Physical Therapy Guide to Cancer

What Is Cancer?

Cancer is the name given to a collection of diseases that involve an uncontrolled growth of abnormal cells. These cells interfere with normal cells and can spread throughout the body.

Cancer is diagnosed in children and adults. It can affect any part of the body, including organs, bones, muscles, and blood. The most common types of cancer in the U.S. (in descending order) are:

  • Breast.
  • Lung.
  • Prostate.
  • Colon.
  • Skin.
  • Bladder.
  • Kidney/renal.
  • Uterine.
  • Thyroid.

Cancer death rates in the U.S. have declined since the early 1990s. More Americans are surviving cancer than ever before.

Treatment for cancer can include surgery, chemotherapy, and/or radiation. Some people with cancer also may be treated with immunotherapy (using the immune system to fight cancer), targeted therapy (gene therapy), or hormone therapy. Cancer and the side effects of treatment can cause physical problems, such as:

  • Pain.
  • Numbness, tingling, and/or reduced feeling in your arms and legs.
  • Blockage in the lymphatic system (lymphedema). This blockage can lead to swelling in your arms, legs, shoulders, hands, fingers, chest, or neck.
  • Muscle weakness.
  • Joint stiffness.
  • Fatigue.
  • Loss of endurance.
  • Loss of bone density (bone strength).
  • Difficulty moving or walking.
  • Chronic risk of losing your balance.
  • Weight gain or weight loss.
  • Cognitive changes (brain fog).
  • Heart problems.
  • Shortness of breath or breathing difficulties.

Signs and Symptoms

Sometimes cancer does not cause any signs or symptoms, but it is found during a medical examination or screening.

Common signs and symptoms of cancer can include the following.

Signs:
  • Unexplained weight loss.
  • Unexplained bleeding or bruising.
  • Skin changes.
Symptoms:
  • Fever.
  • Night sweats.
  • Fatigue.
  • Pain.
  • Numbness.
  • Nagging cough.
  • Headaches.
  • Vision problems.
 

How Is It Diagnosed?

A doctor diagnoses cancer. A physical therapist can examine a person who has received a cancer diagnosis for physical problems that cause discomfort or difficulty with movement. This examination is designed to test a person’s strength, flexibility, balance, sensation, coordination, endurance, and ability to walk and get around. Physical therapists create specialized treatment plans to address the needs and goals of people affected by cancer.

How Can a Physical Therapist Help?

Physical therapists are trained and educated to understand all of your health conditions, including a cancer diagnosis. Physical therapists evaluate individuals for their unique treatment needs and may help them recover faster than they would on their own.

Your physical therapist will work with you to develop a specialized treatment program to help reduce and improve cancer-related problems, improve your strength and function, and address your needs and goals.

Physical activity can help people maintain a normal body weight and may help to decrease the risk of:

  • Some cancers.
  • Heart disease.
  • High blood pressure.
  • Diabetes.
  • Osteoporosis.

In addition to reducing the risk of developing certain cancers, physical activity and exercise also can improve a person’s chances of surviving cancer. The American Cancer Society and other groups recommend physical activity for people who are receiving cancer treatment and those who have completed treatment.

Physical therapists design personalized exercise and treatment programs to help cancer survivors increase their physical activity. Physical activity has been shown to reduce or prevent many cancer-related problems, including fatigue.

Physical therapists can help people before and after cancer surgery. Before surgery, they can evaluate cancer survivors for existing problems (such as those listed above) and help address them. After surgery, they can help to:

  • Address any movement issues.
  • Reduce pain.
  • Manage the healing of the incision site.
  • Minimize scarring.

Many cancer survivors choose to recover at home through programs that help them regain their strength. Choosing a physical therapy-based telerehab program with monitoring to treat cancer-related problems outperforms monthly home monitoring alone, and, according to a new study, is proven to be cost-effective. Researchers calculated the economic impact of choosing a physical therapy-based telerehab program to treat cancer-related problems versus home monitoring, and they found that doing so saves $3,514, including all the hidden costs of your time, pain, missed life events, and the dollars paid for services. 

Whether you choose to receive physical therapy at home via telerehab, in -person home health care, or in the clinic, your physical therapist will work with you to help you improve your:

Comfort and well-being. Cancer and cancer treatments can cause symptoms such as pain, burning sensations, numbness, tingling (neuropathy), cramps, or spasms. Your physical therapist may apply hands-on techniques (manual therapy) or use treatments like electrical stimulation to help decrease your pain and ease your symptoms. They may teach you gentle exercises or techniques to perform at home to aid your recovery. All of these options may reduce or eliminate the need for opioid pain medication.

Aerobic capacity. Cancer or cancer treatment may have decreased your ability to process oxygen (aerobic capacity). This can cause fatigue. Research shows that 150 minutes per week of moderate-intensity exercise (such as walking) can help improve aerobic capacity, reduce fatigue, and promote healing for patients with cancer. Your physical therapist can assess your aerobic capacity and determine the best aerobic activities for you.

