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Year : 2018  |  Volume : 12  |  Issue : 2  |  Page : 98-99

Providing cancer rehabilitation services: Are there some guiding principles?

1 Department of Rehabilitation Medicine, Singapore General Hospital, Outram Road, Singapore, Singapore
2 Department of Rehabilitation Medicine, Dunedin Hospital, Southern District Health Board, New Zealand

Date of Web Publication17-Dec-2018

Correspondence Address:
Dr. Tan Yeow Leng
Department of Rehabilitation Medicine, Singapore General Hospital, Outram Road, Singapore 169608
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/PJIAP.PJIAP_27_18

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How to cite this article:
Leng TY, Mar SH. Providing cancer rehabilitation services: Are there some guiding principles?. Physiother - J Indian Assoc Physiother 2018;12:98-9

How to cite this URL:
Leng TY, Mar SH. Providing cancer rehabilitation services: Are there some guiding principles?. Physiother - J Indian Assoc Physiother [serial online] 2018 [cited 2022 Jan 17];12:98-9. Available from: https://www.pjiap.org/text.asp?2018/12/2/98/247609

Dear Editor,

We read with interest the publication by Guru et al. in evaluating the physiotherapy services for cancer patients.[1] With increased cancer survival rates, there is a need for Allied Health to provide comprehensive cancer rehabilitation services. We agree with Guru et al. that a huge bulk of cancer patients is unaware of the benefits of rehabilitation. Referrals to physiotherapists are often not initiated early, if not, at all. We will like to use this study as a platform to provide views on cancer rehabilitation.

This survey described the cancer-related impairments in 15 cancer centers followed by physiotherapy. Various medical and physical parameters (e.g., pain, range of motion, and heart rate) were charted. However, it was unclear whether these assessment tools chosen were based on the International Classification of Function, Disability and Health (ICF) Core Sets.[2],[3] ICF framework is a useful model for assessing global function in cancer patients. At present, breast cancer and head and neck cancers have their respective Core Sets to set standards for the assessment of function. It might be worthwhile to consider the Core Sets for the different types of cancer.

This study also mentioned about cancer rehabilitation in stages.[4] Dietz et al. described how a rehabilitation team set appropriate goals for cancer patients by first categorizing them into four stages: preventive, restorative, supportive, and palliative. The aim is to consider the physical, mental, emotional, social, sexual, and economic needs at each stage followed by appropriate plan. Preventive rehabilitation emphasizes early intervention and exercise to prevent or delay complications related to cancer or its therapies. Restorative rehabilitation envisions full reintegration of the patient back into society. Supportive rehabilitation promotes functional independence to the maximum, and the palliative rehabilitation aims to maximize comfort and caregiver support. Cancer is a dynamic disease with existence of gray areas. Patients may straddle in between stages; hence, this framework serves as a useful anchor for the physiotherapy team pertaining to goal setting and selection of outcomes. The physical and psychological needs of the cancer survivors could also be identified at each stage.

Our final view touches on physiotherapy knowledge in cancer rehabilitation. The lack of cancer rehabilitation knowledge is often the reason leading to false belief that limited duration of survivorship is not worth the effort for rehabilitation. We need to recognize that most cancer patients can benefit from rehabilitation despite the varied spectrum of cancer prognoses and on-going treatment. Radiotherapy, chemotherapy, and metastasis do not necessarily limit functional gains despite changes in body structure and functions brought about by cancer and its related treatment.[5] It is important to rectify the negative perception and attitude pertaining to the effectiveness of cancer rehabilitation at different stages of disease. Strategies include increasing awareness of evidence-based cancer rehabilitation and enhancing knowledge on cancer-specific rehabilitation, such as cognitive rehabilitation, fatigue management, and physical therapy.

This letter highlights the principles of ICF Core Sets, cancer stages, and perception of cancer rehabilitation. We congratulate Guru et al. and team for this insightful paper.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Guru K, Manoor U, Supe SS. Physiotherapy services for cancer patients in South India: A survey. Physiother J Indian Assoc Physiother 2018;12:22-9.  Back to cited text no. 1
Brach M, Cieza A, Stucki G, Füssl M, Cole A, Ellerin B, et al. ICF core sets for breast cancer. J Rehabil Med 2004;(44 Suppl):121-7.  Back to cited text no. 2
Tschiesner U, Rogers S, Dietz A, Yueh B, Cieza A. Development of ICF core sets for head and neck cancer. Head Neck 2010;32:210-20.  Back to cited text no. 3
Dietz JH Jr. Rehabilitation of the cancer patient. Med Clin North Am 1969;53:607-24.  Back to cited text no. 4
Marciniak CM, Sliwa JA, Spill G, Heinemann AW, Semik PE. Functional outcome following rehabilitation of the cancer patient. Arch Phys Med Rehabil 1996;77:54-7.  Back to cited text no. 5


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