Cancer Rehabilitation
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1 Cancer Rehabilitation Improving Outcomes in Lung Cancer Dr. Leslie J. Waltke April 6, 2016
2 Leslie J. Waltke, PT, DPT System Cancer Rehabilitation Coordinator Aurora Health Care 945 N. 12 th Street Milwaukee, WI (414)
3 LeslieWaltkePT.com Rehabilitative Treatment for the Patient with Cancer April 16 & 17 North Chicago
4 weakness fatigue walking problems numbness & tingling pain limited motion balance problems LeslieWaltkePT.com
5 Cancer Diagnosis Surgery Radiation Chemotherapy Biological Therapy Fatigue Pain Weakness Limited ROM Scarring Stiffness Edema Neuropathy Osteopenia Muscle loss Weight loss Weight gain Balance issues LeslieWaltkePT.com
6 FACT: A majority of persons undergoing treatment for cancer will experience physical, physiological and functional decline. LeslieWaltkePT.com
7 FACT: Rehabilitation may reduce, eliminate or prevent symptoms associated with cancer treatment. LeslieWaltkePT.com
8 Cancer Rehabilitation From diagnosis to survivorship Evaluation and Treatment of: musculoskeletal, cardiopulmonary and functional impairments LeslieWaltkePT.com
9 I love cancer rehab!
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18 Benefits to Patients Will live better Will live longer More will survive Lessened fatigue, pain, weakness, functional loss Maximized cardiopulmonary function Maintain / improve BMI Faster recovery post treatment LeslieWaltkePT.com
19 Benefits to Medical Team Fewer ED Visits Shorter hospital LOS Decreased re-admits Fewer falls Improved chemotherapy delivery rate Better performance status Maximize BMI, EF Increased revenue LeslieWaltkePT.com
20 Cancer Rehabilitation NCCN recommends rehab begin at diagnosis ACS recommends minutes of aerobic exercise and 2-3 days of strengthening LeslieWaltkePT.com
21 Cancer Rehabilitation Best Practice Immediate encouragement to increase activity and exercise Post operative rehabilitation Rehabilitation and oversight during and after chemotherapy Rehabilitation and oversight during and after radiation Survivorship care End of life care LeslieWaltkePT.com
22 Who needs a cancer rehab consult? Persons who have had cancer surgery Persons having chemotherapy Persons having radiation LeslieWaltkePT.com
23 LeslieWaltkePT.com
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25 What does this patient look like? 47 yo female Stage IIB (R) breast CA triple negative s/p neoadjuvant Adriamycin, Cytoxan, Taxol 16 weeks s/p (R) modified radical mastectomy, (L) prophylactic simple mastectomy with SLNB (B) tissue expanders; over expanded 6 weeks s/p (R) chest wall radiation LeslieWaltkePT.com
26 Let s stop treating these people like they re going to break! esliewaltkept.com
27 Photo credit: Bigstockphoto Lung cancer
28 LeslieWaltkePT.com Lung Cancer Surgery
29 Post Surgical Lung Cancer Rehabilitation Treatment of: pain, flexibility, tissue tightness, ROM, weakness Purpose eliminate pain Restore full strength at chest / shoulders Restore full ROM at rib cage, chest and shoulders restore pre-operative function educate on long term and late effects LeslieWaltkePT.com
30 LeslieWaltkePT.com Source: Diseases of the breast Published by Lippioncott - Raven
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35 Rehabilitation and Chemotherapy Treatment with: cardiopulmonary and strength prescription Purpose: decrease fatigue decrease pain maintain treatment schedule decrease osteopenia, sarcopenia maintain BMI improve/maintain EF minimize nausea, anxiety & depression LeslieWaltkePT.com
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40 Rehabilitation and Radiation Treatment with Manual therapy, cardiopulmonary exercise, strengthening Purpose Minimize, eliminate fatigue Restore ROM, flexibility, strength and function Reduce risk of late stiffness, pain and weakness LeslieWaltkePT.com
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43 Rehabilitation & Survivorship Treatment of: Bone density Effects of neuropathy Pain/Fatigue Muscle weakness Weight management Continued cardiopulmonary and strength exercise Post radiation fibrosis LeslieWaltkePT.com
44 Team Phoenix Survivorship Redefined LeslieWaltkePT.com
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46 Rehabilitation & End of Life Treatment of: Balance and gait safety Maintain independent ADLs Pain/Fatigue Muscle weakness Continued cardiopulmonary and strength exercise LeslieWaltkePT.com
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50 Key Points Rehabilitation is evidence based third party reimbursed medical treatment If patients will under go surgery, chemotherapy, radiation a rehab consult is warranted Important for all stages of disease Survivorship is much too late to start LeslieWaltkePT.com
51 Take home points Cancer Rehab has been shown to: improve quality of life lengthen life save lives So
52 Leslie s motto: If you have to be bald
53 I want you bald, smiling and sweating!
54 Thank You! LeslieWaltkePT.com
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