Download Report on the rehabilitation of cancer patients Cancer rehabilitation

Report on the rehabilitation of cancer patients
Cancer rehabilitation helps a person with cancer obtaining the best physical,
social, psychological, and work-related functioning during and after cancer treatment.
The goal of rehabilitation is to help a person regain control over many aspects of their
lives and remain as independent and productive as possible. Rehabilitation can be
valuable to anyone with cancer and those recovering from cancer treatment.
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Rehabilitation can improve the quality of life for people with cancer and
their families, including:
Improving physical strength to help offset any limitations from cancer and
cancer treatment
Helping the person with cancer become more independent and less reliant
on caregivers
Helping the person with cancer adjust to actual, perceived, and potential
losses due to cancer and cancer treatment
Reducing sleep problems
Lowering the number of hospitalizations
The Department of Radiation Oncology in Debrecen offers a variety of cancer
rehabilitation services to their Hungarian and Romanian patients, or are willing to help
them identify local resources to assist with rehabilitation. Patients and family members
are encouraged to be active, informed partners in the rehabilitation process and seek
out the services they need. Talk with a nurse or social worker about the services you
are interested in:
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Patient and family education and counseling
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Pain management techniques and medications
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Nutritional counseling
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Exercise programs to help to build strength, endurance, and mobility
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Smoking cessation education and support programs
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Assistance with activities of daily living (ADLs) such as eating, drinking,
dressing, bathing and using the toilet,
Nutritionist at the Department of Radiation Oncology, University Debrecen
evaluates the patient’s nutritional condition, assesses the additional metabolic demands
that the cancer places on the body, and recommends the optimal diet with respect to
specific clinical condition, caloric intake, food ingredients of choice, optimal
consistency for easy swallowing, and the individual’s tastes. The nutritionist judges
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total food intake by closely monitoring the patient’s weight and counting calories and,
if nutrition is inadequate, may recommend interventions to facilitate adequate intake in
the presence of poor appetite and swallowing disorders. The nutritionist should teach
the patient and family general and specific dietary principles and consult with the
clinical staff on the optimal parenteral nutrition when the need for that arises.
Psychologist at the Department of Radiation Oncology, University Debrecen assesses
the patient’s cognition and behavior, including intelligence, personality (i.e.,
ideational, emotional, behavioral, and character patterns), personal history, motivation,
reaction to the illness, and coping skills. Following the diagnosis of cancer and the
development of a disability, both the patient and family members may experience
reactive depression or grief, which often is expressed in diverse ways, including
denial, anger, anxiety, panic, fear, dependent behavior, depression, and the unmasking
of previously controlled psychopathology. The primary role of the psychologist is to
assist the patient and the family in coping, as well as to counsel and consult with the
rehabilitation team members in managing the emotional reactions. The effectiveness of
psychosocial intervention has been successfully demonstrated with cancer patients.
Physical therapist at the Department of Radiation Oncology, University Debrecen
teaches the patient to perform specific exercises to strengthen muscles, to increase
stamina, and to maintain or improve joint range of motion and trunk flexibility. When
indicated, training is provided to improve balance and coordination, as well as
functional skills: transfers into and out of bed, wheelchair locomotion, and ambulation
with or without assistive devices. Instructions are provided on how to normalize gait
patterns and to safely ascend and descend stairs and curbs. Various physical modalities
may be used by the therapist to reduce pain, such as superficial and deep heat, cold,
transcutaneous electrostimulation (TENS), and massage, but the clinician needs to
stipulate that heat modalities and massage should not be applied directly over or
immediately adjacent to a site of cancer. Physical exercise is perhaps the most
important therapeutic modality in the rehabilitation management of physical
disabilities. Muscle-strengthening exercises may be either isometric, isotonic, or
isokinetic. Isometric exercise does not involve joint motion, and so is prescribed for
painful or unstable body parts, whereas isotonic exercise involves joint motion against
variable resistance. Isokinetic exercise, a most effective strengthening exercise,
involves the use of specific devices to maintain constant speed of motion independent
of the force applied. Passive stretching exercises are done by the therapist without the
patient’s direct participation to maintain or increase joint mobility. Task-oriented
exercises, such as ambulation or training in self-care, may improve function and safety
by repetition and prolonged therapy.
Highly trained physical therapist at the department is also specialized on the treatment
for lymphoedema affecting an arm or leg. This treatment involves:
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skin care to prevent injury and infection
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positioning and moving the limb to help drain fluid
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compressing the area using compression garments such as sleeves, stockings,
special bras, or compression bandages
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exercising and keeping active to improve the flow of lymph
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specialised massage, called manual lymphatic drainage (MLD), or self-massage,
called simple lymphatic drainage (SLD), to help drain fluid
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deep breathing exercises built into daily routines
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radiation therapists: after appropriate radiation treatment indication follow
the status of their patients during the treatment. Provide the adequate pain
relief, refer to blood tests and diagnostic imaging tests
Manage the side effects of the radiotherapy as:
• radiodermatitis of the skin
• radiomucositis of the oral cavity
• xerostomy, decreased sense of taste
• tracheitis, oesophagitis, pneumonitis, cough
• hair loss, weight loss
• diarrhea, cystitis, nausea, anaemia
Recognize and manage the late side effects of the radiotherapy, provide the regular
medical follow-up after the treatment.
The complex work of these specialists and professionals provides in the Department of
Radiation Oncology, University Debrecen the improvement of rehabilitation of
patients with different types of cancer.
The content of this report does not necessarily represent the official standpoint of the
European Union.
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