Physical Rehabilitation: Detailed Information

This information is meant to be a general introduction to this topic. The purpose is to provide a starting point for you to become more informed about important matters that may be affecting your life as a survivor and to provide ideas about steps you can take to learn more. This information is not intended nor should it be interpreted as providing professional medical, legal and financial advice. You should consult a trained professional for more information. Please read the Suggestions and Additional Resources documents for questions to ask and for more resources.

Physical rehabilitation is the process of physically recovering from your cancer and adjusting to any physical changes you may experience. Cancer and its treatment affect some survivors’ bodies more than others. You may have been able to physically recover from cancer on your own. Or, you may have a hard time physically adjusting to life after cancer and want to seek help from a medical professional.

Medical professionals who can help you with physical rehabilitation focus on:

• Restoring your independence
• Preventing other physical problems you may get from being inactive for so long
• Assisting you with adjustments from physical changes and disabilities
• Helping you physically handle day-to-day activities

For some survivors, life after cancer means learning how to live with major physical changes. You may have to find new ways to do things or change the things you do on a daily basis. This may affect you emotionally. It’s perfectly understandable if adjusting to physical changes upsets you. The information in this document can help you identify whether you would benefit from getting help with your physical rehabilitation. If you want to learn more about how physical changes can affect you emotionally, you should talk to a mental health professional.

A physical rehabilitation plan is something you can develop with the help of your health care team. A part of your physical rehabilitation plan may be working with therapists who specialize in helping your body recover after cancer. These therapists can help you with physical changes throughout your survivorship.

Who can benefit from physical rehabilitation?

Recovering from cancer and its treatment is difficult for many survivors. Getting back to work, regaining your independence and feeling like you have enough energy to get through the day may take time. Physical rehabilitation is important for all survivors who feel that cancer or its treatment affected them physically. It’s important to give your body some time to recover, but if you are struggling with your physical recovery at any time during your survivorship, you can talk to your health care team about physical rehabilitation.

Working with a therapist on physical rehabilitation is usually recommended for survivors who have a leg or arm amputated, receive a prosthetic, or experience any other serious physical change that interferes with their mobility or ability to physically function. It can also be helpful for survivors who experience minor physical changes but still have a hard time physically adjusting to life after cancer. If you feel like the physical effects of cancer and its treatment are seriously interfering with your life after your treatment ends, you can ask a member of your health care team if you would benefit from help.

What are some signs that a survivor might benefit from help with their physical rehabilitation?

• You feel weak all the time
• You often lose your balance
• You have difficulty moving your arms and legs
• You don’t have enough energy to get through the day
• You have muscular or orthopedic problems
• You have difficulty walking and going up stairs
• You have difficulty swallowing
• You have difficulty talking
• You are recovering from a major surgery
• You're having a hard time adjusting to major physical changes

Who can help a survivor with physical rehabilitation?

The type of physical rehabilitation therapist you should see will depend on your individual needs. You may need to learn how to use your muscles again. You may need to learn how to move around your home or conserve your energy so you can return to work. You may have trouble communicating with people because of physical changes to your face, mouth or throat. There are therapists who specialize in each of these areas.

A physical therapist can help you adjust to the physical changes in your body by teaching you exercises and physical activities that can help condition your muscles and restore strength and movement.

Examples of things a physical therapist may do:

• Evaluate your muscle strength, mobility and how well you can move your joints
• Teach you exercises that increase or maintain your range of motion, strength, flexibility, endurance, coordination, posture and balance
• Help you manage aftereffects from treatment
• Assist you in chronic pain management
• Design a self-care exercise program that fits your recovery needs

An occupational therapist will help you learn to manage your daily activities and incorporate any physical changes caused by cancer into your home and work life.

Examples of things an occupational therapist may do:

• Help you learn to use assistive devices like walkers, if needed
• Discuss with you possible changes in your home or workplace to accommodate your physical changes
• Show you ways to conserve your energy and plan your days
• Examine your hand/eye coordination
• Evaluate any cognitive changes cancer or treatment may have caused

A speech therapist will help you if you have difficulty talking or swallowing after your treatment for cancer.

Examples of things a speech-language pathologist (therapist) may do:

• Evaluate and train you in areas where you may have difficulty communicating
• Help you with difficulty swallowing
• Teach you about voice preservation and treatment in voice restoration
• Treat symptoms of memory loss and attention

How long should survivors work with therapists on their physical rehabilitation?

Some of the physical side effects that survivors experience are only temporary. You may want to participate in some kind of physical rehabilitation plan only while the temporary change affects your daily life. There are also physical side effects that may not happen until years after treatment ends. If these changes require adjustments in your daily life, you might benefit from physical rehabilitation. A progressive and ongoing physical rehabilitation plan may enhance the quality of your life at any time during your survivorship.

Depending on your specific issues, the length of the physical rehabilitation process can vary. Some insurance plans only cover a limited number of visits. You should ask your insurance company about the number of visits allowed in your plan if getting financial assistance to pay for your physical rehabilitation is important to you.

