Physical therapy helps improve quality of life for cancer patients and survivors

If you receive a cancer diagnosis, one of the first treatments you think of might be chemotherapy. It’s a common form of cancer treatment that can affect your body in many ways, from fatigue and brain fog to limiting strength and mobility. To help combat those effects, LMH Health offers physical therapy geared toward cancer patients and survivors.

What is chemotherapy?

Chemotherapy uses drugs that destroy cancer cells by interfering with their ability to grow and divide. Doctors may use these drugs alone or in combination with radiation and surgery. You can receive therapy:

• Orally (by mouth)
• Through an IV (intravenously) in a vein or artery
• Through an injection into a muscle or under the skin

Dr. Jodie Barr

Dr. Jodie Barr, an oncologist at the LMH Health Cancer Center, explained that chemotherapy isn’t prescribed for all of her patients. It works well to treat some cancers but doesn’t work well for others. It can also have a wide range of side effects, including:

• Anemia (low red blood cell counts)
• Balance issues
• Brain fog or “chemo brain”
• Fatigue
• Hair loss
• Limited strength and mobility
• Lymphedema (swelling caused by fluid buildup)
• Nausea and vomiting
• Numbness and tingling (neuropathy)
• Pain

“When we look at using chemotherapy to treat a cancer, our goal is to ensure we provide a regimen that the patient can tolerate and that allows them to lead a good quality of life,” Dr. Barr said.

Physical therapy provides benefits

When cancer throws life a curve ball, physical therapy can help mitigate the effects of chemotherapy – before, during and after treatment. Dr. Barr explained that oncology patients who have multiple comorbid conditions before starting chemotherapy benefit from pre-rehab. This is physical therapy you begin before your cancer treatment starts.

“Data supports that patients who have comorbidities – having two or more medical conditions at the same time - benefit the most from starting rehab early,” she said. “They tolerate treatment better, have less delays in their treatment plan and have fewer hospitalizations.”

The team at the LMH Health Cancer Center works with you to determine if you may benefit from physical therapy. They use the Karnofsky Performance Status (KPS), which is a way of measuring the ability of patients to perform activities of daily living. Patients self-report this information and are asked to do it periodically throughout treatment. Scores range from 0 to 100. A higher score means you’re better able to carry out daily activities.

“Some of my patients get a couple of weeks into treatment when side effects of chemo begin to set in. You may not think about having brain fog or not being able to get up and stand at the stove for 30 minutes to be able to cook dinner,” Dr. Barr said. “We talk about the program and I let them know that spending time in physical or occupational therapy may help their stamina.”

Personalized care from a certified therapist

Jonathan Todd

Participating in physical therapy as part of your treatment plan can help you maintain or regain strength and quality of life. When you are referred to LMH Health Therapy Services, you’ll work with Jonathan Todd. He’s certified in chemotoxicity and cancer exercise management by the Physiological Oncology Rehabilitation Institute (PORi).

“Patients living with cancer haven’t historically received physical therapy. Oncologists have been focused on their recovery,” Todd said. “As more people survive their diagnosis, we’re finding they have functional issues whether it’s fatigue, weakness, neuropathy or balance issues. It’s important to me to be able to care for this expanding population.”

Research from the American Cancer Society shows that for most people, exercise is safe and helpful before and throughout cancer treatment. It can also help you cope with the side effects of treatment and may decrease your future risk of cancer.

“One of the biggest side effects of chemo and immunotherapy is fatigue. That’s where physical therapy is extremely beneficial,” Dr. Barr said. “Studies show that the more we can get patients active, even if it’s just getting up and walking for five minutes a day, the more it helps to combat cancer-related fatigue.”

During the first physical therapy visit, Todd will evaluate your current situation. He will talk with you to assess your past history, learn about your current symptoms and determine how he is able to help.

“We’ll go through a series of tests that will help to assess weakness, balance, activity tolerance and overall frailty,” he said. “When a patient leaves that first appointment, I’ll make sure that they have some exercises to begin working on at home.”

Todd has also helped patients start an exercise program and then work with them periodically to assess their progress. He also works with occupational and speech therapists to coordinate any needs patients may have in that arena.

“People who are undergoing chemo can sometimes suffer from brain fog – forgetfulness, problems focusing, concentrating and paying attention,” he said. “We want to make sure that we’re treating all of their concerns.”

While patients living with cancer may have a road map for their treatment including the type of chemotherapy and number of cycles they’ll face, Todd shared that there isn’t a hard and fast time that physical therapy may last.

“Therapy for an injury may last for three months at most, but it’s a long-term process for cancer patients and survivors,” he said. “If the patient wants to be seen on an ongoing, monthly basis, that’s what we’ll do.”

Does it work?

“The feedback we get from our patients about their work with the therapy team has been great,” Dr. Barr said. “Patients have found this beneficial and they feel better overall. We’ve seen that they have better appetite, are able to do more daily activities, and have less delays in treatment and fewer hospitalizations.”

LMH Health Therapy Services is looking to the future and expanding the programs they offer to those living with and who have completed cancer treatment. This includes therapies for breast cancer, head and neck cancers, and pelvic and lower extremity cancers.

“This program provides benefits to patients by giving them things they can work on themselves and see progress,” Todd said. “I see a number of patients who are down and don’t feel like they’ll be able to improve, but this work can help physically and mentally. I’m excited to see the program grow. It’s work worth doing.”