Life as a Cancer Survivor Poses Physical and Emotional Challenges - Wall Street Journal

Cancer Survivorship Care Programs Integrate the Body, Mind and Soul of the Survivor

Cancer rehabilitation services in Canada are rarely received, although they are needed as much as in the US

Cancer physiotherapy, emotional aid and plans for treatment follow-up are becoming the norm at a number of hospitals and community cancer centers in the US where survivorship care programs have an integrated approach that takes care of the body, mind and soul of the survivor. Unfortunately in Canada, these rehabilitation services are still rarely received, although they are needed just the same. (see Oncology Rehabilitation Provision and Practice Patterns Across Canada, Canestro et al, Physio Canada, 2013)

As reported in The Next Front in Cancer Care at the Wall Street Journal, "Chemotherapy and radiation can damage vital organs such as the heart and liver, possibly causing secondary diseases years later. The body can be debilitated, cognitive functions impaired and emotions distressed, making return to normal life and work difficult. Some 70% of cancer survivors experience depression at some point. Patients have higher levels of anxiety years after the disease is cured." The focus of treatment is on curing the cancer, but often there is no care provided for the side effects that occur as a result of the cancer treatment.

Cancer Rehab Canada feels the same rehabilitation services should be offered to Canadians who are living with cancer, whether their impairments are physical or psychological in nature. We have a long way to go to provide the same array of services available to many Americans, but we are working hard to build the same level of rehab care for all Canadian cancer survivorships.

Read the full Wall Street Journal article.

To find a Cancer Rehab Canada near you, visit the list of British Columbia, Saskatchewan, Ontario, or Nova Scotia locations.

Urban Poling Improves Quality of Life for Cancer Patients

Urban Poling is a growing wellness trend that combines specialized poles with walking

Urban Poling Help Survivors Recover from Cancer and Cancer Treatment

Walking poles are an excellent choice for people recovering from cancer and the cancer treatments they have received. The poles improve your balance and posture while walking. They allow you to walk further with less fear of falling and less stress on your joints. By using your upper body as well as your lower body, you will burn more calories which will assist you in weight loss. The swinging motion of your arms is particularly good exercise for the mobility of your shoulders. Shoulder restriction is so often a problem for breast cancer patients who have had surgery or radiation in the area.

Proven Benefits of Walking Poles

Evidence based studies have indicated the effectiveness of walking poles on shoulder function in breast cancer survivors. Other proven beneficial effects are:

• Self-esteem

  

  Anne Edgell-Kennedy, Clinic Director of
  LifeMark/Centric Health in Fonthill ON
  instructs a patient in proper use of urban poling

• Social interaction
• Improvement in pain management
• Anxiety
• Depression
• Quality of life
• Functional independence
• Core strength
• Upper extremity mobility and strength
• Muscular endurance
• Posture, stability and balance
• Exercise tolerance
• Personal exertion limits

Ensure Proper Height of Poles

It is important that the poles are the right height for you. Stand up straight with your elbows at your sides and bend them to 90 degrees (an "L" shape) and then adjust your poles so you are holding the handles while your arms stay in this position. A physiotherapist can help get you properly fitted and help you with your poling technique. It can take some practice to feel comfortable using the poles.

More Resources on Urban Poling

Read about the Health Benefits of Nordic Walking.

To see how Urban Poling works in action, check out our video.

To find a Cancer Rehab Canada near you, visit the list of British Columbia, Saskatchewan, Ontario, or Nova Scotia locations.

Calgary Volunteers Raise Awareness for Cancer at Run for the Cure

by Barb Morrison, Clinical Director, Max Bell Physiotherapy

Run for the Cure Shows Spirit of the Calgary Community

This year, Calgary's Mayor Naheed Nenshi sent out a message to Calgarians about volunteerism. Whether it is bringing this city back to life after the floods or supporting events such as the Run for the Cure, volunteers make it happen. "This is Calgary, folks," he said. "This is the spirit of the Calgary community."

Centric Health's Calgary Region Provide CIBC Run for the Cure Team and Massages to Participants

On October 6, 2013, Centric Health's Calgary Region once again gave back to the community by providing a CIBC Run for the Cure team. For the eighth year in a row, employees provided massages to the participants as well as entered a team that walked or jogged the five kilometre route.

Clinical Director Barb Morrison gets a 'selfie' with Calgary Mayor Nenshi

As Physiotherapists, Chiropractors, Kinesiologists and Massage Therapists, we are fortunate to have a skill set that allows us to provide this service to our community. More than 7,780 registered runners and about 1,000 volunteers took part in this year's CIBC Run for the Cure, which raised more than $1.3 million in Calgary alone. At the start of the race, I took a moment to get a 'selfie' with Mayor Nenshi.