Bone density or bone strength. Lack of activity coupled with certain cancer treatments can cause weakening of your bones, which could lead to bone fractures. Certain types of exercise can prevent bone loss and help maintain bone strength. Your physical therapist can teach you safe and effective exercises to help steadily build your bone strength.

Lymphedema and swelling. Some cancer treatments can result in lymphedema (swelling caused by a blockage in the lymphatic system) or other types of swelling. Your physical therapist can use methods to reduce, control, and prevent lymphedema and swelling, such as:

  • Hands-on therapy (manual lymphatic drainage).
  • Special movements and exercises.
  • Applying and showing you how to use compression (bandages or garments, such as arm sleeves, gloves, and leg stockings).

Surgical incisions. Your physical therapist can help you care for any surgical incisions. They can check for infection and assist with dressing changes. They also can help prevent some kinds of scarring and skin tightness as your incision heals. Your physical therapist can use very gentle massage or certain technologies to keep your skin as soft and flexible as possible.

Body weight. Your physical therapist can tailor an exercise program just for you to help you achieve and maintain a healthy body weight. This can improve your energy levels and reduce your risk for heart disease, diabetes, and other chronic conditions.

Mood. Physical activity helps elevate mood and reduces symptoms of depression in everyone, including cancer survivors. A cancer diagnosis, and cancer treatment, can be stressful and cause mood changes. Proper exercise, designed by a physical therapist for your specific condition and goals, can help you reduce stress and improve your mood.

Cognitive changes (brain fog). Exercise has been shown to help manage decreased memory or attention, which is sometimes called brain fog. Your physical therapist can design a personalized program of exercise that can help improve your memory, attention, or organization skills.

Daily activities. Your physical therapist will discuss activity goals with you and use them to design your treatment program. Cancer survivors usually increase their physical activity gradually. Your treatment program can help you reach your goals in the safest, fastest, and most effective way possible.

Walking. Your physical therapist can help you improve your ability to walk using strengthening exercises, walking training, and balance activities. If you have nerve damage (neuropathy), your physical therapist may recommend bracing and other techniques to make it easier or safer for you to walk. They also may teach you to use an assistive device, such as a walker or cane, if needed.

Sports training ability. Athletes undergoing cancer treatment can continue to train for their sport to a degree. Your ability to train will depend on the type of cancer and treatment. Physical therapists design safe, challenging, sport-specific training programs to help athletes minimize loss of fitness and strength during cancer treatment.

Motion. Your physical therapist will choose specific activities and treatments to help restore normal movement in any stiff joints. These might begin with passive motions that the physical therapist performs for you, and progress to active exercises and stretches that you do yourself. You can perform these motions at home to help speed healing and pain relief.

Flexibility. Your physical therapist will determine if any muscles are tight. They will start helping you stretch them and teach you how to improve your flexibility at home.

Strength. If your physical therapist finds any weak or injured muscles, they will select, and teach you, the right exercises to steadily restore your strength.

Coordination. Your physical therapist can help you improve and regain your coordination and agility. This will help you to perform household, community, and sports activities with greater ease.

Balance. Your physical therapist will examine your balance. They will teach you specific exercises to perform in the clinic and at home. These exercises can help to improve your balance and prevent falls. Your physical therapist also may teach you how to use a cane or walker for balance when walking and standing.

Home program. Your physical therapist will teach you strengthening, stretching, and pain-reduction exercises to perform at home. These exercises will be designed specifically to meet your needs and goals.

Can This Injury or Condition Be Prevented?

Research has shown that there are risk factors that may increase a person’s chances of getting cancer. The risk of cancer may be reduced by:

  • Maintaining a healthy diet.
  • Regularly exercising or performing physical activity throughout life.
  • Keeping your weight at a healthy level.
  • Avoiding tobacco in any form.
  • Limiting how much alcohol you drink.
  • Avoiding too much sun exposure.

Side effects of cancer treatment may be reduced or prevented by:

  • Staying active every day.
  • Avoiding too much bed rest.
  • Participating in activities and exercises that you enjoy, as often as possible.

Your physical therapist can help you choose the safest, most effective activities and exercises to do before, during, and after cancer treatment.

What Kind of Physical Therapist Do I Need?

All physical therapists are prepared through education and experience to treat cancer-related movement problems and help restore function for cancer survivors. However, you may want to consider:

  • A physical therapist who has experience treating people with cancer before and after surgery, during cancer treatment, and after cancer treatment has ended. Some physical therapists have a practice with an oncology, lymphedema, or pain-management focus.
  • A physical therapist who is a board-certified clinical specialist or who completed a residency or fellowship in oncologic physical therapy. This physical therapist has advanced knowledge, experience, and skills that may apply to your condition.

You can find physical therapists who have these and other credentials by using Find a PT, the online tool built by the American Physical Therapy Association to help you search for physical therapists with specific clinical expertise in your geographic area.

General tips when you’re looking for a physical therapist (or any other health care provider):

  • Get recommendations from family, friends, or other health care providers.
  • When you contact a physical therapy clinic for an appointment, ask about the physical therapist’s experience in helping people who have cancer-related problems.
  • Be prepared to describe your symptoms in as much detail as possible, and say what makes your symptoms worse.