Can Chemo Brain Be Prevented?

Occupational Therapists and Psychologists can use cancer rehabilitation strategies to improve cognition

Cognitive Training and Counseling Can Maximize Cognitive Efficiency and Reduce Symptoms of Chemo Brain

There is no known way to prevent chemo brain, but cancer rehabilitation goes a long way in treating it. Strategies used by an Occupational Therapist or Psychologist in cancer rehabilitation can be employed to improve cognition, cognitive efficiency, and quality of life for cancer survivors who have received chemotherapy. These cognitive issues should be assessed and addressed rather than ignored, as they may lead to feelings of lowered self esteem and depression.

Chemotherapy, Hormone Therapy and Radiation Therapy All Linked to Cognitive Changes After Cancer Treatment

A decade of study on chemo brain has linked cognitive changes with chemotherapy used in the treatment of breast cancer.  But what is less recognized is that hormone therapies and radiation can also cause chemo brain. According to a Medcape Oncology interview with Jeffrey S. Wefel, PhD, both brain structure and brain function are changed after chemotherapy treatment  is finished and can even impact survivors many years afterwards. In some cases the cognitive deficits not only remain but worsen, sometimes causing premature aging.


It is not yet known what the risk factors for chemo brain are, but current studies are being conducted with breast cancer patients over age 60 to try and identify whether cancer and cancer therapy augment age-related cognitive decline and speed up the aging process. Since most published studies have been done with breast cancer patients it is also unknown whether gender affects the development of chemo brain or not, but a small number of studies of men with prostate or testicular cancer have shown cognitive decline as a result of hormone therapy as well.

• Studies using animal models and in vitro cell lines have clearly indicated that some chemotherapies have an effect on cognition-related cells
• The medical community is now changing radiation therapy to preserve function
• As well, biologically based interventions that may stop the cognitive dysfunction experienced by cancer survivors are now being studied

Healthcare Systems and the Global Economy Affected by the Magnitude of Chemo Brain

There is a lot of proof that the cognitive dysfunction related to cancer treatment has negative implications that start with limitations on survivors’ quality of life. As our population ages and the number of cancer survivors increase, the effects of chemo brain are also having a negative impact on global healthcare systems and the economy.

Read our other posts on Chemo Brain:

Challenges and Rewards of Exercising With Chemo Brain

Chemo Brain is Real

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

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

Side Effects of Cancer Treatment Affects Pelvic and Sexual Health

Treatments for Gynecologic Cancers Can Affect Sexual Function and Responses to Intimacy

Side effects of gynecologic cancer and its treatment can affect sexual identity and sexual health

While many of the side effects of cancer and its treatment cannot be seen, they can still have a detrimental effect on cancer patients' sense of well-being and quality of life. One of these is the side effects that cancer treatments such as radiation and chemotherapy have on pelvic and sexual health.

According to the University Health Network, the changes experienced from treatments for gynecologic cancers can affect patients' sexuality in different ways, both directly and indirectly. It often involves a lot of creativity, communication and patience to copy with them while dealing with cancer and still maintain a sexual identity and sexual health.

Vaginal Stenosis, Pelvic Floor Muscle Weakness and Urinary Incontinence Can Result from Gynecologic Cancer and Its Treatment

Some of the ways that cancer and its treatments can impact healthy pelvic and sexual function are:

• Radiation to the pelvis can cause vaginal dryness and stenosis (narrowing and shortening of the vagina) that can lead to pain with penetration or intercourse ("dyspareunia") or even pelvic exams that are so important for cancer reoccurence monitoring
• Pelvic radiation and chemotherapy can lead to pelvic floor muscle wasting and weakness which can lead to urinary/fecal incontinence and even pelvic organ prolapse

Pelvic Floor Rehabilitation Can Help Restore Sexual Function and Pelvic Health After Cancer

At Cancer Rehab Canada, a trained pelvic health physiotherapist can be an invaluable resource to help cancer patients overcome the side effects that cancer treatment may have on their sexual and pelvic health. According to Liane McCabe, Physiotherapist at the LifeMark Bathurst Clinic, pelvic floor rehabilitation includes:

• Teaching patients how to locate and strengthen pelvic floor muscles to improve bowel/bladder control or pelvic organ prolapse
• Teaching patients how to relax and stretch tight pelvic floor muscles to make sexual intercourse and pelvic examinations less painful
• Educating patients on techniques to improve the health of their vaginal tissues

For more resources on cancer and sexual and pelvic health please visit:
Canadian Cancer Society – Sexuality and Cancer
University Health Network Gynecologic Cancers
Ovarian Cancer Canada
Foundation for Women’s Cancer

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

Alberta
British Columbia
Saskatchewan & Manitoba
Ontario
Nova Scotia

Cancer Rehabilitation: An Update and Discussion on Future Care

Workshop by Dr. Julie Silver at American Congress of Rehabilitation Medicine

Nicole Stout and Dr. Julie Silver at the American Congress of Rehabilitation Medicine in Toronto Oct 8, 2014

Today at the American Congress of Rehabilitation Medicine, I was fortunate to have attended a workshop with Dr. Julie Silver, co-founder of Oncology Rehab Partners, an associate professor at Harvard and a breast cancer survivor. I have been reading her cancer rehab research over the past couple years and it was a thrill to hear her speak.