We all have very busy lives and we may question whether we have the time to volunteer, but having the opportunity to participate in events such as Run for the Cure is very rewarding. At the end of the event, a woman in a pink 'Survivor' shirt came over and gave me a hug. She said "Thank you for what you... I am still here because of people like you who volunteer to raise awareness about the impact of cancer."

A huge thank you goes out to all of the Centric Health employees and family members who participated. Every year Centric Health has a strong presence at this event and we are recognized as a key player in the Calgary Run for the Cure.

See you next year!

Barb Morrison
Clinical Director, Max Bell Physiotherapy

What Causes Lymphedema?

Lymphedema is Experienced as a Side Effect of Cancer Treatment by Many Cancer Survivors

Anything that damages lymph nodes or vessels can cause lymphedema.

As a side effect experienced by many cancer survivors who have undergone cancer treatment, secondary lymphedema can be caused by surgery, sentinel node biopsy, radiation therapy, or infection. Primary lymphedema is genetic in nature and is caused by problems in the lymph system from birth.

According to the Canadian Lymphedema Framework, which was put together in 2009 to construct a national strategy on lymphedema, it is an "under-recognized and undertreated condition that affects many cancer survivors." They identified some of the reasons for this as being:

• Lack of awareness among medical professionals about the condition
• Insufficient education about the lymphatic system
• Limited access to lymphedema treatment
• Lack of research

Since the lymphatic system can spread cancer through the body, sometimes the cancerous lymph nodes are removed as part of cancer treatment. And in radiation therapy, while the cancerous cells in lymph nodes or vessels become destroyed, the vessels and nodes can become damaged. It is important to recognize this damage to the lymphatic system and work to minimize the impact through careful monitoring, early intervention and good management of the subsequent swelling that may result.

Early Physiotherapy Intervention Can Be Effective in Prevention of Lymphedema Following Breast Cancer Surgery

There is evidence to suggest that early physiotherapy intervention could be effective in the prevention of secondary lymphedema in women following surgery for breast cancer. Judy Boivin, a physiotherapist working with all types of cancer patients states "We are monitoring cancer patients closely for lymphedema throughout the first year following treatment, at the same time as we are ensuring full range of motion of the limbs and providing education regarding regular exercise and skin care." It is important to minimize the risk factors and identify lymphedema in the early stages.

So although the damage of the lymph system from cancer treatment may be inevitable, there is a great deal that can be done to minimize the impact. Consulting with a cancer rehab professional in the early stages following cancer treatment is recommended.

For related information, read Lymphedema - Canadian Strategy for Management, and our post on What is Lymphedema?

To find a Cancer Rehab Canada near you, visit the list of British Columbia, Saskatchewan, Ontario, or Nova Scotia locations.

November is Lung Cancer Awareness Month

Public opinion is turning a blind eye to lung cancer patients' need for support

Lung Cancer Awareness Month Signals the Need for Greater Public Awareness

In a first-ever public opinion poll on Canadians' understanding of lung cancer, Lung Cancer Canada found that while over half of respondents knew of someone with the devastating disease, very few knew that more women die of lung cancer than breast cancer in Canada every year - and the five-year survival rate for lung cancer patients has remained only 15% for years. As reported in Lung Cancer Canada's Spring 2013 newsletter, "The fact that most Canadians are unconcerned about a disease that accounts for over a quarter of all cancer deaths in this country only reinforces how much work we have to do," said Dr. Natasha Leighl, President of Lung Cancer Canada and a medical oncologist at Princess Margaret Hospital in Toronto. "Ignoring this dreadful disease won't make it go away."

Public Opinion Turning a Blind Eye to Lung Cancer Patients' Need for Support

Fundraising for lung cancer research and assistance for lung cancer patients have both been compromised by the public's association of lung cancer with smoking. This has caused public opinion to turn a blind eye to patients' need for support. Additional support for lung cancer patients could include greater public understanding of the disease, more dollars raised to help fight it, and increased awareness of the benefits of cancer rehabilitation to help patients recover from the side effects of cancer treatment.

Cancer Rehabilitation Can Help Manage Treatment Side Effects for Lung Cancer Patients

Greater public awareness of lung cancer can also encourage lung cancer patients to seek cancer rehabilitation, which may help reduce anxiety and overcome feelings of shortness of breath, whether they have survived the disease or are in palliative care. Some other concerns experienced by lung cancer patients are difficulty breathing, pain, fatigue, and post-surgical mobility restrictions. Many of these conditions can be improved with interventions from a rehabilitation professional with specialized training, such as a physiotherapist, occupational therapist or massage therapist. People who have had cancer treatments are often not receiving cancer therapy or rehabilitation service despite the growing scientific evidence that it is very beneficial in obtaining optimal recovery.

