Every Survivor Should be Screened for Cancer Rehabilitation Services

Dr. Julie Silver by Dr. Julie Silver

In a recent Washington Post article, a physician at New York’s Memorial Sloan-Kettering Cancer Center who is also the chair American Society of Clinical Oncology’s survivorship committee, stated, “Rehabilitation programs are probably the single most underappreciated service among cancer survivors right now.”

If you are a cancer survivor, clinician, policy maker, advocate or have any involvement in cancer care at all, here are a few things that you should know:

  • Cancer rehabilitation is similar to stroke rehabilitation and all survivors should be screened by their doctors and/or healthcare team for physical impairments and then referred appropriately to physiatrists (doctors who specialize in rehabilitation medicine), physical/occupational/speech therapists and other members of a multidisciplinary team.
  • Cancer rehabilitation is generally covered by health insurance, including Medicare, if provided by healthcare professionals who are board certified and/or licensed in rehabilitation medicine.
  • The American College of Surgeons’ Commission on Cancer mandates that all accredited facilities offer cancer rehabilitation care.
  • There is excellent research that demonstrates the benefits of cancer rehabilitation  and also shows that most cancer survivors need this care.
  • Research also shows a strong link between distress in cancer survivors and physical disability, so it makes a lot of sense to make sure that survivors have appropriate rehabilitation in order to improve both physical and emotional health.
  • Cancer rehabilitation is distinctly different from general exercise and wellness programs and shouldn’t be confused with these. An easy test to determine whether you have had cancer rehabilitation is to consider whether you have been referred to a rehabilitation healthcare professional such as a physical therapist for one-to-one treatment in a medical setting that your health insurance covered.
  • Cancer prehabilitation is also emerging as an important part of care that may improve physical and emotional outcomes when offered to people who are newly diagnosed.

If all of these things are true, and you are a survivor who hasn’t been offered cancer rehabilitation, you are probably wondering, “Have I been suffering needlessly?” The answer is “maybe”. Too often cancer survivors are told to accept a “new normal” without being screened for physical impairments and then referred appropriately to highly skilled rehabilitation healthcare professionals. The good news is that a lot of hospitals and cancer centers are developing much better cancer rehabilitation service lines. If you think cancer rehabilitation might help you or someone you care about, take this quiz:

  1. Are you able to do all of the things that you used to do before diagnosed with cancer?
  2. Do you have problems with your memory or difficulty concentrating (“chemo brain”).
  3. Are you more tired than you used to be?
  4. Do you have pain that interferes with your ability to do the things (including sleeping well)?
  5. Do you have problems with speaking or swallowing?
  6. Are you experiencing urinary incontinence or other bladder/bowel problems?
  7. Are you weaker than you were before being diagnosed?
  8. Do you have more difficulty walking or performing other activities?
  9. Do you have lymphedema or neuropathy or another problem related to cancer treatment?Do you think that rehabilitation might help you for a problem that is not on this list?

If you answered yes to any of these questions, then ask your doctor if a referral to a cancer rehabilitation program is right for you. Rehabilitation is a critical component of high quality cancer care.

Julie Silver, MD is an associate professor in the Department of Physical Medicine and Rehabilitation at Harvard Medical School. She developed the STAR Program
® (Survivorship Training and Rehabilitation) Certification, which has been adopted by more than 100 hospitals and cancer centers in the United States and is available at several hundred locations. For more information about cancer rehabilitation and the STAR Program visit www.OncologyRehabPartners.com

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