Our Oncological Rehabilitation programs aim to increase the quality of life for cancer patients by enhancing their physical strength, reducing pain, and promoting functional independence during and after their illness. Personalized exercises, massage, physiotherapy applications, and rehabilitation programs are tailored to each patient’s condition. These issues can arise in all tumor types, but the need for rehabilitation is especially significant in central nervous system, breast, lung, and head and neck tumors.
Effects of Cancer on Body Systems
Long-standing systemic disease can lead to immobility, malnutrition, decreased immune function, and psychological factors affecting the patient's general condition. Cancer treatments often impact cell division, leading to gastrointestinal issues such as nausea, vomiting, and diarrhea. Disability in cancer patients usually results from tissue spread and pain, with pain being one of the most significant problems.
Immobility and Related Problems
Bed rest in cancer patients leads to various metabolic and physiological changes, including bone loss, muscle fiber type changes, and joint physiology alterations. These factors can cause pressure sores, mononeuropathy, contractures, deep vein thrombosis, and pulmonary embolism. To combat these, patients can perform exercises against gravity or light resistance using elastic bands. Normal joint movements help prevent contractures, maintain strength, and endurance. Preventing pressure ulcers involves frequent position changes, pillow support, air mattresses, close monitoring of skin lesions, and moisturizing creams.
Central Nervous System Involvement
CNS involvement can be primary or metastatic, with common brain metastases from lung, breast, gastrointestinal carcinomas, and melanomas. Early symptoms include headaches, seizures, and cognitive impairments. Rehabilitation focuses on the identified deficits. Spinal cord involvement may result from primary or metastatic tumors, with radiation myelitis being related to radiation dose. Rehabilitation for spinal cord involvement is similar to traumatic spinal cord lesion treatment.
Peripheral Nervous System Involvement
Chemotherapy-induced neuropathy is usually distal and symmetrical, while brachial plexopathies can occur with radiotherapy. Lymphedema often accompanies these conditions. Neuropathic pain treatment and supportive devices, orthoses, and walking aids are crucial.
Myopathies
Carcinomatous myopathy is common with metastatic disease and requires supportive treatment. Steroid-induced muscle weakness results from type II fiber atrophy in proximal muscles. Isometric exercises can aid recovery by enhancing muscle metabolism.
Bone Involvement
Bone metastases commonly occur in breast, lung, kidney, colon, prostate, bladder, ovarian, and uterine carcinomas, primarily affecting the spine and proximal extremities. Primary bone tumors like osteogenic and Ewing sarcoma can also occur. Pain, especially at night and with weight-bearing activities, is the main symptom and suggests pathological fractures.
Cachexia
Cachexia is a condition characterized by protein breakdown and muscle mass loss that cannot be reversed with conventional nutritional support.
Lymphedema
Lymphedema results from impaired lymphatic or venous drainage, deep vein thrombosis, or post-surgical interventions like mastectomy. It can be acute, subacute, or chronic. Treatment includes elevation, isometric exercises, compressive dressings, and long-term edema management programs.
Psychosocial Problems
Cancer patients often face psychosocial issues that can persist after treatment. These problems affect both patients and their families. Effective psychosocial rehabilitation includes family involvement, addressing depression, social isolation, hopelessness, and ensuring access to individual or group therapies.
Sexual Issues
Sexual problems vary based on cancer type and treatment. These issues are prevalent in genital cancer patients and those undergoing pelvic radiotherapy but can occur in all cancer types. Addressing these issues requires taking a sexual history and developing a treatment plan. Sexual rehabilitation should start preoperatively, involving both patients and their spouses.
Group Treatments
Group treatments provide patients with a platform to discuss their emotions, share experiences, access local resources, and gain more information about their condition.
Soft Tissue Tumors
Soft tissue malignant tumors affect connective tissue, vessels, lymphatic system, muscle, adipose tissue, fascia, and synovial tissue. Treatment varies based on the lesion's size, depth, and location and can range from simple excision to amputation. Chemotherapy and radiotherapy also play roles in determining the rehabilitation program.
Bone Tumors
Bone tumors require treatments based on lesion localization, type, and extent. Cancer patients have a higher amputation rate, and temporary prostheses are recommended post-operation, especially for young patients. Cosmetic prostheses are suggested for those unable to use functional prostheses.
Breast Cancer
Breast carcinoma is the most common malignancy in women. Treatments include lumpectomy or mastectomy, lymph node dissection, and radiotherapy, which can lead to lymphedema and shoulder joint limitations. Postoperative mobilization should begin early to prevent limitations in shoulder movement.
Head and Neck Tumors
Treatment of head and neck tumors often results in functional and cosmetic disorders, causing psychological trauma. Postoperative rehabilitation includes facial muscle exercises, chewing and swallowing exercises, strengthening exercises for neck and shoulder muscles, and speech therapy. Mechanical devices and esophageal speech training may be needed to restore voice functions.
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