Harvard Doctor Trains Hospitals To Rehab Cancer Survivors

Stroke survivors and victims of heart attacks and trauma often require rehabilitation once they are stable in order to regain their strength and improve functioning. However, cancer patients are rarely afforded such opportunity. Thirty years ago, a diagnosis of cancer meant an extended hospitalization for treatment and rehabilitation. As cancer treatments have improved, patients are more often treated on an outpatient basis and rehabilitative programs have become a thing of the past.

Sandra Wade, a social worker from Florida, is a breast cancer survivor. She was diagnosed with an incurable type of cancer about 10 years ago. After two surgeries and years of chemotherapy, she was left with other problems including nerve damage, arthritis, chronic swelling, and a damaged heart. She states, “They didn’t send me home well; they sent me home sicker than I began.”

The medical world is beginning to realize again the importance of rehabilitation following treatment for cancer. There are currently 12 million cancer survivors in the United States, and efforts to address their care post treatment are improving. Catherine Alfano is the program director for the Office of Cancer Survivorship at the National Cancer Institute. She reports that survivors now have better rehabilitative services than were present before.

Dr. Julie Silver is a rehab physician at Harvard Medical School and is herself a cancer survivor and one of the leaders in the movement to elevate cancer rehabilitation to a level of standard practice in a more comprehensive plan of care for cancer patients. In 2009, she and her business partner, Diane Stokes, founded a program called Oncology Rehab Partner, to assist hospitals and establish rehab programs to fine tune their programs to better accommodate the needs of cancer patients.

Their program is called the Survivorship Training and Rehab program (or STAR) and has been adopted by many facilities over the past few years. This training is available to both medical and nonmedical personnel. Its goal is to teach staff about the special needs of cancer survivors. Once the training is complete, Oncology Rehab Partners helps those involved develop a system for referral and evaluation of cancer patients in need of rehabilitation. Some cancer patients are even referred for such alternative treatments as fitness classes, massage, or yoga to help alleviate the effects of cancer treatment. Such efforts, in addition to more traditional rehab treatments, help patients recover function and make the transition back to their work and family.

For example, oftentimes survivors of head and neck cancers cannot continue driving due to having a hard time turning their heads. Physical therapy can increase flexibility in the neck which improves motion in the neck thus permitting patients to drive again, which often means being able to return to work. Other problems that can be helped by physical therapy include trouble swallowing and difficulty speaking. Oncologists may not always realize the importance of therapies to help such problems. These difficulties need not be considered a normal side effect of cancer treatment, but rather something that can be alleviated with the appropriate rehabilitative efforts.