4 Part Series of Cancer Physical Therapy Treatment:
Part 1: Breast Cancer
Welcome to part one of our Physical Therapy Cancer treatment blog. Here at Rehab Solutions we have two providers that are specialized in Oncology Rehab. Tiffany Nielsen, PT, DPT and Emily Swanson, PTA work as a team to provide you with the best care to meet your goals during and after a cancer diagnosis. Both therapists are certified through Physiological Oncology Rehabilitation Institute (PORi), who are the leaders in Oncology Rehab. After being diagnosed with cancer, your plate can be overwhelming with choices and recommendations of treatments to complete. We know adding one more appointment to your schedule can be daunting, but we hope to put that stress at ease with a better understanding of the services we can provide.
Upon your diagnosis, you may have experienced a biopsy for confirmation. At this point, your oncologist will help you decide your plan of care. The top treatments typically discussed include: which surgery is best for you to remove cancer cells and the best treatment for you such as chemotherapy and radiation to continue to kill remainder cancer cells in the area. Chemotherapy and radiation are commonly used together but can be used as separate treatments.
Common surgeries that may be an option are; lumpectomy or mastectomy with lymph node removal. Surgery may happen before or after your other treatments. Lymph node removal does not mean you will get lymphedema but it increases the risk. Lymphedema is a chronic, progressive inflammatory lymphostatic disease caused by mechanical failure of the lymphatic system. Tiffany and Emily’s manual techniques help re-activate the lymphatic system to help with any edema that may be present or help keep edema away. Lymph node dissection and radiation therapy are NOT the CAUSE of lymphedema. They simply result in an overall functional loss and transport capacity SLOWING in the territory/local lymph system.
Chemotherapy is a systemic drug, meaning it is designed to seek out all rapidly growing and dividing cells in the body, cancerous and noncancerous. Common drugs for breast cancer include adriamycin, cytoxan, and taxol. Each of these drugs has pattern of side effects that Tiffany and Emily are aware of and try to track and help any of these symptoms that may come up, such as, peripheral neuropathy, vestibular problems, and cardio toxicity to name a few. Radiation treatment is localized to the treatment area, but may come with side effects such a burns, skin and muscular fibrosis, and loss of shoulder range of motion due to the fibrosis.
During your initial evaluation with Tiffany, she will take you back to one of our private rooms and ask about your diagnosis, what treatment you have or will be receiving, what your pain levels are, assess your motion of joints and goals you have during or after your treatments. Then she will provide part of our hands on treatment to assess your skin, any wounds that may still be healing, and help start initiating the process of our certified technique of manual therapy. As far as how many visits to expect with us, we appreciate having one visit to establish a baseline of what is normal for you before your first surgery, then approximately three weeks after surgery we will resume treatment 1-2x per week depending on how you are feeling. Our treatments continue throughout your chemotherapy and radiation dependent upon how you are feeling and skin integrity with radiation. We love to help you beyond the current treatment to get you back to all your life goals.
Through PORi we have learned a specific sequence of hands on techniques to help navigate your lymph fluid back to the main channels to allow your own body to improve it’s own healing and function. We provide education on movements to improve your motion, manage pain and understand stressors to improve your lymphedema. While providing these manual treatments it allows us to help monitor your healing phases and be aware of any red flags that another physician may need to look at. PORi has also integrated a body systems approach to our technique to involve your muscular, skeletal, lymphatic and neural systems to name a few. We want to help optimize and stabilize your system to help you feel like you again.