To find out more about lung cancer, visit Lung Cancer Canada.

To find a Cancer Rehab Canada near you, visit the list of British Columbia, Saskatchewan, Ontario, or Nova Scotia locations.

Physician Information When Referring Patients to Cancer Rehab

How can I convince my cancer patients of the therapeutic value of exercise?

How Can I Convince My Cancer Patients of the Therapeutic Value of Exercise?

Although exercise for cancer patients is strongly supported in studies, surprisingly few patients realize that physical activity can actually improve their survival outcomes and reduce their odds of reoccurrence, especially for colorectal and breast cancer patients. This is documented by Barbaric et al in Effects of Physical Activity of Cancer Survival: A Systematic Review. Physiotherapy Canada. 2012: 62:25-34.

When Should Patients be Referred for Cancer Rehabilitation?

The Cancer Rehab Canada program is appropriate for those who have completed their cancer treatments and are medically stable. Early referral to rehabilitation allows us to recognize and treat cancer-related physical impairments before they negatively impact daily function and increase emotional distress. Candidates must be willing to actively participate in their rehabilitation process.

Why Cancer Rehabilitation?

The goal of Cancer Rehab Canada is to optimize your patient’s functional abilities, enabling them to gradually return to work in a safe and timely manner in a capacity suitable to their abilities.

Cancer rehabilitation is strongly supported in the research for all types of cancer diagnosis and at all stages of survivorship. As stated in Advances in Survivorship Care: Resources, Lessons Learned and Promising Practices. Canadian Partnership Against Cancer, good survivorship care includes a plan to help patients achieve their optimal level of function.

What Types of Cancer Impairment Can Rehab Help?

Functional impairments that benefit from rehabilitation include:

• Cancer Related Fatigue
• Pain
• Chemo Brain
• Radiation Fibrosis Syndrome
• Scar Tissue Management
• Lymphedema
• Frozen Shoulder & other movement restrictions
• Axillary Web Syndrome
• Chemo Induced Peripheral Neuropathy

What Safety Measures Are Followed by Cancer Rehab Canada?

We monitor for potential problems such as bony metastasis, cardiac autonomic insufficiency, balance issues, fever, and fluctuating blood lab values indicating problems such as anemia or neutropenia. We will be reporting any medical red flags to you immediately and asking for your assistance in directing the appropriate medical follow up.  Cancer patients should be carefully screened for impairments prior to participating in community or group exercise, in order to address their individual needs, as outlined in Patient Safety in Cancer Rehabilitation. Physical medicine and rehabilitation clinics of North America. 2012:23(2): 441-56 by Cristian et al.

Principles of the Cancer Rehabilitation Program

 Client-centered, active rehabilitation and empowerment are the principles of the program that is now offered at over 60 LifeMark/Centric Health clinics.

Client Centered – individualized, evidence based care provided in your community

Active – increasing your physical activity will have the biggest impact on your recovery

Rehabilitation – includes a multi-disciplinary team of rehab professionals

Empowerment – providing you with the tools you need to regain control of your life

Please contact one of our 62 Cancer Rehab locations across Canada. Links will direct to a Cancer Rehab provider in your area.

Ontario
British Columbia

Alberta

Saskatchewan & Manitoba

Nova Scotia

What is Lymphedema?

Lymphedema Experienced as a Side Effect by Many Breast Cancer Survivors

Lymphedema is a protein rich swelling caused by a defect or blockage in the lymphatic system. It is seen as a side effect experienced by many breast cancer survivors who have undergone cancer treatment. Lymphedema presents with a feeling of heaviness or achiness of the affected limb because of the accumulation of lymphatic fluid within the lymphatic vessels and affected lymph nodes. The reason lymphedema is so dangerous is the risk of developing infection in the affected limb. Areas affected by lymphedema are prone to infection, since bacteria can grow easily in protein-rich lymphatic fluids.

Laurel Osborne, RMT performs lymphatic drainage at LifeMark Physio on Bay

"Best Kept Secret in the World of Cancer"

Even though its dangers are widely acknowledged within the medical and clinical communities, lymphedema is still not an everyday term. According to the Lymphedema Chronicles, lymphedema is the best kept secret in the world of cancer. "Many women do not even hear the word lymphedema nor receive any instructions for precautions to lessen their risks of developing lymphedema. Additionally, for the women who do develop lymphedema, they are hard pressed to find information let alone where to find treatment," cites author Carol Enters.

At LifeMark Health/Cancer Rehab Canada, we urge early rehabilitation treatment for cancer patients and cancer survivors to lower their risk of developing lymphedema. It is vitally important to manage signs and symptoms early, and through physiotherapy exercise, manual lymph drainage, bandaging and other education and techniques, lymphedema can be effectively managed.

