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.