Cancer Survivorship: A Growing Role for Physiatric Care

Smith, Sean R.; Reish, Andrew G.; Andrews, Cody

doi:10.1016/j.pmrj.2014.12.004

Cited by 15 publications

(8 citation statements)

References 10 publications

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“…This strategy helps capture symptoms as they arise, possibly reducing symptom burden and improving outcomes. Ultimately, assessments and recommendations for palliative care and rehabilitation services at the moment and in the future should be integrated into a patient's survivorship care plan [70].…”

Section: Advancing Collaborative Interdisciplinary Care Coordinationmentioning

confidence: 99%

Cancer rehabilitation and palliative care: critical components in the delivery of high-quality oncology services

Silver

Raj

et al. 2015

Support Care Cancer

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172

112

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Palliative care and rehabilitation practitioners are important collaborative referral sources for each other who can work together to improve the lives of cancer patients, survivors, and caregivers by improving both quality of care and quality of life. Cancer rehabilitation and palliative care involve the delivery of important but underutilized medical services to oncology patients by interdisciplinary teams. These subspecialties are similar in many respects, including their focus on improving cancer-related symptoms or cancer treatment-related side effects, improving health-related quality of life, lessening caregiver burden, and valuing patient-centered care and shared decision-making. They also aim to improve healthcare efficiencies and minimize costs by means such as reducing hospital lengths of stay and unanticipated readmissions. Although their goals are often aligned, different specialized skills and approaches are used in the delivery of care. For example, while each specialty prioritizes goal-concordant care through identification of patient and family preferences and values, palliative care teams typically focus extensively on using patient and family communication to determine their goals of care, while also tending to comfort issues such as symptom management and spiritual concerns. Rehabilitation clinicians may tend to focus more specifically on functional issues such as identifying and treating deficits in physical, psychological, or cognitive impairments and any resulting disability and negative impact on quality of life. Additionally, although palliative care and rehabilitation practitioners are trained to diagnose and treat medically complex patients, rehabilitation clinicians also treat many patients with a single impairment and a low symptom burden. In these cases, the goal is often cure of the underlying neurologic or musculoskeletal condition. This report defines and describes cancer rehabilitation and palliative care, delineates their respective roles in comprehensive oncology care, and highlights how these services can contribute complementary components of essential quality care. An understanding of how cancer rehabilitation and palliative care are aligned in goal setting, but distinct in approach may help facilitate earlier integration of both into the oncology care continuum-supporting efforts to improve physical, psychological, cognitive, functional, and quality of life outcomes in patients and survivors.

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Section: Advancing Collaborative Interdisciplinary Care Coordinationmentioning

confidence: 99%

Cancer rehabilitation and palliative care: critical components in the delivery of high-quality oncology services

Silver

Raj

et al. 2015

Support Care Cancer

Self Cite

172

112

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“…These serve as a way to inform patients about potential short- and long-term complications from cancer or its treatment, and explain how to obtain supportive care services [16]. Unfortunately, while SCPs increase the likelihood of patients attending follow-up visits, they do not appear to increase awareness about the late or long-term effects of cancer [17], and there is a lack of consensus on format and delivery of the plans [18].…”

Section: Introductionmentioning

confidence: 99%

“…Physiatrists and other rehabilitation providers are uniquely suited to manage neuromusculoskeletal and cognitive deficits in cancer survivors, and their involvement may reduce unmet rehabilitation needs in this population [16]. Improving function becomes all the more important when one considers that weight gain is a risk factor for cancer recurrence among those with no evidence of disease [79].…”

Section: Introductionmentioning

confidence: 99%

The Intersection of Oncology Prognosis and Cancer Rehabilitation

Smith

Zheng

2017

Curr Phys Med Rehabil Rep

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Purpose of reviewThis review examines the delivery of rehabilitation care to cancer patients with relation to disease prognosis. This includes the evaluation when patients are referred for rehabilitation services and the effectiveness of rehabilitation interventions across the cancer continuum.Recent findingsAlthough prognosticating life expectancy is difficult, referrals for rehabilitation interventions appear to be affected by physician attitudes towards patients with advanced disease, in part because of misconceptions about the nature of rehabilitation for oncology patients. Rehabilitation may also be underutilized in long-term survivors with no evidence of disease. Despite this, our review found that rehabilitation in advanced disease, end-of-life, geriatric cancer patients, and in long-term survivors can be beneficial. There is a relative dearth in studies on rehabilitation interventions specifically at the end-of-life.SummaryCancer rehabilitation can be helpful to patients along the spectrum of cancer prognoses. Examining more accurate ways to prognosticate life expectancy, improving communication and education between oncologists and rehabilitation team members, and modifying survivorship plans to include patient education on functional changes over time may improve the delivery of rehabilitation care.

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“…In 2015, a group of physiatrists from a variety of institutions across the US developed a modern definition for cancer rehabilitation aimed at clarifying some of the confusion: “Cancer rehabilitation is medical care that should be integrated throughout the oncology care continuum and delivered by trained rehabilitation professionals who have it within their scope of practice to diagnose and treat patients' physical, psychological and cognitive impairments in an effort to maintain or restore function, reduce symptom burden, maximize independence and improve quality of life in this medically complex population” [31]. Cancer rehabilitation physiatrists and other rehabilitation specialists have continued to educate colleagues about the role of the physiatrist [32], safety concerns in these complicated patients [33,34], and employment and disability issues in these patients [35,36].…”

Section: The Rise Of Survivorship Carementioning

confidence: 99%

Integrating Rehabilitation Into the Cancer Care Continuum

Silver

2017

PM&R

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Cancer Survivorship: A Growing Role for Physiatric Care

Cited by 15 publications

References 10 publications

Cancer rehabilitation and palliative care: critical components in the delivery of high-quality oncology services

Cancer rehabilitation and palliative care: critical components in the delivery of high-quality oncology services

The Intersection of Oncology Prognosis and Cancer Rehabilitation

Integrating Rehabilitation Into the Cancer Care Continuum

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