Patients diagnosed with breast cancer pose a welcome challenge to licensed therapists in that no two patients are alike. They do not undergo the same exact surgical procedure. They do not receive the same exact physician follow-up care. And they do not present with the same post-surgical underlying impairments. Therapy rehabilitation potential and treatment options are based upon the type and stage of breast cancer; lumpectomy vs. mastectomy, radiation vs. chemotherapy, breast tissue involvement vs. mammary duct vs. lymph node, depression vs. anxiety vs. positive mental attitude, physically active vs. inactive.

Whether a patient undergoes a radical mastectomy followed by chemotherapy and radiation with resultant post-surgical lymphedema or has a small lumpectomy with no need for radiation or chemotherapy, all can benefit from therapy services. Some patients will have obvious impairments that include upper extremity range of motion deficits, strength deficits, lymphedema and activities of daily living functional deficits, while others may not be as obvious. Some patients may develop extreme fatigue or postural changes or excessive scar tissue in the surgical region, which can then create glenohumeral and scapulothoracic dysfunction leading to potential rotator cuff pathology.

In a recent meta-analysis of studies involving over 3 million participants, it was concluded that not only does physical activity (PA) reduce cancer mortality, but the mortality risk decreases as the amount of PA goes up—and the effects seem to be even greater for individuals who have been diagnosed with cancer. The researchers determined that in the overall population, following the minimum recommendations of 2.5 hours per week of moderate intensity PA (equivalent to 7.5 metabolic equivalent of task h/week), led to a 13% reduction in cancer mortality. Cancer survivors undertaking the highest level of physical activity had a 22% reduction in cancer mortality.

In further analysis of breast cancer survivors, the researchers pinpointed differences among PA levels.

“Compared with no recreational activity, 5, 10, 15, and 20 MET-h/week of pre-diagnostic [physical activity] reduced breast cancer mortality by 24%, 28%, 29%, and 30% respectively…Meanwhile, breast cancer mortality reduced by 24%, 32%, 39%, and 40% when individuals participated in the [same levels of MET-h/week] after diagnosis.”

What does this all mean? Get your patients physically active!

My mother is a testament to post-cancer activity. She survived 20 years after being diagnosed with stage 4 metastasizing breast cancer, undergoing multiple surgeries, chemotherapy, radiation, lymphedema, loss of left arm function…you name it. Her doctors initially gave her 6 months. It wasn’t that she loved exercise. She was just very stubborn and refused to give up; she kept active. She also listened to her physical therapists…her daughter and another colleague.

Amazing results can occur by addressing all underlying impairments and simply getting our patients more physically active whether they are pre-cancerous or cancer surviving. Activity becomes an issue of survivability. No professional is more knowledgeable and skilled than licensed occupational or physical therapists when it comes to prescribing safe and effective physical activity programs. Therapy gave my mom more years than any physician could have imagined.

Read the referenced article abstract here: http://www.ncbi.nlm.nih.gov/pubmed/26385207