The Oncology Care Team
Physiotherapy

Oncology Physiotherapists

 

 

The role of physiotherapy in Oncologic rehabilitation includes restoring function, reducing pain, reducing disability, increasing endurance and mobility and ultimately improving quality of life.

 

Physiotherapy interventions may include:

  • Positioning for pain control and pressure relief

  • Respiratory care: management of dyspnoea, removal of secretions, pacing strategies

  • Mobility: evaluate and improve bed mobility, transfers, ambulation, stairs

  • Exercise therapy to improve flexibility, strength, balance, endurance and function

  • Neurological rehabilitation techniques

  • Education of patient and family in appropriate handling techniques for transfers

  • Relaxation techniques to reduce levels of anxiety

  • Assist with discharge planning by recommending mobility aids and follow-up PT services if appropriate

Physiotherapy has a key role to play in the managements of patients throughout their cancer journey. The primary goal is to assist the person with cancer in achieving maximum physical functioning within the limits imposed by their disease or treatment.

 

Team work

 

Physiotherapists work closely with other members of the oncology team:

  • Physicians: diagnosis, prognosis, care plan

  • Occupational Therapy: home assessment, seating, ADL’s

  • RN: transfer techniques, meds

  • CCAC: discharge planning

  • Social work and spiritual care

     

     

 

 

Oncology physiotherapists have specialized knowledge of oncology that allows them to tailor the physiotherapy treatment plan and interventions to taking into account:

  • review of relevant lab values in the oncology patient population and how it affects physiotherapy intervention (for example, the importance of reviewing coagulation profiles and platelet counts when assessing the risk of complications from a fall)

  • increased risk of DVT/PE

  • bony metastisis - how this affects mobilization guidelines (ex. WBAT - weight bearing as tolerated) Are resisted exercises safe? Is manual chest physiotherapy safe?

  • malignant pleural effusions - is there a role for chest physiotherapy?

  • spinal cord compression - may present similar to paraplegia. Is there a risk of inability?

  • be aware of basic chemotherapy and radiation side effects and how they may affect physiotherapy intervention

  • overview of common cancers and prognosis (ex. AML, CML, ALL, CLL, NSCLC, DLBCL, ovarian, breast, brain)

  • red flags for suspicion and diagnosis of cancer

 

Physiotherapists are involved in assessing and treating:

  • mobility: strength, range of motion, ambulation, stairs

  • balance

  • providing mobility devices

  • energy conservation techniques

  • breathing techniques: to control SOB, aid in relaxation

  • positioning for pain relief

Physiotherapy services at the KGH are provided in all program areas by referral.

 

Physiotherapy Resources 

McDonnell ME, Shea BD. The role of physical therapy in patients with metastatic disease to bone. Back and Musculoskeletal Rehabilitation. 1993; 3:78-84.

 

The Role of Physiotherapy for People with Cancer - CSP Position

Statement July 2003 The Chartered Society of Physiotherapy