The Challenges Faced By Cancer Survivors

Feeling On Your Own After Cancer

Some cancer survivors describe feeling a sense of abandonment, and feel "left hung out to dry"

Although there is a lot of cancer information out there, it is sometimes difficult for cancer patients after treatment to feel supported with the tailored information and care that they need. The way some cancer survivors have described it to us is that they feel a sense of abandonment, or feel "left hung out to dry". But with regular care from a cancer rehabilitation professional, these feelings can gradually be overcome and survivors can get back to their regular routines.

Dis-Ease Means Unease With a Disruption to Self

Some cancer patients indicate feeling a lack of ease with themselves and their physical fragility that no-one is addressing or helping them get through. This unease really speaks to a need for integrated cancer rehabilitation services to help patients:

• recover their identity
• learn how to manage and adapt to any permanent impairments
• have a regular exercise schedule that has been tailored for them and will help to overcome the sense of constant fatigue
• receive specialized physiotherapy to address movement restrictions, swelling and cancer related pain
• when necessary, have counseling to overcome the sense of being deflated, dejected and even jaded after surgery

Acquiring a New Meaning for Physical Activity

When exercise means lowering the chances of cancer ever coming back, it takes on a new meaning. As one patient puts it, "keeping her blood oxygenated" through everyday exercise is the best way to keep the cancer away. For her, exercise has become a tool for a second chance and the gateway for her to get back to living her life. Building up muscle mass that has deteriorated is another often challenging aspect of post-cancer physical activity, but the benefits of exercise for cancer management are numerous and encouraging!

Cancer Rehabilitation is Available In Canada at 62 Different Locations

We offer a means for cancer patients to overcome many of the challenges and impairments that have resulted from cancer and its treatment. These side effects are most effectively overcome with an individualized treatment plan designed by a Cancer Rehabilitation professional.

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

British Columbia

Alberta

Saskatchewan & Manitoba

Ontario

Nova Scotia

Other Helpful Links for Cancer Rehabilitation

Willow Breast Cancer Support Canada

Canadian Cancer Society

Livestrong Foundation

ELLICSR Kitchen - UHN Princess Margaret Cancer Centre

Childhood Cancer Canada Foundation

Canadian Partnership Against Cancer

Cancer Rehab and Return to Work

More People Surviving Cancer Due to Improved Treatments

Although returning to work after cancer can be challenging, rehab can play a valuable role

Returning to work following a cancer diagnosis is more viable than it ever has been before. More people are surviving cancer due to improved treatments, better diagnostics and the fact that many are being diagnosed at a younger age. Although returning to work can sometimes be a challenge, rehabilitation can play a valuable role in achieving this important step in the transition from illness to wellness. The success and durability of their return to work depends on many factors which we are only now beginning to recognize.

Multidisciplinary Rehabilitation is Effective in the Return to Work Process

Research shows that the majority of people who are diagnosed with cancer want to return to work however many struggle to do so and end up having to leave or change jobs, if they manage to return at all. So how are we best able to support and encourage this return to work process?  A Cochrane review article, including 18 research studies and 1652 participants studied the effectiveness of interventions aimed at enhancing return to work in cancer patients. They concluded that there is moderate quality evidence to suggest that multidisciplinary interventions involving physical, psychological and vocational components led to higher return to work rates. Multidisciplinary rehab should always be considered over the “wait and see” approach.
(de Boer A, Taskila T., Frings-Dresen M, Feurstein M., Verbeek, J: Interventions to enhance return-to-work for cancer patients: A Cochrane Review. Proceeding of the First Scientific Conference on Work Disability Prevention and Integration.  2010)

Rehabilitation Not Routinely Offered

The current research recommends rehabilitation to address and treat the cancer related and cancer treatment related “side effects” for improved functional outcomes. However it is clear that although rehabilitation services are needed they are not usually received by cancer survivors. Only 19% of breast cancer patients reported having received any physical, psychological or educational rehabilitation service. The medical profession continues to be disease centered and there continues to be a lack of consideration of the possible rehabilitation services, which in turn negatively impacts successful return to work. In many cases the health disability insurance companies are left to encourage and fund this important step in the recovery process.
(Silver Jk, Gilchrist LS: Cancer Rehabilitation with a focus on evidence-based outpatient Physical and Occupational Therapy Interventions. Am.J. Phys.Med. Rehabil. Vol 90, No 5 (Suppl), May 2011)