Lymphedema is Manageable With The Proper Treatment

"Lymphedema is a manageable condition. With the proper treatment measures and ongoing home care, lymphedema can be reduced and maintained so that swelling remains minimal", says Laurel Osborne, RMT at LifeMark Physiotherapy on Bay.

As an integral part of the immune system, the lymphatic system fights infection and removes toxins from body tissues.

Lymphedema can happen when lymph vessels are damaged and damaged lymph nodes cannot handle the lymph fluid. If lymph nodes aren't functioning properly, the vessels can no longer stretch and they become enlarged, causing pressure on the lymph vessels. When this goes on for a long time, the vessels can no longer carry lymph fluid, so the lymph collects in nearby tissue.


To find a Cancer Rehab Canada near you, visit the list of British Columbia, Saskatchewan, Ontario, or Nova Scotia locations.

Standing Room Only For Cancer Rehab Training

Increased Demand from Patients Prompts Clinicians to Seek Out Cancer Rehab Training

"Tell me and I forget, teach me and I may remember, involve me and I learn." - Benjamin Franklin

12 physiotherapists, 5 occupational therapists, 7 kinesiologists and 1 massage therapist take cancer rehab training

As a final taste of summer was sweeping across most of the country, 25 professionals from LifeMark/Centric Health came together at LifeMark Meadowvale during the last weekend in September. The purpose of the gathering was a one-day introductory course on Cancer Rehabilitation. "Many of the clinicians have recognized the lack of specialized cancer rehab services as well as the increased demand from patients, so they are eager to learn how they can improve their knowledge and rehab skills for cancer patients," said Judy Boivin, Clinical Practice Lead for Cancer Rehab Canada.

This is the third time Cancer Rehab Canada has offered the course in Ontario since March 2013, and it has been fully registered each time, with some participants being put on a waiting list.

The group consisted of 12 physiotherapists, 5 occupational therapists, 7 kinesiologists and one massage therapist.

Taught by Judy Boivin and Swapnil Rege, both registered physiotherapists, the session's content included:

• Pathophysiology of cancer
• Cancer treatments such as chemotherapy and radiation
• Side effects experienced by cancer survivors
• Rehab techniques that have been proven to be beneficial in treating these side effects
• The importance of safety considerations when working with cancer patients
• Latest research confirming the need for cancer rehab

Cancer Rehab Services - Transitioning from Illness to Wellness

Special emphasis was made on the provision of rehab services for all cancer patients to help them resume their normal lives as quickly and fully as possible. So many people need help in the "survivorship phase" transitioning from illness to wellness.

The hands-on educational session was hosted by LifeMark Meadowvale, and participants traveled from as far away as Windsor and Ottawa to be involved in the training.

LifeMark/Cancer Rehab Canada now has 30 clinics able to offer this standardized cancer rehab program in their own communities across Ontario.

To find a Cancer Rehab Canada near you, visit the list of British Columbia, Saskatchewan, Ontario, or Nova Scotia locations.

Minimizing the Effects of Breast Cancer Through Cancer Rehab

Getting Back to Living - Not Just Surviving - After Breast Cancer

Even after surviving breast cancer, many patients find that although the treatment has ended, the cancer experience has not. The impact of cancer treatment and surgeries on psychological, emotional and physical well-being affects individuals in many ways causing problems such as:

• Pain
• Fatigue
• Decreased strength and mobility in shoulders
• Muscle aches
• Tingling in hands and feet
• Lymphedema

Cancer Rehabilitation Helps Minimize the Side Effects

The risk of developing lymphedema, or swelling in the arm, can be minimized through early cancer rehab treatment. A specially trained Physiotherapist can help to minimize the risk of developing lymphedema through exercise and education. It is vitality important to manage signs and symptoms early. Manual lymph drainage, provided by a certified therapist, has also been shown to effectively treat lymphedema and should even be considered proactively to prevent it in the first place.

Patient receives acupuncture after undergoing cancer treatment

Other benefits of cancer rehabilitation include exercise prescriptions to reduce the pain and fatigue that may be a result of the radiation or surgery that breast cancer patients have received.   Massage therapy, acupuncture and TENS can be used successfully to manage pain and parathesia, in addition to reducing stress. By seeking rehabilitation early, the research has shown we can prevent complications from occurring down the road, such as shoulder tendonitis or frozen shoulder. 

Restoring breast cancer survivors' previous level of function is a primary goal of cancer rehabilitation, and each client will have a tailored treatment plan to meet their individual goals.

