Oncology Rehabilitation: Web-based Learning for Physical Therapists
Who Provide Rehabilitation to Patients with Breast Cancer
File #6
Presentation Conclusion
Presentation Conclusion
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Case Studies
Survival
Education
Join your peers and reach for progress
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Case Studies
The following are a few case studies that I
have been involved with, over the years.
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Case # 1
Telephone call from patient; recent
bilateral TRAM procedure; physician
advised her to find a therapist;
unsuccessful finding anyone with
experience in treating a TRAM patient;
networking, I was able to find her a
physical therapist in her hometown of St.
Louis, who was experienced in breast
cancer care; received fax from patient,
notifying me of her satisfaction and
success in P.T.
Case #2
• 35 y/o model advised by her physician
(surgeon) that after her breast surgery she
would be unable to return to her career and
must limit exercises; telephone call from her
physical therapist, who had read my
publications; discussed my thoughts on a
quality of life program for this patient; advised
therapist, if desired, I would communicate with
physician about the benefits of therapy postop; discussed program with physician, who
hesitantly agreed with program; with
rehabilitation, Result: patient able to resume
full activities, including modeling.
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Case # 3
• 38 y/o female scheduled for breast reduction,
advised by her physician that a mammogram
was not needed; independently patient decided
to undergo diagnostic test; diagnosed with a
intraductal carcinoma; patient completed left
modified mastectomy with a TRAM
reconstruction and a reduction of the right
breast; followed individualized plan of treatment
with positive response.
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Case #4
• 33 y/o female noted a lump in her breast;
advised by physician that she was too young to
be worried; because patient was worried she
independently went for a second opinion and
mammogram; patient diagnosed with breast
cancer; right modified radical mastectomy
followed by a TRAM procedure (8 hrs.),
hospitalized 6 days, only therapy received was
for gait training due to weakness following bed
rest. Program of out-patient rehabilitation
progressed patient (out-pt. and home program)
to independence within two months.
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Survival
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Survival
• Over 8 million Americans alive with a history of
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cancer.
2.3 million with a history of breast cancer
5 million diagnosed five or more years ago.
Five year survival rate generally considered
cured, meaning no evidence of disease and
regular life expectancy.
Report from American Cancer Society,
Surveillance Research.
(www.cancer.org, 2005)
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Breast Cancer 5 Year Survival Rates
by Stages:
• Stage 0
• 98-100%
• Stage I
• 85-97%
• Stage II
• 70-90%
• Stage III
• 40-70%
• Stage IV
• 5-20%
(Dollinger, 2002)
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Education
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• Breast Cancer education is limited at
many educational facilities.
• Hours vary, but generally minimal, due to the
great amount of material that has to be covered
for overall educational requirements.
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Telephone Survey
Cancer education presented in physical therapy curricula
Average Hrs. of Oncology Taught at Random Universities
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Hours on Cancer Ed
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3
2
1
0
A
B
C
E
F
G
H
I
J
K
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University Participation
M
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(Study completed by Coleman, 2005)
N
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P
Q
R
S
“I found that, working with
breast cancer patients is very
educational and challenging,
but this specialty can be most
exciting and rewarding”
M.S. Coleman
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Potential
• Now that you have reviewed the basic oncology
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portion, as well as the breast cancer interventions
associated with physical therapy, you should be
motivated by the research and various therapy
regimes which have been reviewed. Incorporating
everything together, I hope you are ready to provide
quality care to the patient diagnosed with breast
cancer.
The American Cancer Society reports that exercise
programs for breast cancer patients, “Are popping up
all over the U.S.”. Let the new programs be run by
physical therapists, like yourself.
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Conclusion of presentation
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Conclusion:
Objectives Covered
•Presented the reality of cancer.
•Statistics of growth and progression of this
disease.
•Medical team approach, including physical
therapy.
•Why patients diagnosed with cancer need
rehabilitation.
•Wellness / Cancer should be synonymous.
•The Physical Therapist’s Role.
•The need to promote Quality care through
continual education.
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Your peers can assist you
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Join the Oncology Section
Network made up of active physical therapist
throughout the USA, working in cancer rehab.
• Educate the patient, health care provider and the
public of the benefits of cancer rehabilitation.
• Share Knowledge with other professionals.
• Participate in research studies.
• Contribute knowledge through research and case
studies to quarterly publications.
• Special Interest Group available: HIV/AIDS
• Become a member of a section, of the APTA, that
could use your help in developing quality care for the
patient diagnosed with cancer.
• Spread the word about early detection and care.
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Answers to the pre/post test
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Answers to pre/post test
1.
2.
3.
4.
5.
6.
7.
8.
9.
Cancer is a large group of diseases characterized by uncontrolled
growth and spread of abnormal cells and if not controlled can lead to
death.
C – Change in bowel or bladder habits
A – A sore that does not heal
U – Unusual bleeding or discharge
T – Thickening or lump in breast or elsewhere
I – Indigestion or difficulty swallowing
O – Obvious change in wart or mole
N – Nagging cough or hoarseness
Family history; Long menstrual cycles; age at first pregnancy; education
& socioeconomic class; stress; obesity; live in Northern U.S.; history of
colon or other female cancers.
Tumor size; Node involvement; Metastasis
Physical Therapist plus entire medical team
Oncology Section of the A.P.T.A.
Promote Quality of Life
D. All facilities listed
Increase muscle protein; joint mobility and strength; decrease edema,
pain, anxiety, and depression. Enhance Immune system and decrease
infections.
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Continue test answers
10.
11.
12.
13.
14.
15.
Diagnostic: Biopsy / Obtain tissue for diagnosis
Curative: Remove cancer with attempt to cure
Palliative: Improve Quality of Life
Prophylastic: Prevent future disease
Radiation
Questionable; Know the contraindications of modalities before taking a
chance when treating Lymphedema.
Inguinal; Axilla; Popliteal
Unusual fatigue; dizziness; unusual weakness; nausea; platelets; white
blood cell counts.
Demonstrate the progress that has been reported with research and
prolonged quality of life, for the patient receiving breast cancer
rehabilitation.
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Michael S. Coleman, P.T.
COLEMAN
CONSULTING
user521159@aol.com