The Oncological Rehabilitationaims to optimize the quality of life of the cancer patient, helping the patient and his family to adapt to living standards as close as possible to those preceding the disease, with the aim of minimizing physical disability, functional and psychological deficits, which often occur as a result of cancer or related therapies.
The disabilities presented by cancer patients are varied and complex and manifest themselves on a physical, relational, psychological and social level; the objectives are therefore different in relation to the patient, the type of neoplasm, the stage, the stage of the disease, the comorbidities, the family and social context.
Due to the diversity of the pathological conditions, the variety of the natural history of the disease and the multiplicity of the possible outcomes, the multi-specialized team of Oncological Rehabilitation will structure and modulate the Individual Rehabilitation Project based on the stage and evolution of the disease, to the type and concomitance of complications arising, the expectations and motivation of the patient and his family.
In the reality of our Institute, patients can access the oncological rehabilitation program:
- in the post-intervention phases (be it surgical, chemotherapeutic or radiotherapeutic), when the Individual Rehabilitation Project aims to optimize functional recovery, reduce hospitalization times, allow better tolerability of the treatments to be implemented, favor the restoration of psychological well-being and the reintegration of the patient in its socio-family context.
- during the course of the neoplastic disease, when situations arise which may benefit from a rehabilitative intervention.
Some examples of indications are:
- loss of autonomy in daily activity
- difficulty walking
- pain (post-surgery, post-radiotherapy, post-chemotherapy)
- impairment of speech and swallowing
- neurological impairments
- inactivity syndrome / asthenia (fatigue syndrome).
The settings used for rehabilitation treatment are those specific to rehabilitation:
admission under the ordinary hospitalization regime, complex outpatient macro-activities and outpatient services
The rehabilitation process is based on 3 pillars:
- physical activity
- psychic balance
Physical activity includes group therapy and individual sessions with the physiotherapist. It is based on muscle strengthening and the gradual recovery of physical resistance through training in the gym and, when indicated, even in the pool. In individual sessions the therapist treats any pain and symptomatic areas due to various types of mobility deficits.
The nutritional status is evaluated by the specialist doctor and the diet is best adapted to the patient’s needs. Particular attention is given to the re-education of patients with nasogastric tube for tumors of the cervico-cephalic district.
In agreement with the patient, individual interviews with a psychologist can be arranged and the opportunity to participate in relaxation sessions is offered.
The flexibility of therapeutic pathways is one of the characteristics of oncological rehabilitation. The neoplastic disease rarely presents conditions of stability and when the clinical status changes it is advisable to modify the treatment plan by re-evaluating the rehabilitative interventions in relation to the new disabilities, taking into account the person as a whole, his general state, the type of cancer, the specific therapeutic options and general prognostic indices.
This is made possible and guaranteed by the multi-specialist team of the Oncological Rehabilitation of our Institute, which provides for the presence of various professional figures: the physiatrist, the medical oncologist, the internist, the palliator, the physiotherapist, the speech therapist, the nutritionist, the psychologist and other organ specialists (cardiology, neurology, pneumology).
The rehabilitation of the person with a disability due to neoplastic disease
by the Working Group of the Section S.I.M.F.E.R. of Oncological Rehabilitation – Activity and participation in the person with disability due to neoplastic disease.
M. P. SCHIERONI, S. STERZI, M. PINTO, M. CARLONE
with the collaboration of: F. Coppadoro, F. Gariboldi, M. Maselli, F. Pessina, I. Springhetti