Rehabilitation can significantly improve a cancer patient’s quality of life by helping to alleviate pain and reduce fatigue, among many other benefits. A comprehensive review of rehabilitation guidelines has identified dozens of scientific recommendations for people with specific cancers and side effects, according to researchers at the West Virginia University (WVU) School of Public Health and Cancer Institute.
However, there is a discrepancy between rehab recommendations and what most doctors actually do, the researchers noted. In the vast majority of cases, doctors don’t refer their cancer patients to rehab services.
For their analysis, researchers evaluated rehabilitation recommendations included in cancer treatment guidelines globally. They identified 69 unique high-quality evidence-based guidelines for the management of specific cancers (including breast, prostate, head and neck, lung and thyroid) and cancer- and treatment-related symptoms.
However, few oncologists follow these guidelines. According to Nicole Stout, DPT, a research assistant professor with the WVU School of Public Health and Cancer Institute, other studies have found that only between 2% and 9% of cancer patients with functional impairments have been referred to rehab, suggesting such services are very underutilized. Functionality refers to the ability to think, speak, move and carry out the countless other activities that make up daily life.
Stout believes one possible reason rehab services are underutilized is that the medical field has become better at diagnosing and treating cancer. Fifty years ago, she notes, many people didn’t survive a cancer diagnosis. Today, more than 70% of people diagnosed with cancer will live beyond five years, but care hasn’t keep pace. It’s no longer good enough to tell these folks that they will have to live with pain and fatigue for the rest of their lives when rehabilitation can help them, said Stout.
The goal is to get more doctors to follow these guidelines. To that end, the World Health Organization (WHO) has launched its Rehabilitation 2030 initiative to identify rehabilitation-specific recommendations in a variety of medical disciplines, including oncology. The current study, published in CA: A Cancer Journal for Clinicians, contributes to that initiative.
The WHO will then compile all these guidelines into a tool kit that will serve as a single, trustworthy source and increase the chances that doctors will refer their patients to rehab services.
Even with this in mind, Stout encourages patients to advocate for themselves.
“I encourage patients to not just ask, ‘Do you think we should do something about this swelling I’m having?’” said Stout. “They need to tell their physician, ‘I’m having swelling. I need a referral to see a rehabilitation specialist.’ And you know what? The doctor and the nurse, they’ll do it.”
For related coverage, read “Cancer Rehabilitation” and “Phone-Based Rehab Helps People With Advanced Cancer Stay Independent.”