Cancer Survivorship: A Lifelong Journey

I’m a survivor.

That’s what every person diagnosed with cancer wants to say, and turns out, can say once diagnosed.

While some think survivorship is after the end of treatment, it begins from the time of diagnosis through end of life.

As of 2022, 18.1 million people in the United states were diagnosed with cancer and in some stage of survivorship. By 2030, according to the Journal of the National Cancer Institute, the number of survivors is projected to increase to 21.6 million people. That’s not surprising — as medical advances are made, the number of cancer survivors is also growing.

People are living longer, and whether you are managing an active cancer or have a history of cancer that has latent or long-term effects on the body, cancer rehabilitation can be a vital resource in living well beyond cancer.

Cancer rehabilitation – Making the most of survivorship

Survivorship looks different for everyone, but regardless of the cancer type or treatment, cancer rehabilitation specialists can enhance recovery and assist with the management of current or persistent issues secondary to cancer treatments. Unlike traditional therapy services, cancer rehabilitation is specialized for the needs of cancer survivors. Cancer rehabilitation specialists view survivors from a whole person perspective, treat areas of need and connect patients to the resources they need to optimize every part of survivorship.

Never too late to start, best to begin early

So if survivorship begins at diagnosis, when should you add cancer rehabilitation as part of the journey? The answer is, “start early.”

You are investing in yourself when you include cancer rehabilitation as part of your care plan early in your diagnosis. Cancer rehabilitation specialists can:

• Meet you where you are.
• Get to know who you are before treatment begins.
• Have a full understanding of what cancer-specific treatments or surgeries are part of your plan and how they can impact your function throughout the journey.
• Build a plan around your life goals during and after treatment.

For patients who will be undergoing surgery as part of treatment, a therapy regimen can be created to build strength before surgery, setting you up for a faster recovery post-surgery.

In many cases, cancer rehabilitation can predict where you might experience issues based on your treatments and assist in addressing or avoiding complications from treatment proactively.

Busting the myth about cancer rehabilitation

There is a general misconception about cancer rehabilitation People often feel like they already have enough appointments, or they will be too exhausted from treatment “do therapy.”

Specially trained therapists understand the fatigue of cancer.

The goal is start low, progress slow and have fluctuating, flexible schedules of care to accommodate for daily radiation treatments or personal downtimes related to chemotherapy. Intensity of therapy is fluid based on how you are feeling.

The upside — in your therapist, you find a coach, a supporter, a cheerleader, a motivator in what you are going through as you are going through it.

Finally, it’s never too late to benefit from cancer rehabilitation. Whether you’re on day one of diagnosis or year 20 post-cancer treatment with latent effects — partnering with a cancer rehabilitation specialist can make the most out of living with and beyond cancer.

Whole body approach means understanding who you are

Cancer rehabilitation patients can expect a thorough evaluation. Questions will be asked about the cancer you’re facing and your full medical history. You may think, “why do rehabilitation therapists need to know about my medical history,” but it’s a vital key to your individual care plan.

Therapists take into consideration your whole body. Every bit of information allows them to identify any physical and functional issues you may be experiencing or might experience down the line due to the effects of cancer and its treatment. They tune in to your level of function as well as fitness status and then work with you to determine your goals and develop a head to toe plan to meet those goals and to get you in the best shape possible for the way you live your life.

Survivorship rewards

If you’re wondering how you might benefit from cancer rehabilitation, there are a number of positives. Let’s look at cancer rehabilitation as a rewards program and where you gain survivorship points.

• Surgery preparation: For some, surgery can’t be scheduled right away because of weakness. Therapists focus on building strength and stamina for a better surgical outcome. Cancer rehabilitation therapists can also give advice on how to best prepare your home environment and exercises to do to help you recover quickly from surgery.
• Tolerance: Therapy can assist in cancer treatment tolerance and side effect management, allowing patients to stay on track with a prescribed cancer treatment plan.
• Improved function: Individuals are able to maintain or regain ability to perform daily activities tied to independence.
• Enhanced quality of life: Being active in a cancer rehabilitation program improves overall well-being and allows individuals to participate in activities they enjoy. 
• Support for caregivers: Provides support for family members and caregivers in addition to the supporting you as the patient.

A team of experts on your side

As a specialized therapy program, cancer rehabilitation pulls together the expertise of physical therapists, occupational therapists and speech-language pathologists* as a full team working with you to manage physical and cognitive side effects of cancer treatments.

Each plan is developed and created for you – not a cookie-cutter plan. Components of a program could include:

• Physical therapy: Helps with strength, mobility, balance and endurance. 
• Occupational therapy: Focuses on restoring daily living skills and adapting to new challenges. 
• Speech therapy: Addresses swallowing and communication. 
• Cognitive rehabilitation: Focuses on brain fog, often referred to as cancer-related cognitive decline, and other difficulties with concentration, connecting thoughts or slower than normal thinking processes.
• Pelvic health: Addresses potential issues with bowel, bladder, sexual and pelvic function.
• Pain management: Helps manage pain and discomfort, including pain from cancer and treatment-related side effects. 
• Lymphedema management: Addresses swelling and other issues related to damage to the lymphatic system. 
• Fatigue management: Helps individuals manage fatigue and improve energy levels. 
• Exercise therapy: Improves overall physical health, stamina and well-being. 
• Lifestyle modification: Provides guidance on nutrition, exercise and other healthy habits.

Oncology certified rehabilitation therapists have advanced training in cancer and all of the nuances of treatment — the side effects, the safety precautions patients undergoing treatment need to take into consideration, etc. Using their knowledge and skills, cancer rehabilitation therapists use their extensive training to provide the proper guidance in exercising and recovering safely.

Beyond rehabilitation, therapists are screening for external needs to keep you on track. If you’re showing signs of needing psychosocial assistance, nutritional guidance or vocational support to get you back to work, the team works to get you in touch with those services all while partnering with your primary care provider and oncology care team.

Doesn’t have to be your new normal

During the cancer journey, reaching milestone after milestone, the goal is to overcome cancer. It’s the goal of physicians, specialists and the patient. After ringing the survivor bell, cancer survivors may think any side effects or lingering issues are just their new normal.

Reality check: they don’t have to be the new normal.

In fact, many of the longer term issues or late developing changes to your body because of cancer treatment can be managed through cancer rehabilitation.

Tapping into the power of cancer rehabilitation

More and more, primary care physicians and oncology specialists are recognizing the valuable contribution cancer rehabilitation therapists bring to their patients.

Often, they will recommend or refer you as part of their own care plans. If they don’t, you can be your own advocate and ask about cancer rehabilitation providers near you.

If direct access is not available in your state, ask your physicians for a referral or call a cancer rehabilitation provider for more information on how to get involved with their program.

If you or a loved one are on a survivorship journey, the time is now to say I want to live a better, meaningful life, where you feel your best self to enjoy every moment. Cancer rehabilitation is the tool to make that happen.

Clinical contribution to this blog provided by Audrey Stockwell, a board-certified clinical specialist in oncologic physical therapy.

*Services vary by location