Rehabilitation of Cancer Survivors with Long-Term Toxicities

Abstract

The prognosis of cancer patients is constantly improving, which increases the importance of securing long-term quality of life. While therapy of treatment-related disability mostly succeeds a cancer-specific treatment, physicians' awareness of simultaneous supportive therapy is rising. Early interventions such as physical exercise during chemotherapy are effective in reducing conditions such as fatigue. Specific sensorimotor training is able to improve or even prevent impairment of balance caused by neurotoxic agents. Although targeted therapies reduce the risk of side effects, combinations with established drugs have to be monitored with regard to cardiotoxicity, which is already a concern in children's cancer therapy and is now also focused on in long-term adult survivors. Improvement in diagnosis und surgical procedures have reduced impairments such as lymphedema. Furthermore, management and quality of life of breast cancer patients benefit from evidence showing that physical exercise and resistance training do not increase the risk of developing lymphedema.

Physical function measurement in older long-term cancer survivors

“…Deficits in functioning and global health are described in long-term colorectal cancer survivors with more impairment with advanced age[ 11 ]. Other symptoms reported across long-term survivors[ 12 ] include chronic pain, fatigue[ 13 ], and, for those who received chemotherapy interventions, peripheral neuropathy[ 14 ], all of which influence overall physical function, balance, and mobility. Additional evidence suggests that physical inactivity is associated with low health-related quality of life in long-term cancer survivors with increased comorbidity and further highlights the need for survivorship care that goes beyond the time of active treatment of the disease and rehabilitation[ 15 ].…”

Toxicity-induced modification of treatment: what is in a name?

“…Severe, acute toxicities inevitably have clinical consequences such as hospitalization or modification of the treatment schedule, which in its turn may deteriorate prognosis (2,3). Moreover, some toxicities can persist far beyond active treatment and can impact, to a greater or lesser extent, quality of life and the ability to function of cancer patients (4,5).…”

Physical interventions for patients suffering from chemotherapy-induced polyneuropathy

“…Most cancer survivors are able to benefit from cancer rehabilitation, including interventions to improve physical performance, nutrition, mental health, and pain control [1][2][3][4][5][6]. Successful cancer rehabilitation efforts enable many patients to increase their participation at work, improve active daily living and to return to work [2,5], and risk of cancer mortality and recurrence have been shown to be lowered.…”

“…Cancer rehabilitation normally includes informational support, psychosocial oncology interventions, nutrition counseling, and physical therapies and modalities like regular physical activity and (medical) exercise. Self-management interventions for patients are also important and necessary in order to improve patients' adherence to cancer rehabilitation initiatives [1][2][3][4][5].…”