Cancer Rehabilitation is Cost Effective

A recent large government funded review in the UK found that structured vocational interventions can be both beneficial to individuals and cost effective. They claim that if a cancer patient is supported back into work the cost of the intervention pays for itself within the first 12 weeks that they otherwise would not have worked. This study demonstrates “that personalised and timely vocational rehabilitation interventions do result in better work and health outcomes for people with cancer and can be cost effective.” Assisting people with cancer back to work has a positive economic impact for everyone involved.
(Macmillan (2013) Making the Shift: Providing specialist work support to people with cancer. London. Macmillan Cancer Support)

Early Results from Rehab Professionals Working With Cancer Patients Are Positive

In 2013 LifeMark/Centric Health embarked upon a strategy to train our clinicians, to improve our Cancer Rehab services and to begin to meet the rehabilitation needs of the almost one million cancer survivors living in Canada today. We wanted to ensure that our rehabilitation professionals were prepared with the latest evidence based information on Cancer Rehabilitation.

Moving beyond the research and into clinical care in our clinics, we are beginning to see the evidence borne out in our own clinical results.  The early results from our Cancer Rehabilitation services are beginning to show the positive impact on our patient’s lives.

• 100% of patients attained their return to activities of daily living goals;
• 90% of patients attained their symptom improvements goals; and
• 74% of patients attained their return to work goals

To find out more about Cancer Rehab Canada please see our website.

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

British Columbia

Alberta
Saskatchewan & Manitoba
Ontario
Nova Scotia

Increased Physical Activity Improves Cancer Survival Rates

Are You a Cancer Survivor With N.E.D.?

Cancer survivors can improve their chances of remaining NED through regular exercise

We live in a world of acronyms that are only meaningful to people "in the know". I have worked my whole life with PTs, OTs and RMTs who do things like measure ROM, use the IFC and put people through FCEs. What may seem strange to those outside my physiotherapy world is all very clear to me.

The Importance of the Acronym N.E.D.

One acronym that really sticks in my mind these days though, is N.E.D.! This has a special meaning to me, along with thousands of other cancer survivors. It means No Evidence of Disease. These are the best three letters you can hope to see written at the bottom of your doctor's chart. Nothing makes me happier than hearing that the follow-up test results have shown N.E.D.!

Increased Physical Activity Improves Survival Rates

But the question remains how cancer survivors can improve their chances of remaining N.E.D. One of the best ways is engaging in regular exercise.

A systemic review completed in 2010 by Barbaric et al, looked at the Effects of Physical Activity on Cancer Survival. They concluded after reviewing hundreds of scientific research articles that there is growing evidence demonstrating that increased physical activity improves survival rates in patients with breast or colorectal cancers. The recommended amount required to make a difference is a mere 3 hours of moderately paced walking per week. More recently, there is evidence supporting exercise with other types of cancers including lung and prostate. Surely regular daily exercise is possible for most cancer survivors and should be strongly encouraged by the medical community.

I believe it is time to challenge the meaning of N.E.D.! From now on... let us all remember that it really should mean NEED EXERCISE DAILY!

How to Get Cancer Rehabilitation

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

5 Tips to Keep Cancer Patients Active

Motivation to exercise is important when you can't exercise or feel too tired to exercise

Can't Exercise? Too Tired to Exercise?

The evidence supporting exercise for cancer patients is undeniable. However, sometimes we feel we can't exercise or are too tired to exercise. Although we know we need to be physically active, it is often very difficult to stick to it.

How to Stay Motivated to Exercise

As a physiotherapist and cancer survivor myself, I can certainly appreciate both sides. On those days when my "get up and go" has "got up and left", I put on my physiotherapy hat and recall some of the tips I have learned over the years that help me stay motivated and physically active. Here are a few things to consider:

• Exercise with a friend. If I have someone waiting to meet me at the gym I am far more likely to go, and my friend usually appreciates me encouraging them to be there too.
• Vary your exercise routine to avoid boredom. I like to try something different each day of the week, but also change it up with the seasons.
• Exercise outdoors whenever you can. It just feels healthier to me to be breathing fresh air and enjoying the scenery, regardless of whether it is 20 below or 20 above.
• Record your exercise achievements, so that you can track your progress. There are some cool apps for tracking walking and running progress now, that make this easy and fun.
• Identify barriers to exercise and work to overcome them. One example of this is using urban walking poles to give you confidence to walk further or on uneven terrain when your balance might be slightly impaired.

