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Need to start cancer treatment? Ask to see your Occupational Therapist BEFORE treatment begins!

Updated: Mar 2, 2023

It might seem silly since you aren't displaying limitations or side effects but, YUP, you read that right "see your Occupational Therapist BEFORE you start cancer treatment"

Therapy has often been recommended after someone has completed their cancer treatment. This approach can end up being a huge disservice to our oncology population, decreasing their recovery time and impacting their quality of life. Not to mention many cancer treatment side effects can be reduced by implementing therapy interventions early. Working with an Occupational Therapist from the start can help guide you during your course of treatment from providing exercises, education and resources. They could also help you generate validating questions to ask your oncology team during your care.

Fortunately, of recent I have witnessed an increase in physicians referring patients EARLY in care BEFORE cancer treatment begins! This way of monitoring and intervening cancer care is becoming the new standard of care approach - us therapists are loving the outcomes! Using this proactive approach aids to significantly reduce and/or eliminate impairments and side effects; it has multiple benefits and gives our oncology population better outcomes meaning better quality of life!

To help support our oncology clients with faster recovery and have an overall better quality of life, here are three important reasons why you should see a therapist (occupational or physical) who specializes in oncology rehabilitation or practice as a Certified Lymphedema Therapist before treatment.

What to anticipate before, during and after diagnosis

It’s hard enough accepting the news of your oncology diagnosis - the whirlwind of information and all the emotions happening at once - it is exhausting and overwhelming. It feels like grief - it IS grief. There are A LOT of questions racing through your head - or maybe there are no thoughts and you're still in shock. Unfortunately, all of this is NORMAL. Everyone's level of grief is different at different points of their journey.

One of the most common comments I get from my clients after being diagnosed is “I wish I knew what to expect. I wish I asked better questions!” My response is that it’s hard to think of everything when given this type of news, there is tons of information thrown to you at once, not everyone's journey is or will be the same, and with a diagnosis of cancer, how would you know what questions to ask or if it is the right question for you to ask.

The first two things I recommend: try and take it one day at a time (I know easier said than done) and have a great support system close to you. It’s also extremely helpful having a second set of ears with you when going to appointments. Often times is hard to think of questions on the spot with the doctor so typically offices have a few resources in place to help you navigate your care outside of the surgery.

Some oncology offices will have a helpful binder and/or nurse navigators to help answer questions you might have during the course of your care. Additionally, when being treated by an Occupational Therapist regularly they too can help navigate your care and lead you to resources. Since you typically see them weekly, they are an excellent resource to ask questions!

SO outside of the procedure...

Though everyone’s plan of care is individually specialized, all cancer survivors should anticipate they will experience one or multiple side effects from their treatment.

Some side effects, short or long term, can include:

  • Decrease mobility and strength

  • Edema

  • Lymphedema

  • Skin care and managing skin changes (scar tissue or hardening of the skin)

  • Pain

  • Fatigue

  • Brain fog

  • Neuropathy

  • Bowel & bladder issues

  • Gut health

  • Oral, gum, taste changes

  • Sexual dysfunction

  • …the list goes on.

These side effects can range from mild to severe, but if you know ahead of time what to expect, you can be better prepared. Your certified lymphedema and/or oncology therapist can educate you on different side effects to expect as well as strategies to either minimize or resolve symptoms.

Interventions can include exercises, strength training, lymphedema treatment, brain stimulating exercises, and providing resources pre-operation and prior to or throughout chemotherapy and radiation. Additionally, depending on your needs, your therapist can also help determine if you would benefit from an oncology dietician and/or a pelvic health therapist to be a part of your clinical team.

Baseline measurements Having your therapist get baseline measurements prior to treatment will help track any swelling which could be a sign of Lymphedema.

What is Lymphedema you ask...

Lymphedema is a progressive condition involving abnormal accumulation of protein-rich fluid and tissue swelling due to damage of the lymphatic system.

Lymphedema can be a common side effect after having a procedure where lymph nodes are impacted, in the oncology population this could be due to lymph node removal and/or radiation therapy. The area at risk for lymphedema would be near the area being treated. For example, if someone has a left mastectomy with lymph node dissection, the area at risk would be that person's left breast, arm, hand, axilla, left side of the trunk, shoulder, and scapula.

Having pre-treatment measurements helps inform your therapist and oncology team 'your normal' girth volume and where your measurements should be roughly measuring during and post treatment (short & long term).

It can also help obtain compression, which is part of Complete Decongestive Therapy if someone has Lymphedema or risk factors for Lymphedema. Wearing compression has clinically been proven to help reduce chances of Lymphedema, a great Lymphedema prevention strategy, and a great way to manage Lymphedema if it is diagnosed. Check out my blog on Lymphedema 101 for more details -!

Decrease treatment side effects More research has shown the benefits of exercising before, during, and after cancer treatment to decrease side effects. Always work with a qualified healthcare professional (ie. OT or PT) who has oncology rehabilitation training or is a Certified Lymphedema Therapist. These professionals assess your baseline function first to then provide you with an individualized, safe, and progressive program. To name a few, exercise has been shown to help:

  • Improve function of daily tasks and outcomes after surgery

  • Improve endurance

  • Improve functional strength and range of motion

  • Improve brain fog

  • Improve participation in Activities of Daily Living (ADL) and Instrumental ADL

  • Strengthen your immune systems

  • Maintain a healthy weight

  • Decrease risk of developing lymphedema

  • Decrease depression and anxiety

Managing the side effects of cancer treatment can be overwhelming on your own but navigating them with a therapist (OT or PT) specializing in oncology or Lymphedema can alleviate the stress of self-directed care and can help you be more successful with reaching your goals and overall improving your quality of life.

*Though I am an Occupational Therapist and a Certified Lymphedema Therapist, I may not be YOUR therapist. This is general education and not take place of professional medical advice, diagnosis or treatment. Please reach out to your medical team for proper care and management. :o)

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