Breast Cancer Affects 1 in 9 Canadian Women

Breast cancer survivors can minimize the risk of developing lymphedema through cancer rehabilitation

According to the Canadian Breast Cancer Foundation, breast cancer affects 1 in 9 Canadian women in their lifetime, and it is estimated that in 2013 23,800 Canadian women will be diagnosed with breast cancer. Non-modifiable risk factors are listed as gender and age, personal & family cancer history and genetics, early menstruation and late menopause, breast density and breast conditions. Lifestyle choices included in the list of modifiable risk factors are smoking, body weight, physical activity, alcohol use, exposure to hormones (the Pill, in vitro fertilization, and hormone replacement therapy), among others. 

If you are a breast cancer survivor or a friend or family member of a breast cancer survivor, please visit one of our British Columbia, Saskatchewan, Ontario, or Nova Scotia locations.

Treatment of Axillary Web Syndrome

by Swapnil Rege, MSc PT
Clinic Director & Physiotherapist - LifeMark Health Brampton

Technique Improves Shoulder Range of Motion While Decreasing Axillary Cording

Several years ago, while on a shadowing placement, I had a chance to visit a non-profit cancer treatment clinic. We were shown a very simple technique to treat axillary web syndrome that significantly improves range of motion of the shoulder and decreases the axillary cording. I have used that technique successfully for every axillary web syndrome client I have seen since. Over time, I have established my own routine for treating these individuals.

What Causes Axillary Web Syndrome?

Axillary web syndrome is thought to be caused by a disruption of the lymphatic network following sentinel axillary node biopsy or axillary lymph node dissection [1], which in lay terms means the removal of nodes of the lymphatic system that are most likely to contain cancer cells. This type of biopsy can be used to help determine the stage of cancer or extent of cancer in the body.

Traditional treatment methods, which are still effective, include assisted range of motion exercises of the shoulder with pulleys, and passive range of motion performed by the therapist and scar tissue massage.

The presentation of axillary web syndrome includes:

• Reduced abduction of the affected shoulder, worse than limitation in flexion. Pain will be reported with both movements (worse with abduction)
• Palpable and/or visible axillary cord in the affected side. The cord generally runs from the axilla and can extend medially all the way to the wrist. In many cases, the cord may not be visible. Do not discount the presence of axillary web syndrome if you do not see the cord. If your client has had breast cancer surgery and has limited shoulder range of motion, I would pursue the treatment as a trial
• Subjective complaints of pulling in the axilla and medical aspect of the arm
• Significant difference in median nerve glide tension between the affected and unaffected arm

Swapnil Rege, MSc PT, demonstrates treatment of Axillary Web Syndrome

Treatment of Axillary Web Syndrome Includes the Median Nerve Glide

The treatment includes:

1. Moist heat to the cord 8-10 minutes with extra padding and frequent visual inspection of the site to avoid burns due to sensory impairment. Make a clinical judgment on whether you want to use heat. It will depend on time since surgery, skin integrity, inflammation present, etc.
2. Client perform AAROM exercises of the affected shoulder, 10 repetitions in flexion and abduction with a 5 second hold at a comfortable level
3. Manual median nerve glide on the unaffected side - 1 repetition, followed by median nerve glide on the affected side - 1 repetition. Do this sequence until you have completed 5 median nerve glides on each side
4. AAROM of the affected shoulder as described previously
5. Patient-directed median nerve glide on the wall. Start with unaffected side - 1 repetition, followed by nerve glide on affected side - 1 repetition. As with the therapist-directed medial nerve glide, continue this procedure until the client has completed 5 repetitions on each side.
6. Ice post-treatment if required. As with the application of heat, precautions need to be taken prior to applying ice.
7. Education on home program:

• AAROM exercises of the affected shoulder: provide pulleys for home or alternatively can do wall-walking exercise
• Patient-directed median nerve glide, 5 repetitions each side, 2-3 times per day
• Heat and ice application as appropriate

You may choose to complete the protocol differently than what is presented above. However, the key is to complete the median nerve glide. There are no research studies to date about the efficacy of median nerve glide with treatment of axillary web syndrome and hence this is considered anecdotal evidence.

This treatment, if done correctly, resolves the axillary web and significantly improves shoulder range of motion within one to two treatments. Do not be discouraged if you see significant improvements on one day and significant regression the following day. In my experience, this is common and within 2-3 weeks, resolves completely. I encourage patients to complete the exercises for one additional month after complete resolution to ensure no reoccurrences.

View the video of Swapnil Rege, MSc PT demonstrating the treatment of Axillary Web Syndrome at http://youtu.be/XGuVBaCHTgI !

To find a Cancer Rehab Canada near you, visit the list of British Columbia, Saskatchewan, Ontario, or Nova Scotia locations.