How Physiotherapists Can Help

Physiotherapists are trained to help individuals with a variety of disabilities overcome their barriers to being physically active. Physiotherapists have heard every excuse in the book as to why someone cannot exercise. In most cases, modifications can be made to create a safe and effective exercise program for just about anyone. It may definitely be worthwhile to consult a physiotherapist during or after your cancer treatment to develop a physical activity plan with achievable goals.

To find out more about Cancer Rehab Canada please see our website.

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

British Columbia

Alberta

Saskatchewan & Manitoba

Ontario

Nova Scotia

LifeMark Atlantic Participates in Bust a Move for Breast Health™

LifeMark Halifax Clinic Helps at Community Celebration Fundraiser for Breast Health Centre

LifeMark's finest massage therapists were on hand at Bust a Move for Breast Health™ in Halifax

The fifth and final Bust a Move for Breast Health™ was held on March 22 at the Canada Games Centre in Halifax. Hundreds of participants, sponsors and volunteers gathered to celebrate the Breast Health Centre in aid of better breast health. Dancers, yoga practitioners, and aerobics exercisers were taught by some of Nova Scotia’s finest instructors. And on hand to revive their aching muscles were none other than LifeMark’s finest massage therapists, who donated their time in support of the event.

Bust a Move for Breast Health™ Ends on a High Note

According to the QEII Health Sciences Centre Foundation, the Halifax community came together and raised $331,490 net for the Breast Health Centre in Halifax. In addition, the Canadian Breast Cancer Foundation – Atlantic Region, wowed the crowd by announcing a significant contribution of $250,000. That wonderful announcement, combined with the QEII Foundation and the IWK Health Centre Foundation each raising an additional $250,000 through generous community support, brought the 2014 breast health campaign to an amazing $1,081,490 net!

The Halifax community came together and raised $331,490 net for the Breast Health Centre in Halifax

To find out more about Cancer Rehab Canada please see our website.

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

Nova Scotia
British Columbia
Alberta
Saskatchewan & Manitoba
Ontario

Benefits of Exercise for Cancer Management

Incorporating Exercise into Your Cancer Management Plan

Exercise is one of the most beneficial things that cancer patients can incorporate into their cancer management plan

Physical activity is important in all stages of cancer. Many cancer patients are reluctant to exercise for fear of ‘making things worse” when in fact it is one of the most beneficial things that they can do. The scientific evidence to support this is growing and every effort should be made to incorporate exercise as part of the accepted cancer management plan.

How Exercise Benefits Cancer Patients

During cancer treatment 

• Reduces pain and fatigue
• Prevents decline of physical function
• Manages stress and improves mental outlook

After cancer treatment

• Increase energy levels
• Assists in the recovery of physical function
• Improves quality of life

During and after cancer treatment

• Reduces the risk of cancer reoccurrence
• Reduces the risk of developing other long term complications

Advanced cancer

• Helps maintain independence and well being

How a Physiotherapist Trained in Cancer Rehabilitation Can Help

People living with cancer should be advised to gradually build up their physical activity to meet the recommended guidelines. A physiotherapist trained in cancer rehabilitation can assist them in preparing an exercise program that meets the energy expenditure amounts recommended in the research, in addition to making sure that they are safely adapting to meet any medical restrictions or physical impairments.

It is important that we continue to encourage, support and assist cancer survivors to initiate and maintain a lifestyle that regularly includes physical activity at all stages of their journey with cancer.

To find out more about Cancer Rehab Canada please see our website.

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

British Columbia

Alberta
Saskatchewan & Manitoba
Ontario
Nova Scotia

Running Through Cancer and Beyond

Running Important to Physical and Mental Recovery After Cancer

Running is important to cancer recovery both physically and mentally

It’s been three years since my battle with cancer. I had always been a casual runner, venturing out for a 5 km jog a couple of times a week but lately I have been running a lot; enjoying the cooler temperatures and increasing ease in my stride. And I have my cancer diagnosis to thank for this transformation.

