Most National Cancer Institute-Designated Cancer Center Websites Do Not Provide Survivors with Information About Cancer Rehabilitation Services

Silver, Julie K.; Raj, Vishwa S.; Fu, Jack B.; Wisotzky, Eric; Smith, Sean R.; Knowlton, Sasha E.; Silver, Alexander J.

doi:10.1007/s13187-016-1157-4

Cited by 27 publications

(18 citation statements)

References 14 publications

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“…The lack of information about cancer rehabilitation services provided by oncologists and medical centers has not helped this issue. A recent study evaluating the existence and quality of patient‐related cancer rehabilitation content on the websites of the National Cancer Institute (NCI)−designated cancer canters found that 69% had no description of cancer rehabilitation services on their website [20]. A total of 21% required a search to find a description of cancer rehabilitation services, and only 10% had an easily identifiable link.…”

Section: Discussionmentioning

confidence: 99%

The Underutilization of Rehabilitation to Treat Physical Impairments in Breast Cancer Survivors

Stubblefield

2017

PM&R

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Breast cancer survivors can experience multiple neuromuscular, musculoskeletal, pain, and functional disorders as a result of their cancer and its treatment. Common disorders include shoulder dysfunction, postmastectomy syndrome, chemotherapy-induced peripheral neuropathy, axillary cording, lymphedema, and a host of others. Cancer rehabilitation is a process that helps breast cancer and other survivors to obtain and maintain the highest possible physical, social, psychological, and vocational functioning within the limits created by cancer and its treatments. There are good data supporting the safety and efficacy of cancer rehabilitation in the treatment of many breast cancer-related impairments, including shoulder dysfunction and lymphedema, among others. Despite the goals and efficacy of cancer rehabilitation, there is a marked underuse of services. The reasons for this phenomenon are many, but broadly result from a lack of knowledge about cancer rehabilitation on the part of patients and referring clinicians, limited access to services, and suboptimal adherence. This article explores underutilization of cancer rehabilitation in breast cancer survivors and provides an opportunity to consider ways to improve this gap in care.

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Section: Discussionmentioning

confidence: 99%

The Underutilization of Rehabilitation to Treat Physical Impairments in Breast Cancer Survivors

Stubblefield

2017

PM&R

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“…Unfortunately, there are no requirements for provision of rehabilitation services as a requirement or recommendation for obtaining selection as a comprehensive cancer center. In fact, 75% of these centers do not mention rehabilitation on their Web site [47]. Many in the field believe this is a shortcoming of the designation.…”

Section: Seminal Authors and Early Models Of Cancer Rehabilitationmentioning

confidence: 99%

A Brief Historical Perspective of Cancer Rehabilitation and Contributions From the National Institutes of Health

Gerber

Hodsdon

Comis

et al. 2017

PM&R

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People who have cancer diagnoses often need care throughout their lives through all stages of their illness. These stages include diagnosis, primary treatment, survivorship, and end of life. The management of people with cancer, now a common and chronic illness with long-term survival improving, is complex, challenging, and rapidly changing. Rehabilitation for people with cancer diagnoses is a new specialty and is charged with providing care throughout the trajectory of illness and wellness to maximize potential for function and mitigate disability. Rehabilitation interventions include the application of physical and occupational therapeutics, speech and language interventions, and physical medicine in order to help patients reach their individual goals and to promote life satisfaction. The Department of Rehabilitation in the Clinical Center of the National Institutes of Health has pioneered this field through research and clinical care models over the past 40 years. Staff of this department has supported clinical research investigators at the National Institutes of Health in their exploration of new treatments using chemotherapies, surgery, radiation, and psychosocial interventions. They have also engaged in research specific to rehabilitation to devise and improve functional outcome measures, design exercise interventions, devise orthotics, and prosthetic devices for adaptation to functional loss. Collectively, the staff has published widely in oncology textbooks and professional journals in order to share findings and improve the quality of cancer rehabilitation treatment across the continuum of care.

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“…They could not see the value of OT/PT, even in light of GA‐defined deficits. These barriers reflect real‐world issues such as valid concerns of patients about cancer care cost, lack of awareness of the potential value of rehabilitation, and poor integration of rehabilitation services within cancer care . A better understanding of how to get past the first barrier to participation in rehabilitation, willingness to consider OT/PT, is an important consideration for future efforts to study and/or build an OT/PT program for older patients.…”

Section: Discussionmentioning

confidence: 99%

“…These barriers reflect real-world issues such as valid concerns of patients about cancer care cost, 39 lack of awareness of the potential value of rehabilitation, and poor integration of rehabilitation services within cancer care. 40,41 A better understanding of how to get past the first barrier to participation in rehabilitation, willingness to consider OT/PT, is an important consideration for future efforts to study and/or build an OT/PT program for older patients. And then, close to a third of patients were lost to follow-up, some for unavoidable reasons such as death or illness; others simply could not be contacted despite repeated labor-intensive efforts to reach them.…”

Section: Discussionmentioning

confidence: 99%

Older Adults with Cancer: A Randomized Controlled Trial of Occupational and Physical Therapy

Pergolotti

Deal

Williams

et al. 2019

J American Geriatrics Society

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OBJECTIVES The impact of occupational therapy (OT) and physical therapy (PT) on functional outcomes in older adults with cancer is unknown. DESIGN Two‐arm single‐institution randomized controlled trial of outpatient OT/PT. SETTING Comprehensive cancer center with two off‐site OT/PT clinics. PARTICIPANTS We recruited adults 65 years and older with a recent diagnosis or recurrence of cancer within 5 years, with at least one functional limitation as identified by a geriatric assessment. Participants were randomized to OT/PT or usual care. INTERVENTION Rehabilitation consisted of individualized OT and PT that addressed functional activities and strength/endurance needs. MEASUREMENTS Primary outcome was functional status as measured by the Nottingham Extended Activities of Daily Living scale. Secondary outcomes were Patient‐Reported Outcomes Measurement Information System‐Global Mental Health (GMH) and Global Physical Health (GPH), ability to participate in Social Roles (SR), physical function, and activity expectations and self‐efficacy (Possibilities for Activity Scale [PActS]). RESULTS Among those recruited (N = 63), only 45 patients (71%) were evaluable due to loss of follow‐up and/or nonreceipt of intervention. The median age was 74 years; 53% were female, and 91% were white. Overall, 30% patients had hematologic malignancies, 30% breast cancer, and 16% colorectal cancers. A total of 65% were in active treatment; 49% had stage 3 or 4 disease. At follow‐up, both OT/PT (P = .02) and usual care (P = .03) groups experienced a decline in functional status. PActS scores between groups (P = .04) was significantly improved in the intervention group. GMH and SR met criteria for minimally important clinical difference favoring the intervention, but not statistical significance. Several barriers were noted in the implementation of the intervention program: recruitment, concerns about cost, distance, scheduling, and limited treatment provided. CONCLUSION OT/PT may positively influence activity expectations and self‐efficacy. Future research needs to address significant barriers to implementation to increase use of OT/PT services and access to quality care. J Am Geriatr Soc 67:953–960, 2019.

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Most National Cancer Institute-Designated Cancer Center Websites Do Not Provide Survivors with Information About Cancer Rehabilitation Services

Cited by 27 publications

References 14 publications

The Underutilization of Rehabilitation to Treat Physical Impairments in Breast Cancer Survivors

The Underutilization of Rehabilitation to Treat Physical Impairments in Breast Cancer Survivors

A Brief Historical Perspective of Cancer Rehabilitation and Contributions From the National Institutes of Health

Older Adults with Cancer: A Randomized Controlled Trial of Occupational and Physical Therapy

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