---

[1] Moskovitz AH, Anderson BO, Yeung RS, et al. Axillary web syndrome after axillary dissection. Am J Surg. 2001;181:434–9.

Cancer Rehab Canada/LifeMark Donates $1,000 to Hearth Place Cancer Support Centre at Annual 5K Run

Cancer Rehab Canada's LifeMark Physiotherapy clinics participated in the 4th annual Hearth Place event

Hearth Place 5K on the Runway Takes Off

Several colleagues from Cancer Rehab Canada's LifeMark Physiotherapy Clinics in the Durham Region stood ready for takeoff at Oshawa's municipal airport to support runners in the 4th annual Hearth Place 5-kilometre event that took place on September 22. A total of $1,000 was donated by the group, as a sponsorship to Hearth Place's Cancer Support Centre.

Information on Cancer Rehabilitation Services Distributed to Hearth Place Run Participants

Cancer Rehab Canada/LifeMark was on hand to let the runners, their friends and family know about the benefits of cancer rehabilitation to address the pain, fatigue, joint restrictions, and cognitive & memory problems often faced by cancer patients. Led by Krista McIntyre, Clinic Director and Physiotherapist of LifeMark Physiotherapy Whitby, members of the Cancer Rehab Canada/LifeMark team gave out water and hand sanitizer, as well as literature on the ability to empower each cancer survivor to take control of their life and feel better, stronger and happier. Massage beds were also set up on site where the team provided complimentary 5-minute pre-and post-race massages to runners.

Krista McIntyre, Clinic Director and Physiotherapist of LifeMark Physiotherapy Whitby, offers supplies to participants

"The Hearth Place 5K on the Runway was a wonderful opportunity for Cancer Rehab Canada/LifeMark to let people know about our cancer rehabilitation services. We not only had a chance to meet with different survivors and practitioners, but felt that the community responded with great interest in our new specialty programs", said Krista McIntyre.

Clinic representatives at the race included Krista McIntyre, Clinic Director and Physiotherapist of Whitby, Nadia Ramprasad, Physiotherapist of Whitby, Luke Tavernier, Exercise Therapist of Whitby, Michelle Gray, Massage Therapist of Whitby, Joy Brooks-Desbarres, Clinic Director and Physiotherapist of Oshawa, Michelle Lees, Kinesiologist of Oshawa, and Graham Doig, Clinic Director and Physiotherapist of Ajax. The team also gave out pens, ice/heat gel packs, and lip balm to participants both before and after the race.

Over 700 participants took part in Hearth Place 5K on the Runway, raising $69,000 for Hearth Place

There were over 700 participants and overall donations raised for Hearth Place at this year's run totaled $69,000.

Hearth Place addresses the social, practical, emotional, educational and spiritual needs of people dealing with all types of cancer. It is a well-known cancer resource centre in Central East Ontario for its wellness programs focusing on coping with cancer, healing, living well beyond cancer, and cancer support.

To find a Cancer Rehab Canada near you, visit the list of British Columbia, Saskatchewan, Ontario, or Nova Scotia locations.

Physiotherapy Can Help Childhood Cancer Patients Regain Quality of Life

Physiotherapy can help childhood cancer patients regain quality of life

Cancer Rehabilitation Can Help Childhood Cancer Survivors

It is important to recognize the role rehabilitation can play in helping childhood cancer survivors overcome the damage to their growing bodies from cancer treatments. Although childhood cancer survival rates have improved from 71% to 82% over the last 30 years, the impact of long-term effects of treatment can also be lessened through cancer rehabilitation.

Adverse Effects Related to Childhood Cancer Treatment Experienced Later in Life

There are currently 10,000 children living with cancer in Canada. As documented in the publication Cancer in Children in Canada, about 800 new cases of childhood cancer are diagnosed in Canada every year, with treatment consisting of a combination of chemotherapy, radiotherapy, and surgery. The report states that "approximately two-thirds of survivors experience adverse effects related to treatment later in life known as late effects."

Greater Awareness of Physiotherapy Needed for Childhood Cancer Survivors

Because cancer treatments have such negative effects on growing organ systems, childhood cancer survivors often develop chronic conditions that lead to being less active later in life. Rehabilitation techniques such as physiotherapy, chiropractic and occupational therapy can help to address the neurological, musculoskeletal and cardiovascular "late effects" in childhood cancer survivors. Cancer rehab can help cancer survivors get back to normal. The goals of physiotherapy are to develop, restore or maintain normal function as much as possible, teach ways of coping when normal movement cannot be restored, and adapt survivors' environments so that movement can occur as much as possible.

