Cancer Rehabilitation

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Cancer Rehabilitation Improving Outcomes in Lung Cancer Dr. Leslie J. Waltke April 6, 2016

Leslie J. Waltke, PT, DPT System Cancer Rehabilitation Coordinator Aurora Health Care 945 N. 12 th Street Milwaukee, WI 53201 (414) 219-7193

LeslieWaltkePT.com leslie@lesliewaltkept.com 414-322-8033 Rehabilitative Treatment for the Patient with Cancer April 16 & 17 North Chicago

weakness fatigue walking problems numbness & tingling pain limited motion balance problems LeslieWaltkePT.com - 414-322-8033

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 - 414-322-8033

FACT: A majority of persons undergoing treatment for cancer will experience physical, physiological and functional decline. LeslieWaltkePT.com - 414-322-8033

FACT: Rehabilitation may reduce, eliminate or prevent symptoms associated with cancer treatment. LeslieWaltkePT.com - 414-322-8033

Cancer Rehabilitation From diagnosis to survivorship Evaluation and Treatment of: musculoskeletal, cardiopulmonary and functional impairments LeslieWaltkePT.com - 414-322-8033

I love cancer rehab!

LeslieWaltkePT.com - 414-322-8033

LeslieWaltkePT.com - 414-322-8033

LeslieWaltkePT.com - 414-322-8033

LeslieWaltkePT.com - 414-322-8033

LeslieWaltkePT.com - 414-322-8033

LeslieWaltkePT.com - 414-322-8033

LeslieWaltkePT.com - 414-322-8033

LeslieWaltkePT.com - 414-322-8033

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 - 414-322-8033

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 - 414-322-8033

Cancer Rehabilitation NCCN recommends rehab begin at diagnosis ACS recommends 60-180 minutes of aerobic exercise and 2-3 days of strengthening LeslieWaltkePT.com - 414-322-8033

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 - 414-322-8033

Who needs a cancer rehab consult? Persons who have had cancer surgery Persons having chemotherapy Persons having radiation LeslieWaltkePT.com - 414-322-8033

LeslieWaltkePT.com - 414-322-8033

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 - 414-322-8033

Let s stop treating these people like they re going to break! esliewaltkept.com - 414-322-8033

Photo credit: Bigstockphoto Lung cancer

LeslieWaltkePT.com - 414-322-8033 Lung Cancer Surgery

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 - 414-322-8033

LeslieWaltkePT.com - 414-322-8033 Source: Diseases of the breast Published by Lippioncott - Raven

LeslieWaltkePT.com - 414-322-8033

ltkept.com - 414-322-8033

LeslieWaltkePT.com - 414-322-8033

LeslieWaltkePT.com - 414-322-8033

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 - 414-322-8033

LeslieWaltkePT.com - 414-322-8033

LeslieWaltkePT.com - 414-322-8033

LeslieWaltkePT.com - 414-322-8033

LeslieWaltkePT.com - 414-322-8033

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 - 414-322-8033

LeslieWaltkePT.com - 414-322-8033

LeslieWaltkePT.com - 414-322-8033

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 - 414-322-8033

Team Phoenix Survivorship Redefined LeslieWaltkePT.com - 414-322-8033

LeslieWaltkePT.com - 414-322-8033

Rehabilitation & End of Life Treatment of: Balance and gait safety Maintain independent ADLs Pain/Fatigue Muscle weakness Continued cardiopulmonary and strength exercise LeslieWaltkePT.com - 414-322-8033

LeslieWaltkePT.com - 414-322-8033

LeslieWaltkePT.com - 414-322-8033

LeslieWaltkePT.com - 414-322-8033

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 - 414-322-8033

Take home points Cancer Rehab has been shown to: improve quality of life lengthen life save lives So

Leslie s motto: If you have to be bald

I want you bald, smiling and sweating!

Thank You! LeslieWaltkePT.com - 414-322-8033