Running has been so important to my cancer recovery both physically and mentally allowing me to focus on getting better and cope with difficult times. My diagnosis of Stage Three Colon Cancer meant that I had to undergo surgery to remove a large portion of my colon and surrounding lymph nodes, followed by a six month course of chemotherapy. As any cancer patient understands, you end up feeling much worse after your treatment than you ever felt before. The side effects of therapy certainly left this 50 year old runner struggling to regain and maintain a confident stride through the daily demands as a health practitioner and mother of three active teenagers.  But it was because I felt so lousy and not in the drivers-seat for the first time in my life that I was relentless in my pursuit of recovery and a sense of well-being.

As a career physiotherapist I was well versed on the benefits of running to maintain a healthy lifestyle and more specifically well aware of the scientific research indicating the odds of surviving colon cancer are significantly increased with exercise such as running.  In fact exercise is now recommended during treatment as well as after, for colon and other types of cancers.  This knowledge gave me a means to participate in my own recovery and put me back in the driver’s seat, well at least shot-gun!

Practical Exercise Tips for Running While Battling Cancer

Running proved to be the best exercise for me while battling cancer.  Here are some practical exercise tips, that I learned along the way that may help others to stay active:

• Try a foam donut cut out over your port-a-cath (implant used for chemo) to minimize the irritation of your sports bra rubbing against it.  Camping foam, a couple cm thick works well & it can be easily taped in place, with first aid tape or just slipped under the bra strap.
• Don’t tie running shoes as tightly as you did before treatment; carefully adjust the tongue of the shoe to avoid constriction of the blood flow and minimize pressure on sensitive nerves. 
• Consider new shoes with more cushion support than you previously may have had, to protect the sensitivity of your feet if you are dealing with chemo-induced peripheral neuropathy.
• Consider wearing compression stockings if you have even mild swelling in your feet (a common condition if you have had lymph nodes removed).
• Use lemon or orange slices in your water bottle to minimize the metallic aftertaste of chemotherapy and encourage you to stay hydrated, which is most important during treatment.
• Get some new motivational music on your iPod. It is surprising the impact this can have on your mind and spirit – making the journey so much more tolerable.
• Run outside to avoid crowds and other sources of infection (like pools or gyms) when your white blood cell count is low. There is nothing like a little fresh air to clear the cobwebs of chemotherapy-related fogginess. 
• NEVER run to the point of complete exhaustion - be sensible in your energy expenditure. Always remind yourself not to ‘empty the gas tank’ and leave a little energy to deal with the rest of your day. 

Exercise is an Opportunity to do More Than Just Survive Cancer

Exercise gave me an opportunity to do more than just survive cancer; it helped me to begin living my life again and in many ways helped me to transform into a better human being.  My wish for cancer survivors and runners alike comes from the words of one of my favourite running songs, “May your paths be the sound of your feet upon the ground”. You never know where a run might take you or where life will lead you.

To find out more about Cancer Rehab Canada please see our website.

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

British Columbia
Alberta
Saskatchewan & Manitoba
Ontario
Nova Scotia

8 Ways to Keep Cancer Survivors Healthy

Lifestyle Guidelines for Cancer Survivors Promote Continued Health

Exercise provides physiological and psychological benefits for cancer survivors

1. Get Regular Exercise

Regular exercise is one of the primary ways that survivors can stay healthy.  Exercise lowers reported fatigue in cancer patients by 40-50%, and the scientific evidence supporting exercise as the best intervention for fatigue is very strong. In a study on Exercise and Cancer Rehab, evidence indicated that exercise can provide both physiological and psychological benefits for cancer survivors.  As a prescription therapy for cancer survivors, studies have suggested that regular physical activity will help to reduce the risk of cancer recurrence, given the known anti-inflammatory effects of exercise.  Here are 10 things you should know about cancer exercise.

2. Eat a Healthy Diet

Eating a healthy diet and getting plenty of exercise both give you energy and help you feel better. The Canadian Cancer Society reports that good nutrition is vital at every stage of your cancer treatment and recovery. Following their nutritional guide will help you heal and recover after treatment.

3. Get Regular Check-Ups with Your Healthcare Provider

Having regular check-ups with your healthcare providers is essential for your preventative care to be ongoing. As well, the long-term care of the cancer survivor can be effectively coordinated in an individualized survivorship plan that takes into account the cancer diagnosis, treatment, side effects, follow-up visits, the availability of psychological and support services, and tips on the best ways to maintain a healthy lifestyle.