In a study Physical Therapy and Chiropractic Use Among Childhood Cancer Survivors with Chronic Disease: Impact on Health-Related Quality of Life, it was reported that long-term childhood cancer survivors do not seem to make use of rehabilitation services to increase physical function. This could be changed through greater awareness of cancer rehabilitation. The potential for active rehabilitation to restore movement so that childhood cancer survivors can participate more fully in daily life is still largely unrealized.

To locate a Cancer Rehab location near you please see our British Columbia, Saskatchewan, Ontario and Nova Scotia locations.

Cancer Patients Need a Plan to Help Them Get Back to Work

Cancer patients need a plan to help them get back to work

If you have completed cancer treatment and want to improve your abilities so you can return to work and leisure activities, you are a candidate for the Cancer Rehab Canada program. Here are a few things that you can expect on your first visit:

An Assessment Allows Your Rehab Team to Make a Treatment Plan

You will be assessed by a physiotherapist and/or occupational therapist on your first visit. Your functional status may also be assessed by a kinesiologist, testing for your ability to do things such as lifting, walking, squatting etc. From this information, together with your input, the rehab team will make recommendations and prepare an individualized treatment plan based on your needs.

What a Typical Treatment Program Can Involve

Your treatment sessions will likely vary in length, and your therapist will advise you of this after the first visit. Often sessions become longer as you are able to tolerate more exercise/work conditioning. Although treatment varies for each individual based on their goals, some of the more common type of treatment for cancer rehab may include:

• Exercise
• Work Conditioning
• Manual Therapy
• Cognitive Behavioural Therapy
• Lymphedema Management
• Acupuncture
• Education & Coping Strategies
• Techniques to Reduce Dizziness or Vertigo
• Pelvic Floor Treatment

What You Should Bring to Your First Appointment

We recommend that you dress in comfortable clothing that you can easily move around in, and bring running shoes and a water bottle if possible. Since some clients feel more comfortable using their own mats, so you can also bring your own “yoga” mat if desired.

Principles of the Cancer Rehabilitation Program

Client-centered, active rehabilitation and empowerment are the guiding principles of the program that is now offered at 24 LifeMark/Centric Health clinics.

Client Centered – individualized, evidence based care provided in your community

Active – increasing your physical activity will have the biggest impact on your recovery

Rehabilitation – includes a multi-disciplinary team of rehab professionals

Empowerment – providing you with the tools you need to regain control of your life

Contact us for more information at judy.boivin@lifemark.cajudy.boivin@lifemark.ca.

Acupuncture for Peripheral Neuropathy - Numbness in Hands and Feet

Consider all rehabilitation options to help undo effects of chemotherapy treatment

 The Road to Recovery

As I rang the bell to signify the end of my cancer treatment, I had no idea that this was really just the first step in the road to recovery from the side effects of the treatment. The peripheral neuropathy that started during chemotherapy actually got worse when my treatment ended.

Hiking through the Highlands of Scotland

My husband and I had booked a hiking trip in the Highlands of Scotland to celebrate the end of my treatment. I had continued to exercise daily throughout the 6 months of chemotherapy so I knew I was fit enough for the challenge, but I had not factored in the numbness in my hands and feet. When I asked the oncologist for advice, he said "Rent a bike!" Cute answer, but not exactly a practical solution for the terrain.

Consider All Rehabilitation Options for Chemotherapy Induced Peripheral Neuropathy

As a physiotherapist who uses acupuncture, I began to research the use of acupuncture for peripheral neuropathy (numbness in hands and feet). Research indicated it's successful in treating diabetic neuropathy, but there was very little studied with cancer patients. So I consulted with a colleague trained in acupuncture and after considering any apparent risks, we decided it was worth trying. Within several sessions, it began to improve to the extent that I knew I could go on my trip with partial sensation having returned to my feet and hands. So only 3 months after completing chemotherapy and with the aid of walking poles for balance (another great therapeutic idea) I completed the West Highland Way - a total of 154 kilometres in six days!

I have since used acupuncture with several patients who also reported some improvement in their numbness. However, if you choose to try acupuncture for chemotherapy induced peripheral neuropathy, please make sure you go to a regulated health professional. There is always a risk of infection with acupuncture and anyone with lymphedema must exercise extra caution.

Although the road to recovery after cancer treatment can be difficult, it is certainly worth considering all of the rehabilitation options that might be available to help you along the way.

Our Clinics at Niagara Area Rankin Run

Tod Hinton from our St. Catharines clinic location at the Rankin Cancer Run

Funds Raised For Niagara Area Hospitals and Cancer Support Services

Three of our clinics in the Niagara Region participated in the Rankin Run held on May 25 in St. Catharines, Ontario. With 11,578 participants and more than $675,000 raised this year, the Rankin Cancer Run raises funds for Niagara area hospitals and cancer support services. What is unique about the Rankin Run is that it donates all raised money directly back into its own local communities.

