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How Occupational Therapy can help you throughout your Breast Cancer Journey

Breast cancer patients are some brave warriors, their treatment may consist of surgery, chemotherapy, radiation therapy, and/or hormone therapy. Throughout or following one or more of these treatments, many will experience side effects. They could last a short or long time...or ...these side effects could arise much later (ie. months or years) after completing treatment.

It's often asked - is there anything that can be done about these side effects?! My answer is always - YES!

There are certain Occupational and/or Physical Therapists that specialize in this area and are a huge asset in your recovery plan. They can address and/or provide resources for the common and not so common side-effects. As a seasoned oncology and lymphedema therapist, below are some common side effects that I often see in my patients, and I teach them how they can be managed.

Axillary Web Syndrome (AWS) aka Cording Did you know ... after having breast cancer surgery approximately of 85% of people will develop AWS. It also tends to present more so in women with a lean build and/or those BMI >30. What is AWS? Well AWS often presents as a thin line of fibrotic (aka scar tissue) lymphatic vessel that is within connective tissue and it looks and feels like a guitar string. It’s most often in the axilla (armpit) and can travel down the arm, along the side of the breast, and/or down the side of the trunk. It can be very uncomfortable, painful and make raising your arm a challenge - all of which impacts your quality of life and participation in activities of daily living (ADL). In clinic I always screen my patients for this as well as educate them on how they can perform their own self assessments. The good thing is AWS will resolve on its own, but working with an occupational or physical therapist who are a Certified Lymphedema Therapist (CLT) will help resolve it faster which allows you to get back into living your best life sooner.

Brain Fog / Chemo Brain

Not feeling as sharp as usual? Feel like you're moving in slow motion? Forgetting the reason why you walked into the room or opened the refrigerator door? Leaving your car keys in the freezer? These are just some scenarios my clients have used to describe their brain fog after receiving chemotherapy. My role to address this side effect as an Occupational Therapist would be educate and train you on techniques to overcome that fog feeling. From using strategies to help your memory recall to using fun resources to exercise your brain and to aid with communication. Check out my Neurology Section under Visual Perception & Cognition and you'll find some fun games and apps I have enjoyed using in the clinic.

Cancer-Related Fatigue Is different from “typical” fatigue because it is related to cancer and/or cancer treatment(s), does not resolve with sleep, and impedes your overall daily functional performance which impacts your quality of life. Studies show one of the best ways to treat cancer-related fatigue is with moderate physical activity. Something simple as going for a walk can help squash that cancer-related fatigue sensation. To get the best outcomes it is very common for physicians to refer patients to work with an oncologic occupational or physical therapist. They have the specialized training to ensure you are prescribed an individualized exercise program to give you the best outcomes. Your therapist will assess your balance, posture, endurance, strength, range of motion, flexibility, sensation, and cognition to create your personalized plan. Based on all of this gathered information, they will provide you with a safe and progressive exercise routine to get you feeling better and reaching the goals you have set!

Lymphedema BEFORE you start treatment, you should see a Certified Lymphedema Therapists (CLT) to get pre-treatment measurements of your arms - this is BEST practice. This provides a true baseline arm measurement to monitor for any swelling or signs of lymphedema as you move on from treatment. Working with a CLT before treatment is like finding your oncologic best friend to ride this treatment wave with you. If you do develop lymphedema after breast cancer treatment, your CLT will work with you to reduce and manage the swelling. The sooner lymphedema is diagnosed, the better the outcomes! Check out my blog Lymphedema 101 for more information about Lymphedema.

Pain Pain can be experienced at any point in time throughout your oncology experience whether it be during or after chemotherapy, surgery, radiation treatment, or hormone therapy. Bone pain, joint pain, chemotherapy-induced peripheral neuropathy (CIPN), and post-mastectomy pain syndrome (aka phantom pain) can be side effects of chemotherapy and hormone therapy. Muscular pain and muscle tightness, typically in the chest & shoulder, are present following surgery and radiation. These forms of pain can limit your ability to participate in daily activities because it could impact endurance, strength, range of motion, sensation, energy, and endurance. The good thing is that all of these conditions can be improved (with exercise, sensory techniques, and manual therapy) when working with an oncologic therapist. Understanding the reason for your pain - "the why" - and working with an occupational therapist will aid in tailoring a specific home program just for you!

Skin Care

Did you know that 60% of what you put on your skin gets absorbed into your blood stream in less than 30 seconds - WILD right? Additionally, you want to make sure you are keeping the skin clean and free from irritation (scratches, cuts, cracks due to dry skin, wounds, etc) as it can reduce the risk for lymphedema. Education on signs and symptoms of infection and actions to take immediately should also be reviewed. As skin hydration is always a hot topic and recommendations are asked, I often lean organic and vegan based products -check out my favorites on my Oncology page. Keep in mind that I do want to make sure the product will be the best for YOU and YOUR care during whatever stage of treatment you are currently receiving at the moment -so make sure you ask your therapist before buying. One website I like to recommend is the EWG website, you can plug in your current products to make sure they are clean. Lastly make sure your therapist goes over the National Lymphedema Network Risk Reduction Practices. The NLN is a very reliable and valid resource us clinicians us often - I would also recommend you check out their position papers while you're on their website.

These are the top 6 common side effects that an oncologic therapist or CLT should be screening for and treating if needed - I know I do. If you are about to go to battle with cancer, or if you know someone who is about to start their treatments, please ask your physician to write a referral to Occupational or Physical Therapy - just make sure it is with someone who specializes in oncology care and/or is a Certified Lymphedema Therapist.

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