What Can I Do to Feel Better?
(Hint: The answer may include cancer prehabilitation.)
by Julie Silver, MD
If you’re newly diagnosed with cancer, ask your doctor how prehabilitation can be of benefit to you.
Ask your doctor about cancer rehabilitation if you …
⇒ have pain, including headaches or joint, muscle, or nerve pain
⇒ aren’t able to walk or run as well as you did before your diagnosis – including but not limited to tripping or falling
⇒ feel tired or weak
⇒ find yourself having difficulty thinking, concentrating, or remembering things
⇒ are worried about choking or are having other swallowing problems
⇒ are not speaking as well as you used to
⇒ can’t lift your arms over your head as well as you used to
⇒ aren’t able to turn your head well, especially while driving and checking for oncoming traffic
⇒ have any other problems that are keeping you from feeling comfortable and functioning well
When I was diagnosed with cancer 10 years ago, I remember my initial shock. I also recall that I had to wait to start treatment. I had medical appointments during that period, but I also had plenty of time to worry. As a rehabilitation physician, I know there is a better way to use this critical window of time between diagnosis and the beginning of treatment – and it’s called cancer prehabilitation.
Cancer prehabilitation should be standard care for most newly diagnosed individuals. The goal of prehabilitation is to prepare a person – both physically and emotionally – for upcoming surgery and other cancer treatments. For example, if you’re newly diagnosed with prostate cancer, you would attend a prehabilitation workshop where you would learn pelvic floor muscle exercises to decrease the potential for post-operative urinary incontinence. You would also learn strategies to reduce anxiety and lower stress.
In prehabilitation, it’s ideal to combine emotional support techniques with physical strategies for improving general strength and endurance, as well as more focused physiological outcomes, such as shoulder range-of-motion exercises for a woman about to have a mastectomy or swallowing exercises for a man facing head and neck cancer treatment. This tag team of emotional and physical support through scientifically proven interventions is designed to improve both your treatment experience and your health outcomes.
The goal of prehabilitation is to prepare a person – both physically and emotionally – for upcoming surgery and other cancer treatments.
A cancer diagnosis affects both physical and emotional health, and the relationship between the two is strong, meaning it’s likely that the better you feel physically, the better you will feel emotionally, and vice versa. A recent study found that survivors have a significantly worse quality of life due to physical or emotional problems than people who haven’t had cancer. The study also found that more survivors had a reduced quality of life because of physical problems rather than emotional ones. Other studies have shown that one of the leading causes of distress in survivors is physical disability. The obvious conclusion is that if we prevent physical problems early on through prehabilitation interventions, many cancer survivors will feel better both physically and emotionally.
Too often, cancer survivors struggle more than they need to. They may have a cluster of side effects, including pain, fatigue, and stress, that feed off of each other, making it hard to sleep at night and function during the day. While each side effect might not be a big problem on its own, together they can cause significant physical and emotional disability.
Rehabilitation teams work together to address several cancer-related issues at once. This has a synergistic healing effect that can markedly improve how survivors feel and function in a relatively short period. Cancer prehabilitation can help survivors of all types and stages of cancer to function at a higher level and feel better.
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Dr. Julie Silver is an associate professor in the department of Physical Medicine and Rehabilitation at Harvard Medical School in Boston, MA. She is the author of What Helped Get Me Through: Cancer Survivors Share Wisdom and Hope (American Cancer Society). Dr. Silver has developed a national model for cancer rehabilitation called the STAR Program (Survivorship Training and Rehabilitation), which has been adopted by more than 100 hospitals and cancer centers throughout the United States. Learn more about the STAR Program at OncologyRehabPartners.com.
This article was published in Coping® with Cancer magazine, November/December 2013.