Todd Hinton from our St. Catharines location, Anne Kennedy from our Fonthill location, and Vittoria Mattucci from our Welland location demonstrated the effectiveness of urban walking poles at Cancer Rehab Canada's booth. Information on cancer rehabilitation was distributed to Rankin Run participants and supporters.

About Rankin Cancer Run

In 2004 Rankin Run founder Mary Ann Edwards wondered how she might be able to do more to help raise funds for all cancer related areas in her Niagara community. She made one phone call to Rankin Construction to sponsor a run/walk, and after receiving an immediate commitment from them, launched her event.

The annual run, now in its eight year, attracts phenomenal participation from the approximate 400,000 people living in the St. Catharines/Niagara region. Before the huge turnout this year, the Rankin Cancer Run had already raised $3.229 million to support local cancer services.

10 Things You Should Know About Cancer Exercise

Exercise is an important part of cancer rehabilitation

Exercise and Cancer Rehabilitation

Since exercise is one of the most effective methods of treating cancer and helping cancer survivors on their road to recovery, we wanted to share these important tips about cancer exercise.

1. Exercise is strongly recommended both during and after cancer treatments, and it is safe when you follow some safety guidelines.
2. Before starting an exercise program you should be screened for any physical limitations by a rehab professional such as a physiotherapist. Many problems such as restricted shoulder mobility, high blood pressure, or weakened postural muscles should be addressed before beginning any general exercise program.
3. It is important to monitor your heart rate throughout your workout. The general rule of thumb is that you want to keep your heart rate between 50% and 75% of your maximum heart rate.
4. Exercises should be modified to suit the individual. Anyone with bony metastases, for example, needs to minimize pressure on their bones and should be shown safe body positioning.
5. Do not exercise if you have a fever over 38°C or if your blood values contraindicate exercise. Please check with your doctor if you are unsure.
6. Be sure to take deep breaths, in and out, as you do each exercise. This helps with chest expansion and acts as a pumping action to improve circulation.
7. Exercise has been shown to be beneficial in the treatment of lymphedema.
8. The research indicates that the best treatment for reducing cancer related fatigue is exercise, but when you are exhausted exercise is often difficult to do. You should start slowly, follow a regular routine that includes gradual increase and you will begin to notice a difference in a few weeks.
9. Moderate exercise will improve your quality of life. You will notice that your mood improves after exercising and so does your self esteem. You begin to feel stronger mentally and physically.
10. Most importantly, there is growing evidence indicating that increased physical activity will improve your chances of survival. To date, this evidence is strongest for breast and colorectal cancer patients and the recommended minimum is 30 minutes of moderate exercise, 6 days per week.

Cancer Rehabilitation Improves Cancer Survivors' Quality of Life

Cancer Rehabilitation Benefits Optimal Recovery

Why aren't cancer patients routinely offered cancer rehabilitation services to help them return to normal life? These services are regularly provided for recovering cardiac patients and patients who had joint replacement surgery. Yet those people who have had cancer treatments such as chemotherapy, radiation or surgeries such as masectomy, are often not receiving cancer therapy or rehabilitation service despite the growing scientific evidence that it is very beneficial in obtaining optimal recovery.

Cancer Survivors Often Suffer From Disabilities Associated With Cancer Treatments

Cancer survivors benefit from client centered, active rehabilitation & empowerment

Cancer survivors often suffer from the side effects of their diagnosis and related treatment. Their functional impairments may include persistent fatigue, radiation fibrosis, chemotherapy fog, lymphedema, frozen shoulder and pain. Many of these conditions can be improved with interventions from a rehabilitation professional with specialized training, such as a physiotherapist, occupational therapist or massage therapist.

According to the Canadian Partners Against Cancer, there is estimated to be 1 million cancer survivors in Canada today, with that number expected to increase to over 2 million by 2020. Physical disability is a leading cause of distress in this population. It is critical that this population be appropriately screened and treated for their impairments, so that we minimize their disabilities and maximize their quality of life.

Cancer C.A.R.E. Provides Client Centered, Active Rehabilitation & Empowerment for Cancer Survivors

Judy Boivin, a registered physiotherapist and cancer survivor, will be blogging about ways that cancer survivors can feel better, stronger and happier. Judy has recently developed and implemented an evidence based cancer rehabilitation program at 24 LifeMark/Centric Health locations across Ontario. The program provides Client centered, Active, Rehabilitation and Empowerment for cancer survivors. This service is appropriate for anyone who has received a cancer diagnosis and is receiving or recovering from cancer treatment.