Most people are familiar with rehab for medical conditions. If you've had a knee replacement or hip replacement it's likely that your physician offered physical rehabilitation following the surgery. If you've had a heart attack, cardiac rehab is the norm. If you've had a stroke, it's also likely that rehab services were recommended - physical therapy, occupational therapy, speech therapy, and possibly other services.
So why don't we often hear about rehab for people with cancer?
I could propose many theories. Perhaps it's felt that those of us who have "survived" cancer should be thankful just to be alive. Or maybe - I cringe to even write the words -- it's felt that people with terminal cancer are going to die anyway, and the resources won't make much of a difference. Whatever the reasons, it's saddening, almost shameful, that we have done so little in the way of rehab for people with cancer.
I've written just a few things about cancer rehab - and will take my own medicine and write more - but a new study conducted with patients with advanced, progressive, recurrent cancer in the UK prompted me to write about this important topic without delay.
In the UK there are 2 million people living with cancer. Many of these people have unmet needs after their treatment has been completed. Researchers chose a small number of people with advanced cancer to see if offering rehabilitative intervention would make a difference in their physical and emotional unmet needs.
The answer was an overwhelming yes. For cancer patients with advanced, progressive, recurrent cancer, those who were offered rehabilitative services fared much better from a medical point of view. This group also reported that from a personal standpoint, they were experiencing a better state of health than those who did not have rehabilitative therapy.
In the U.S., rehabilitation after cancer treatment is finally being recognized as well.
In fact, if I were to pick one day in the past year when I felt the most optimism for the future of people with cancer, it was the day that my friend/colleague/life-saver-in-my-own-survivorship/hero Nancy Hutchinson MD, a physical medicine and rehabilitation specialist who is revolutionizing survivorship care for cancer patients in Minneapolis, introduced me to Julie Silver MD.
Dr. Silver, a physical medicine and rehabilitation specialist and a professor at Harvard Medical School, is the co-founder of the Oncology Rehab Partners which founded the STAR program - a program desgined to address survivorship issues for anyone who has faced a diagnosis of cancer. You can check to see if your cancer treatment center has STAR certification here:
STAR Program Institutions
What does this mean for you?
If you are a cancer survivor, or have even just begun treatment, ask about rehab. Does your cancer center offer the STAR program? If not (and after recommending that they consider one) ask what kind of rehabilitative services are available. In some centers, a palliative care team may be able to help you address some of the issues that many cancer survivors face after treatment is done.
A common phrase that's come about for cancer survivors is "learning to accept a new normal." A new normal can go either way. Cancer rehab may just help tip the scales enough that your new normal is better than you ever imagined -- even before cancer.
Jones, L. et al. Rehabilitation in Advanced, Progressive, Recurrent Cancer: A Randomized Controlled Trial. Journal of Pain and Symptom Management. 2012 Nov 20. (Epub ahead of print).