4. Get Cancer Rehab to Overcome Side Effects of Cancer Treatment

Research strongly supports the effectiveness of cancer rehabilitation in improving the quality of life in cancer patients. Early rehabilitation interventions can help with some of the side effects of cancer and its treatments – including fatigue, cancer-related pain, peripheral neuropathy, adhesions & fibrosis, chemo fog, emotional distress, lymphedema and range-of-motion limitations.

5. Don't Smoke

Over twenty per cent of Canadians over the age of 11 still smoke, even though smoking is a known risk factor for many conditions including lung cancer. According to Statistics Canada, however, the rates of smoking in 2012 lowered significantly from 2008 levels. The World Health Organization has declared smoking a preventable cause of death. (2008. WHO Report on the Global Tobacco Epidemic, 2008: The MPOWER Package. Geneva.)

6. Avoid Weight Gain

Another important way to improve your health is to keep your weight in check. Cancer treatment can be complicated by weight gain, and excess body weight is also associated with cancer recurrence, reduced quality of life, and reduced survival. 

7. Drink in Moderation

Drinking alcohol in moderation is important for cancer survivors to stay healthy. As described by our guest blogger DebiLyn Smith in Alcohol and Cancer, drinking more than the maximum three alcoholic drinks a week for women, or seven to fourteen for men, can adversely affect health as well as cancer risk.

8. Stay Connected with Family and Friends

Make sure to have regular visits with your family or friends to maintain your overall health. By maintaining these supportive connections, quality of life is improved and stress, depression and fatigue is reduced.

Please contact one of our 48 Cancer Rehab locations across Canada. Links will direct to a Cancer Rehab provider in your area.

British Columbia
Saskatchewan
Ontario
Nova Scotia

How Physiotherapists Get You Moving Throughout the Cancer Journey

Staying Active Helps Patients from Cancer Diagnosis through Post-Treatment

Exercise reduces risk of prostate-specific mortality

In our rehabilitation of cancer patients we have found that exercise helps them in every stage of the cancer journey - whether during cancer treatment, after cancer treatment, or both during and after cancer treatment. In advanced cancer stages as well, physical activity improves well-being as well as independence. One of the most important ways we can support people regarding the recommended amount and type of physical activity is through carefully tailored cancer exercise programs and rehabilitation treatment plans.

Evidence Indicates that Exercise Reduces Cancer Recurrence

The evidence from cohort studies of cancer survivors indicates reduced mortality risk related to leisure-time exercise. A recent Macmillan Cancer Support review reports that with three hours per week of moderate physical activity (such as brisk walking), prostate cancer survivors had a lower risk of prostate-specific mortality of approximately 30%, as well as a lower rate of disease progression of 57%.

How Exercise Helps Cancer Patients During and After Treatment

• During Cancer Treatment - Studies show that if they exercise during cancer treatment, cancer patients are less tired and experience improved physical activity
• After Cancer Treatment - Research also indicates that cancer survivors experience better recovery of physical function if they exercise after cancer treatment
• Both During and After Cancer Treatment - With regular physical activity both during and after treatment, the risk of cancer recurrence or the development of other long-term conditions can be reduced

At Cancer Rehab Canada we tailor our exercise programs to meet the specific needs of each individual patient, taking into account any special precautions they may have based on their diagnosis and medical history. Many modifications can be made that will safely allow individuals to meet their physical activity goals and, in doing so, improve their survival outcomes in addition to increasing their overall health.

Please contact one of our 48 Cancer Rehab locations across Canada. Links will direct to a Cancer Rehab provider in your area.

British Columbia
Saskatchewan
Ontario
Nova Scotia

Integrating Exercise on the Cancer Care Pathway

Growing Evidence Supports the Role of Physical Activity During and After Cancer Treatment

Research indicates that with tailored programs, exercise is likely to have a positive effect on cancer patients

In a Macmillan Cancer Support Review of the evidence for integrating the promotion of physical activity within the cancer care pathway, a team of medical researchers* found that if exercise prescriptions are individually tailored to each individual and the potential for side effects taken into account, exercise is likely to have a positive effect on cancer patients.

