4 Part Series Of Cancer Physical Therapy Treatment:
Part 2: Pelvic Cancer and Lower Extremity Rehabilitation
Greetings to Part 2 of our blog series. A recap from part one; here Rehab Solutions we have two providers that are specialized in Oncology Rehab. Tiffany Nielsen, 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) the top leaders in Oncology Rehab.
If you are reading this and wondering if this rehabilitation applies to you or someone you know, here are some of the top diagnoses that fit into this category, but are not limited to, ovarian or uterine cancer, kidney cancer, colon cancer, testicular and prostate cancer. We know the word cancer is intimidating and can feel scary. Many choices, procedures, and treatments follow quickly after hearing that word. We want to make one choice easier for you by helping you during your course of treatments.
Upon your diagnosis, you have probably experienced a biopsy for confirmation. At this point, your oncologist will help you decide your plan of care. The top treatments discussed are, 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 remaining cancer cells in the area. Chemotherapy and radiation are commonly used adjacent but can be used as separate treatments.
Since this topic can cover many types of cancer, a variety of proper surgeries happen. To keep things simple there is a high probability that you will have a portion or full removal of the organ affected by cancer cells. Common full removal of organs includes, but is not limited to, hysterectomy, lymph node dissection, radical prostatectomy, nephrectomy, or colectomy. With partial bladder or colon removal, you may receive a colostomy or urostomy bag. We are trained to work around these items and assess healing.
Surgery may happen before or after your other treatments with lymph nodes generally removed from the area to be assessed for any cancer spread. 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. Lymphedema is a chronic, progressive inflammatory lymphocytic 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 at bay.
Chemotherapy is a systemic drug, meaning it is designed to seek out all rapidly growing and dividing cells in the body. Standard drugs for pelvic and GI cancers include Fluorouracil (5-FU), Carboplatin, and Doxorubicin to name a few, all chemotherapy drugs are dependent on diagnosis and each patient’s response to treatment. Every chemotherapy drug has a pattern of side effects that Tiffany and Emily are aware of and will address any symptoms that may come up, such as, peripheral neuropathy, cardiotoxicity, and decreased mucosal irritation of mouth, nose, and GI tracts to name a few. Radiation treatment is delivered to the treatment area and may come with side effects such as burns, skin and muscular fibrosis, and changes in posture 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 incisions or scars, any edema that may be present 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.
For a better understanding of 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 depending on how you feel 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 its own healing and function. We provide education on movements to improve your motion, manage pain and understand stressors to improve your lymphedema. The manual treatments we provide allow 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.