Toward a National Initiative in Cancer Rehabilitation: Recommendations From a Subject Matter Expert Group

Abstract

The health care delivery system in the United States is challenged to meet the needs of a growing population of cancer survivors. A pressing need is to optimize overall function and reduce disability in these individuals. Functional impairments and disability affect most patients during and after disease treatment. Rehabilitation health care providers can 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. However, few care delivery models integrate comprehensive cancer rehabilitation services into the oncology care continuum. The Rehabilitation Medicine Department of the Clinical Center at the National Institutes of Health with support from the National Cancer Institute and the National Center for Medical Rehabilitation Research convened a subject matter expert group to review current literature and practice patterns, identify opportunities and gaps regarding cancer rehabilitation and its support of oncology care, and make recommendations for future efforts that promote quality cancer rehabilitation care. The recommendations suggest stronger efforts toward integrating cancer rehabilitation care models into oncology care from the point of diagnosis, incorporating evidence-based rehabilitation clinical assessment tools, and including rehabilitation professionals in shared decision-making in order to provide comprehensive cancer care and maximize the functional capabilities of cancer

Implementing physical activity programs for patients with cancer in current practice: patients’ experienced barriers and facilitators

“…To improve the uptake of physical activity of patients with cancer, evidence-based guidelines recommend the implementation of physical activity programs or other initiatives to improve the uptake of physical activity during and after cancer treatment [6, 30–36]. However, it appears that the current uptake of physical activity programs is low [37–40] and widespread implementation is lacking [41].…”

Follow the trail: Using insights from the growth of palliative care to propose a roadmap for cancer rehabilitation

“…Rehabilitation services have the potential to reduce the functional limitations experienced by cancer survivors . Cancer rehabilitation is a multidisciplinary field (including, but not limited to, physical medicine and rehabilitation physicians, physical and occupational therapists, speech and language pathologists, exercise scientists, rehabilitation psychologists, and nurses) with the goal of optimizing physical, social, emotional, and vocational functioning despite the challenges created by cancer or its treatment .…”

Changing health behaviour with rehabilitation in thoracic cancer: A systematic review and synthesis

“…Despite their illness, people with thoracic cancer want to “carry on as before,” “live as usual,” and “fulfil social and family roles for as long as possible” . Cancer rehabilitation aims to relieve symptom burden and prevent or delay the onset of disability, supporting people to remain active and independent . It is recommended that rehabilitation, such as exercise or interventions to support independent symptom management and self‐care, be integrated into the oncology treatment pathway starting from the point of diagnosis .…”

“…Cancer rehabilitation aims to relieve symptom burden and prevent or delay the onset of disability, supporting people to remain active and independent . It is recommended that rehabilitation, such as exercise or interventions to support independent symptom management and self‐care, be integrated into the oncology treatment pathway starting from the point of diagnosis . The acceptability of rehabilitation interventions to patients with thoracic cancer is influenced by many factors including, the stage of disease, symptoms, comorbidities, cancer treatment intensity and overall health status.…”