Integrated rehabilitation for breast cancer survivors

Andrea L. Cheville, Sarah A McLaughlin, Tufia C. Haddad, Kathleen D. Lyons, Robin Newman, Kathryn J. Ruddy

Research output: Contribution to journalReview article

5 Scopus citations

Abstract

The physical and psychological side effects of breast cancer therapies can have substantial impact on survivors' physical and social functioning. Roughly half of the more than 3 million Americans alive with a history of breast cancer report adverse, function-degrading sequelae related to their oncologic treatments. Care delivery models for the timely delivery of rehabilitation services have been proposed yet limitedly vetted or implemented. These include the prospective surveillance model, procedure-linked referrals, survivorship care plans, and risk stratification. Patients' capacity to engage in the rehabilitative process varies during cancer therapy and into survivorship. Perioperative attention generally focuses on managing premorbid impairments and normalizing shoulder function. In contrast, during chemotherapy and radiation therapy, symptom control, constructive coping, and role preservation may become more salient. Risk-stratified, individualized screening and prevention activities for specific impairments have become increasingly feasible through predictive models and analytics. Impairments' severity deleterious impact can be mitigated, as has been established for lymphedema, shoulder dysfunction, chemotherapy-induced peripheral neuropathy, cognitive dysfunction, fatigue, and sexual side effects. Integrated rehabilitative programs, often initiated after the completion of cancer treatment, are available in some countries outside of the United States and may offer survivors vital vocation- and avocation-directed services.

Original languageEnglish (US)
Pages (from-to)154-164
Number of pages11
JournalAmerican Journal of Physical Medicine and Rehabilitation
Volume98
Issue number2
DOIs
StatePublished - Feb 1 2019

Keywords

  • Breast Cancer
  • Function
  • Physical Impairment
  • Side Effects
  • Survivorship

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

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