The review reports that exercise during treatment prevents a decline in functional outcomes without increasing fatigue. One study within the review highlighted the fact that the loss of physical function experienced by cancer survivors apply to longer-term survivors, not just patients who have just completed treatment:

“Limitations in physical functioning were reported by a significantly higher proportion of both short-term (54%) and long-term (53%) cancer survivors… The commonest problems experienced (crouching, kneeling, standing for long periods, walking short distances and lifting/carrying a load) are all vital for carrying out basic daily activities…”

 General Exercise Safety Precautions During and After Cancer Treatment

It is important to see a rehab professional with special training in cancer-related physiotherapy techniques for help in deciding what and how much exercise is recommended both during and after treatment. Below are some potentially adverse events associated with physical activity and cancer, with precautions you can take to avoid them:*

To prevent the exacerbation of symptoms (eg pain, fatigue, nausea, dyspnea) - Avoid high-intensity exercise; monitor symptoms; modify exercise type based on site of treatment (eg avoid exercise bike after prostate/rectal surgery).

To prevent immunosuppression – If patient has low white blood cell counts, avoid high intensity/volume of exercise (keep to light – moderate intensity).

To prevent falls – If patient has dizziness, frailty, peripheral sensory neuropathy: incorporate balance and coordination exercises (eg tai chi) and avoid activities needing considerable balance/coordination (eg treadmill).

To prevent bone fracture – If patient has bone metastases/osteoporosis risk avoid high impact or contact activities.

To prevent lymphedema – Progress resistance exercises in small and gradual increments. To avoid exacerbation of lymphedema, avoid strenuous repetitive exercise with affected limb;  wear compression garment.

* Written by Dr. Anna Campbell, University of Dundee; Jo Foster, Macmillan Cancer Support; Dr. Clare Stevinson, Loughborough University; and Dr. Nick Cavill (Cavill Associates Ltd).


A current Canadian study hopes to inspire health-care professionals to incorporate exercise into standard cancer care programs.

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

Challenges and Rewards of Exercising With Chemo Brain

The challenge of doing regular exercise can be overwhelming for a patient with chemo brain

Managing Cancer Rehab Takes A Team Approach

Sometimes the opportunity to work collaboratively from seemingly disparate rehab specialties comes when we least expect it. This is often the case when treating cancer survivors and cancer patients in Cancer Rehab clinics, where we all work together as Physiotherapists, Acupuncturists, Kinesiologists, and Occupational Therapists to help cancer survivors recover from the side effects of their cancer treatment.

Treating an Individual's Frozen Shoulder Also Uncovered Chemo Brain

Recently one of our clinics received a referral for a physio asssessment and physical treatment when the treatment needed was also for chemo brain - requiring both a kinesiologist and occupational therapist.

• The kinesiologist who works with cancer patients will encourage them to exercise to aid in their recovery, but exercise routines are not always easy for cancer patients. The role of the kinesiologist involves recognizing when a patient is having difficulty with proper technique or remembering exercises. These patients may need more one on one instruction, and it is important to provide them with a detailed home exercise program with pictures and instructions that are easy to understand. We know from experience that when a client is having difficulty with the exercise while in the clinic they are definitely going to have trouble at home. Lastly, the kinesiologist will follow up each visit - since repetition is key - and communicate with all team members on progress.

• The occupational therapist treating cancer patients for chemo brain will teach cancer patients how to focus on the positive aspects of what they are doing, recognizing the small gains they make each day. They help patients to organize their thoughts by writing them down and creating a structure or plan, breaking it down in order for it to be less overwhelming. They also ask patients to time their daily activities to allow for complete cognitive rest, away from all mental stimulus including computers and television.

More Awareness of Chemo Brain Needed

Many people, including doctors and insurance companies, fail to recognize the impact chemotherapy can have on the brain and the way we think. It interferes with patients' abilities to multitask and also impairs memory, so that one day they are shown an exercise and the next day cannot recall it. This is not only due to their fatigue and loss of mobility and strength, but due to the mental confusion that comes with chemo brain. The challenge of doing regular exercise and getting back into a normal routine can be overwhelming for a patient with chemo brain.

We have found that managing cancer rehab isn't always what we expect. A lot of education is still necessary, and helping patients get back to living their lives takes a team approach.