What are some suggestions for survivors who need help with physical rehabilitation?

Below is a brief list. For more information, see Suggestions.

• Create a strong physical rehabilitation plan with your health care team.
• Find a good physical rehabilitation therapist.
• Check to see if your insurance plan covers physical rehabilitation services.

This document was produced in collaboration with:
Sue L. Frymark R.N., B.S.
Executive Director, CancerCare Resources

Physical Rehabilitation: Suggestions

Create a strong physical rehabilitation plan with your health care team:

• Make a list of the physical issues concerning you such as difficulty getting in/out of the car, weight loss and difficulty working a full shift.
• Discuss these concerns with your health care team.
• Ask for referrals to someone who specializes in the type of physical rehabilitation you need.
• Ask the physical rehabilitation therapist to evaluate your needs and discuss his or her suggestions with other members of your health care team.
• Together with a therapist, develop your self-care plan for physical recovery.
• Talk to a nutritionist about what diet would be best for your recovery needs.
• Share your plan with your support system (family, friends, support groups, etc.).

Find a good physical rehabilitation therapist:

One of the best ways to find a physical rehabilitation therapist who can help you is to ask for a referral from your health care team. You should discuss how a physical rehabilitation specialist can help you adjust to life after cancer and what things are right for you to do with your therapist. You may also want to ask another survivor for a referral, especially if you know a survivor who had similar physical changes.

When you are looking for a therapist to help you with physical rehabilitation, you may want to ask the therapist:

• Have you treated many cancer survivors?
• Have you helped anyone with a similar issue?
• What do you think will help me adjust to physical changes?
• Would you be willing to discuss your suggestions with my health care team?

You can also ask questions about your particular concerns:

• What can I do to improve my balance?
• Can I improve the strength of my hands?
• What can be done to improve my swallowing?
• How can I manage my job and home life with this fatigue?
• What can I do about my poor memory?
• Are there exercises that will help me get up the stairs?

Anything you do, either with your rehabilitation specialist or on your own, should be first discussed with your health care team. They can advise you on what physical activities are right for you.

Check to see if your insurance plan covers physical rehabilitation services:

• To receive rehabilitation services, you will need a physician's order. You can get this from your oncologist if you and your health care team decide you would benefit from physical rehabilitation.
• Check your insurance coverage to see how many rehabilitation visits you are allowed each year by each type of therapist. Each insurance company may cover physical rehabilitation differently. You may want to call your insurance company’s helpline and ask them specifically what your plan does and does not cover for rehabilitation services.
• If medical devices or aids are needed, ask your rehabilitation therapist about the cost. Many items are covered by insurance and Medicare, but some are not covered. There may be other ways to get the medical devices or aids if you can’t afford them. Your rehabilitation therapist can assist you.

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Physical Rehabilitation: Additional Resources

Click a resource for more information:

• American Physical Therapy Association
• American Occupational Therapy Association
• American Speech-Language-Hearing Association
• LIVESTRONG SurvivorCare Program

American Physical Therapy Association
www.apta.org

The American Physical Therapy Association is a professional organization for physical therapists, physical therapist assistants and students. The consumer section of their Web site has information for patients that explains what physical therapy is and how it can help. Information about insurance coverage for physical therapy is included. You can also use their search tool to find a physical therapist in your area.

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American Occupational Therapy Association
www.aota.org

The American Occupational Therapy Association is a professional organization of occupational therapists. Information is available for consumers to learn what an occupational therapist does and how you may be helped with therapy. Tip sheets on managing physical limitations are included, as well as links to other consumer organizations. The site also provides contact information for state occupational therapy associations, which may provide you with help in finding providers or resources in your area.

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American Speech-Language-Hearing Association
www.asha.org

The American Speech-Language-Hearing Association is the professional, credentialing association for more than 123,000 audiologists, speech-language pathologists, and speech, language, and hearing scientists in the United States and internationally.  The ASHA Web site includes information about problems and treatments related to speech, hearing, language, swallowing and balance. Links to related groups are provided, as well as lists of questions to ask a treatment provider. The Web site also has a search tool to find speech, language and hearing professionals in your area.

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LIVESTRONG SurvivorCare Program
www.livestrong.org/survivorcare

LIVESTRONG SurvivorCare offers assistance to all cancer survivors, including the person diagnosed, caregivers, family and friends. The program provides education, information about treatment options and new treatments in development, counseling services and assistance with financial, employment or insurance issues. To provide these services, LIVESTRONG SurvivorCare has partnered with several organizations, including CancerCare, Patient Advocate Foundation and EmergingMed.

The LIVESTRONG Survivorship Notebook is a tool that can help you organize and guide your cancer experience. The portable, three-ring binder contains a variety of information covering a full range of physical, emotional and practical survivorship topics. You may order a free LIVESTRONG Survivorship Notebook at www.livestrong.org/notebook. Shipping and handling charges will apply.

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