Her message to the medical professionals (oncologists, physiotherapists, physiatrists, nurses) in the room was simple. Cancer cases are expected to surge by 57% worldwide in the next 20 years. People are surviving cancer like never before, but many are living with impairments. Cancer rehabilitation should be provided to address these impairments and yet their needs are consistently not being met leading to disability that could have been prevented.

Nicole Stout Spoke on the Value of Cancer Rehabilitation to Policy Makers and Clinicians

The second speaker of the day, was Nicole Stout, a physical therapist and clinical researcher for the National Institute of Health. She is best known for the Prospective Surveillance Model for Breast Cancer patients. Once again I was awed to be in her presence as she has done so much to elevate the profession of physical therapy with her cancer rehab research and her involvement with policy development on many levels. She feels that the value of Cancer Rehabilitation is finally being appreciated by policy makers and clinicians across the USA, but we are still having difficulty operationalizing its delivery.

Highlights of the 2013 Institute of Medicine Report "Delivering High Quality Cancer Care" 

The 2013 Institute of Medicine report on “Delivering High Quality Cancer Care” concluded that we need to re-examine how we can work together to improve the quality of life and outcomes for people facing a cancer diagnosis. In Canada, it seems that Cancer Rehabilitation is often considered optional and it is time that we include it as part of our standard of care for all cancer patients. This would involve a shared model of care, where the every patient is screened for impairments along their continuum of care and the appropriate rehab intervention is provided in an effort to avoid chronic disability and instead return them to happy and productive lives.


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

Alberta
British Columbia
Saskatchewan & Manitoba
Ontario
Nova Scotia

Pelvic Health Physiotherapy Can Assist with Prostate Cancer & Treatment Side Effects

By Laura Ritchie, MPT, MCISc (Manip), FCAMPT Registered Physiotherapist,  Centric Health Physiotherapy and Wellness, London, Ontario

Prostate Cancer and its Treatment Discussed in Webinar by Dr. Bobby Shayegan

On October 3, 2014 I listened to an interesting webinar on prostate cancer and its treatment, presented by Dr. Bobby Shayegan and hosted by the Canadian Cancer Survivor Network.

Dr. Shayegan is currently an associate professor in the department of surgery at McMaster University.  He received his MD and completed his urology residency from the University of Toronto.  He subsequently pursued a fellowship in urologic oncology at Memorial Sloan-Kettering Cancer Center.

After the webinar I asked Dr. Shayegan a question about the potential side effects of treatment for this type of cancer. He reported that stress incontinence is a common short-term concern following surgery, while urgency incontinence and bleeding are more likely following radiation therapy.

Dr. Shayegan added that sexual dysfunction can occur with both types of treatment and that with radiation in particular, at least half of patients develop erectile dysfunction over time (but not necessarily right away).

How Physiotherapists with Specialized Training in Cancer Rehabilitation Can Help with Prostate Cancer Side Effects

Pelvic Health Physiotherapy can assist with both urological and sexual dysfunction.

Dr. Shayegan also reported bones can become thinner and weaker as a result of treatment and that weight-bearing is recommended to counter this. Physiotherapists with specialized training in Cancer Rehabilitation can prescribe a safe and effective exercise program for this purpose.

The webinar is still available for viewing on the CCSN website.

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

Alberta
British Columbia
Saskatchewan & Manitoba
Ontario
Nova Scotia

LifeMark-Centric Health Proud Sponsor of Calgary Run For The Cure

Calgary Team Assembles for CIBC Run For the Cure

LifeMark-Centric Health has entered a team for the CIBC Run/Walk For the Cure for the past several years

For the past several years, LifeMark-Centric Health has entered a team for the CIBC Run/Walk For the Cure, and this year is no exception! Headed by Barb Morrison, the goal is to have 50 walkers and runners participating on the LifeMark-Centric Health team. Anyone wishing to help build the team or donate can do so at the registration page.

LifeMark-Centric Health Massage Therapists and Physiotherapists Donate Their Time at the Run

Several LifeMark massage therapists and physiotherapists in Calgary will be volunteering their time at the Calgary Run For the Cure. They are offering free massage and physio treatments to participants and attendees who need to get the kinks out and sore muscles soothed.

LifeMark massage therapists and physiotherapists in Calgary volunteer their time at the event

New T-Shirts Accentuate Cancer Rehab's Focus on Your Care

The new t-shirts for Team LifeMark-Centric Health were designed by Barb Morrison, LifeMark Clinic Director

Barb has designed special Cancer Rehab t-shirts for the event which will be worn proudly by the LifeMark-Centric staff.

LifeMark-Centric Health Booth Informs Calgary Run For the Cure Participants of the Benefits of Physiotherapy

Calgary LifeMark staff put the finishing touches on the Calgary Run For the Cure booth

The LifeMark-Centric Health booth has a wealth of information describing how physiotherapy can help you. Along with cancer rehabilitation, other techniques address pain management, dizziness, orthotics and bracing, post-surgical rehabilitation and sports injuries.

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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.

Alberta
British Columbia
Saskatchewan & Manitoba
Ontario
Nova Scotia