There is More to Rehab Than Meets the Eye

Utilizing specialized rehab techniques to assist in the recovery from cancer side effects is still a relatively new field. Cancer patients who utilize rehab services for their recovery benefit from qualified specialists in physiotherapy, kinesiology, occupational therapy and acupuncture to get back on their feet.

Help us to create awareness of cancer rehab by following us on Facebook, Twitter, Google Plus and LinkedIn - help us spread the word!

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

The Best Treatment for Cancer Related Fatigue

Studies indicate that 80% of people who received chemotherapy or radiotherapy will have some degree of fatigue

Cancer Related Fatigue Remains Number One Problem

The most prevalent side effect of cancer treatment is fatigue. Studies suggest that eighty per cent of individuals who have received chemotherapy or radiotherapy will experience some degree of persistent fatigue. In Dead Tired, Dr. Jane Poulson describes her experience of cancer fatigue as "unlike any fatigue I have ever known, not only in severity and longevity but in its effect on my mood and spirits".

 Exercise Lowers Reported Fatigue Levels by 40 - 50%

Physical exercise has been suggested as helpful in reducing fatigue

Although it seems counter-intuitive to most people, the best cure for fatigue is exercise. The scientific evidence supporting exercise as the best intervention for fatigue is very strong. However it is often difficult for those overwhelmed by fatigue to know how to get themselves going again. They need guidance to start slowly and gradually increase their exercise over weeks and months. Every individual is different and some people have medical precautions which make finding their safe level of exercise more challenging. Appropriate screening and modifications of prescribed exercise is extremely important.

Cancer Exercise in the Community

At Cancer Rehab Canada we encourage you to get out there and get active. We want you to find a safe and engaging way to exercise. For some people this may be doing Yoga or Pilates at a local gym, and for others it might mean walking the dog. Exercising with others in a group setting is often an excellent way to take your mind off your fatigue and motivate you to get going, but you need to be mindful that you are an individual and everyone is unique.

If you have any doubt about your abilities to do certain exercises, please consult with a rehab professional at Cancer Rehab Canada. Starting an exercise program after an illness isn't easy, and often a few simple strategies can get you safely on your way to a full recovery. Before you know it you will be able to enjoy increased energy and much less fatigue.

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

Limited Joint Mobility Can Be Improved With Cancer Rehabilitation

Celeste Petrusevski, Registered Physiotherapist at LifeMark Physiotherapy on Bay, guides a patient in range of motion exercises

Joint Stiffness and Reduced Range of Motion Can Happen Months or Even Years After Patients Have Already Completed Their Cancer Treatments

One of the impacts of cancer treatment sometimes experienced by patients after cancer treatment is limited range of motion, or the reduced ability to easily move their limbs from particular joints. This reduced ability to move occurs due to joint stiffness, pain, swelling, or muscle aches. These are among the less recognized problems that can occur after chemotherapy, radiation, hormone therapy or biotherapy treatments. Sometimes side effects of cancer treatment can arise months or even years after the treatment has already ended. Cancer rehabilitation specializes in assisting patients to recover from those side effects and improve their quality of life.

Cancer physiotherapy can help improve limited range of motion through specialized exercise techniques called "range of motion" exercises. These exercises, which are done very gently, are designed to move the stiff joints through to their full range of movement. When working with a cancer rehab physiotherapist, a patient will be prescribed range of motion exercises that are required to be done daily in prescribed repetition according to their individualized treatment plan.

"Many patients will experience loss of mobility and strength following cancer treatment and/or surgery", says Celeste Petrusevski, a Registered Physiotherapist at LifeMark Physio on Bay. "This can greatly affect daily activities and lead to pain and weakness over time. As Physiotherapists we work closely with our patients to guide them through specific exercises that are prescribed on a daily basis and completed at home or in the clinic. These client specific exercise programs will work to restore full mobility to the joint in a safe and effective way. Clients can then return to work, activities and hobbies pain free. Having a health professional such as a Physiotherapist address and improve the functional limitations associated with cancer treatment is an integral part of a full recovery."

Every joint has its own normal range of motion, and when joints are functioning properly it is possible to move around freely and perform regular activities without pain. Early rehabilitation can often prevent problems such as joint stiffness from developing, so please don't wait - it is best to seek treatment in the early stages.

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

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.

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.

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.