Cancer Rehabilitation
The 2006 Institutes of Medicine (IOM) Report, From Cancer Patient to Cancer Survivor: Lost in Transition lists cancer rehabilitation as part of survivorship care. Furthermore, the Commission on Cancer (CoC) requires accredited programs to have a policy, procedure, and process for referral and monitoring of cancer rehabilitation services (Standard 4.6). Qualified rehabilitation professionals include physiatrists, physical therapists, occupational therapists, speech pathologists, and exercise physiologists.  Rehabilitation for cancer survivors can help address physical, cognitive, emotional, and social complications of cancer diagnosis and treatment such as:

  • Fatigue
  • Lymphedema
  • Pain (back, joint, neck)
  • Neuropathy
  • Muscle weakness and cramps
  • Fibrosis from radiation and/or surgery
  • Jaw opening and swallowing problems
  • Bladder and bowel problems
  • Cognitive impairment (chemobrain, anxiety, and depression-related changes)
  • Sarcopenia and cachexia
  • Reduced cardiopulmonary capacity

Resources
Cancer rehabilitation guidelines for disease site and symptom-based

Publications
Cancer rehabilitation as an essential component of quality care and survivorship from an international perspective (2020). Cancer rehabilitation and survivorship care are needed to improve health care quality, as there is an expected influx of cancer patients with new global efforts to improve oncology care. To accomplish this, rehabilitation initiatives must emphasize cancer rehabilitation as a component of any program, and oncology endeavors should include a plan for the rehabilitation of cancer survivors to reduce morbidity and health care costs.

Cancer Rehabilitation: An Overview of Current Need, Delivery Models, and Levels of Care (2017). This paper describes these models and proposes a taxonomy for stratifying the needs of cancer survivors. Criteria for determining a survivor's needs across this spectrum are proposed, and the role of the physiatrist as a vital advocate and champion is discussed.

Making Cancer Rehabilitation Services Work for Cancer Patients: Recommendations for Research and Practice to Improve Employment Outcomes (2017). Coordinated efforts in 3 key areas will better connect patients to rehabilitation interventions that will help optimize employment. These include the following: planning for the impact of cancer on the ability to work; implementing routine screening for impairments and facilitating referrals to cancer rehabilitation specialists; and focusing rehabilitation interventions on preserving employment. 

Impairment-driven cancer rehabilitation: An essential component of quality care and survivorship (2013). This review suggests an impairment-driven cancer rehabilitation model that includes screening and treating impairments all along the care continuum to minimize disability and maximize quality of life.

Supportive Care
Other considerations when providing survivorship care:

  • Exercise and weight management: information about the existing link between obesity, inactivity, and poor diet to poor outcomes in patients with cancer as well as a downloadable provider guide
  • Familial risk assessment and management: information and a toolkit with the tools and resources to assist oncology professionals in effectively integrating hereditary cancer risk assessment into practice
  • Tobacco cessation: information on incorporating the 5 As (ask, advise, assess, assist, and arrange) into practice and access useful resources related to each A as well as a downloadable tobacco cessation provider guide
  • Vaccine prevention: information and resources on vaccines to prevent cancer against HPV