colon, kidney, endometrial, bladder stomach and oesophageal cancer by 10 to 24 percent. At Physio For You, we promote the benefits of a physically active lifestyle to all clients we engage with when screening for injury prevention. Many of the treatments used by therapists to help clients with chronic pain, musculoskeletal, neurological, and cardiopulmonary conditions will facilitate those clients to be more physically active. This can lead to the use of physical activity in self-management of these conditions and have other health benefits such as reduced risk of cancer. There are many other healthy lifestyle behaviours that therapists can encourage in their clients such as smoking cessation. This can be discussed over multiple treatment sessions employing education, follow-up, and reassessment.

Prehabilitation can maximise adherence to cancer therapy and reduce complications

Cancer prehabilitation (prehab) occurs between the time of diagnosis and the commencement of treatment. It should underpin the whole cancer pathway. It begins with an assessment of baseline
outcome measures, identification of risk factors and education about the oncology treatment. Health professionals deliver exercise, nutrition, and psychological health interventions during this
stage. This helps to improve resilience to the effects of cancer treatment, reduce length of stay in hospital, enhance recovery, reduce treatment complications, improve cardiorespiratory fitness,
and improve quality of life (QOL). Exercise and physical activity are a fundamental component of prehab, it should be personalised to the individual, considering their specific needs, oncology treatment and likely side effects. Cardiovascular and resistance training should be prescribed and supervised by the physiotherapist. The length of a prehab program is dependent on upon the urgency of the oncology treatment required with benefits seen after as little as two weeks. Prehab has been shown to empower people with cancer by fostering a sense of control and purpose in an otherwise uncertain time.

Exercise is safe and beneficial during and after cancer treatment

Exercise is an effective and safe way to reduce cancer-related fatigue and to improve quality of life. Exercise can minimise the burden of side effects during chemotherapy. This is important because
high symptom burden can lead to chemotherapy dose reduction or discontinued treatment, which in turn may influence prognosis. To accommodate fluctuating symptoms, intensity, type, and
frequency of exercise will need to be adjusted regularly. It is encouraged that previously active people stay active as much as possible, while sedentary people should be encouraged to commence slowly under the supervision of a therapist. Physiotherapists adjust exercise programs to accommodate treatment plans, side-effects, and co-morbidities such as arthritis or reduced balance. It may be necessary to acquire a medical clearance especially if a patient has cardiovascular health concerns or signs of immunocompromise. To address cancer-related side-effects, patients should have an 8–12-week exercise program consisting of moderate intensity aerobic exercise at least 3 time a week for a minimum of 30 mins a session. Plus, resistance training at least twice a week.

Early detection and management of treatment problems can improve outcomes.

Treatment for cancer commonly cause impairments and functional limitations. As an example, breast cancer treatment may cause pain muscle weakness and reduced range of motion, neuropathy and,
lymphoedema. Cancer treatments are also associated with fatigue, deconditioning and osteoporosis. Physiotherapists are involved in prospective surveillance and management of impairments; this
involves regular reviews to educate and promote healthy behaviours such as physical activity. At this initial assessment, conditions can be identified that may impact planned cancer treatment (eg, a
shoulder injury may restrict radiation therapy position). Prospective surveillance can help to detect subclinical lymphoedema in women with breast cancer, which can lead to early intervention and can
reduce progression to clinical lymphoedema. Prospective surveillance is widely applied in oncology rehabilitation, with physiotherapists having a key role in implementation and evaluation to improve
outcomes for people with cancer.

The role of physiotherapy in palliative care is diverse and patient- specific

Palliative care helps people live their life as fully and comfortably as possible when living with a life- limiting or terminal illness. Physiotherapists working in palliative care adapt and tailor a wide range
of physiotherapy techniques.
Physiotherapy interventions in a palliative care setting include:
– Goal setting to maintain QOL in the face of advancing disease
– Personalised exercise prescription
– Assessing potential for improvements in mobility and function, gait aid prescription
– Easing of carer burden through carer education
– Lymphoedema management
– Respiratory care including non-pharmacological management of breathlessness
– Management of musculoskeletal pain
– Fatigue management strategies
– Fall minimisation strategies