Cancer Rehab Canada Celebrates First Birthday

Cancer Rehab Canada celebrates its first birthday in July 2014!

Helping Cancer Survivors to Feel Better, Stronger and Happier

On July 15, 2013 Cancer Rehab started blogging about ways that cancer survivors can feel better, stronger and happier. Over 45 blog posts and a year later, we have found participation in the online conversation about how to minimize survivors' disabilities to be an extremely rewarding experience.

Cancer Rehabilitation Benefits Optimal Recovery

We are still asking why cancer patients aren't 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 mastectomy, are often not receiving cancer rehabilitation service despite the growing scientific evidence that it is very beneficial in obtaining optimal recovery. Our 62 rehab clinics can offer assistance in minimizing the side effects of cancer and its treatment.

Cancer Survivors Often Suffer From Disabilities Associated With Cancer Treatments

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 Partnership 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.

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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
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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.

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.

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

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.