Pelvic Cancer Rehab 

Gynecological, Male Reproductive and Urological Cancers Rehab is Impactful At Any Stage or Age!

 

Pelvic cancer is an umbrella term that includes all gynecological, reproductive and urological cancers such as uterine cancer, ovarian, cervical, prostate, testicular and bladder cancer to name a few. These cancer types are often complex involving treatment pathways that may involve diagnostics such as retroperitoneal or visceral lymph node dissection. Treatment may also include surgeries such as debulking, hysterectomies, salpingo-oophorectomy ). Other treatments may follow or come prior to surgery such as chemotherapy; Taxol, Carboplatin or HIPEC (hyperthermic intraperotineal chemotherapy) to name a few. Radiation may also be part of the treatment pathway taking the form of brachytherapy or external radiation. Targeted therapies such as Avastin or Lynparza, immunotherapies such as Keytruda or hormone therapies such as aromitase inhibitors (Anastrozole, Letrozole) may also be included in your treatment regime. Further blood testing for biomarkers and genetics such as HBOC genes (BRCA1/2) or Lynch genes (MLH1, MSH2, MSH6, EPCAM amongst others) may be offered to better personalize your treatment plan, include risk assessment of family within the genetic line and provide probability of other cancers.

 

Each stage of treatment may cause a variety of symptoms such as fatigue, mucosal irritation, cardio-toxicity, peripheral neuropathies, inflammation of various viscera, bladder/bowel changes and joint pain amongst many others others.

Patients benefit immensely from a comprehensive rehabilitation plan specific to the patient's health history and cancer type, stage and grade. Your rehab team should include more than just a radiation and medical oncologist; an oncology rehab therapist is a key care team member to help you best manage any physical symptoms that come as a consequence to treatment. Together we discuss functional concerns, symptoms and touch on salient goals; our aims is to help you feel a sense of control. Furthermore, I am familiar with the oncology resource landscape in BC and can refer to within your community for additional support when needed. I offer evidence rich rehab plans for any pelvic cancer type, promoting better outcomes and accessible clinical support. We can work together to provide a rehab plan specific to you!

 

 

I offer specialized rehab plans and support with:

  • pre-operative planning for all surgeries

  • comprehensive post-operative rehab planning i.e: 

        biopsy/dissection, 

  • comprehensive radiation management

  • comprehensive chemotherapy management

  • chemotoxicity management

  • peripheral neuropathies, cording, long thoracic nerve palsy, scapular dyskinesia, adhesive capsulitis, cancer related fatigue and other symptoms.

  • arm/breast lymphedema risk management 

  • safe exercise prescription/return to activity  despite functional limitations or symptoms.

  • dry needling and safe manual therapy for the breast oncology population

  • patient self-management tools and education

  • long term screening and monitoring (bone and joint health etc.); supporting patient advocacy for changing care pathways

"Nadine has been invaluable throughout my treatment for breast cancer and my recovery. Her expertise and support helped me through surgery, chemo, radiation, cancer-related fatigue and now we are working a gradual return to work plan. She is wonderfully kind and understanding and works from the heart. I am very glad to have her as my physio and as part of my health team!" -Beth

STAGES OF REHABILITATION

     Most breast cancer journeys have a general treatment pathway and fall into one of three treatment phases, each in which a personalized rehabilitation can help. Often the symptom burden can be very heavy and remain untreated; and at times post treatment you are expected to jump back to work and life. Education is power, rehab plans work and together we can find tools that help you feel better

PREHAB/PRE-TREATMENT PHASE

     The prehab phase starts immediately after diagnosis prior to treatment; a rehab plan has important impact here. Diagnostics can involve blood work (cancer markers or signs of inflammation), a tissue biopsy and/or detailed imaging. Often your medical oncology team will obtain information as to whether your cancer is estrogen, progesterone or HER 2 positive. At times a genetics assessment is also warranted to determine whether susceptibility genes are involved. Starting rehabilitation in prehab can lessen hospital stays, improve post-operative outcomes and simply provide patients a sense of control right from the start.

TREATMENT PHASE

     The treatment phase often varies, for some it starts with a mastectomy or lumpectomy, for others it starts immediately with systemic chemotherapy, this is often when patient's start noticing a symptom burden. Depending on the tissue type, staging, grading and cell cycle a personalized treatment plan will be discussed with your medical oncology team. The need for a personalized rehab plan according to your cancer stage, type and treatment stage is vital here.

 

 

 

 

     Systemic chemotherapies cause mylosuppression and may cause toxicity, neuropathies and fatigue to some degree. Targeted chemotherapies work more specifically on receptor blockers, enzyme inhibition or cell membrane infiltration but they too may cause symptoms. Unfortunately, the treatment phase is coupled with many burdening symptoms. A rehabilitation plan promoting joint health, cardiorespiratory health and energy conservation can be very effective through out this stage to get you feeling better!

     The treatment stage can further involve radiation and hormone therapy. Mobility of the shoulder is vital through-out and post radiation to optimize tissue extensibility while in the proliferation phase of healing, along with preventing the onset of radiation fibrosis. This risk continues through our radiation to 2 months post, so once again rehabilitation has a vital role in radiation to maintain tissue extensibility and promote manageable scarring. There are many tools that you can use to promote self management and optimize your outcomes through out this stage. 

     Hormone therapy is in itself yet another stage that can come with a very personal experience of symptoms. Together we can work to manage fatigue, joint arthralgia and better sleep hygiene just to name a few of the individual symptoms you may experience.

RETURN TO WORK/ACTIVITY

 

     This is an exciting stage but often patients find themselves stuck here. Sometimes the focus on survivorship and treatment can mean that rehabilitation was put a side and once treatment is over, you may be left with unmanaged symptoms and feeling a bit alone. Returning to work or activity may seem like a daunting task when you are feeling de-conditioned or left with complications from treatment. Together we can work with your insurance provider to create a manageable graded return to work providing the needed documentation. Or perhaps your goal is a personal rehab plan for return to your favourite sport. Often push crash cycling and pain can hinder progress; but together we can get you moving safely; and best managing symptoms.

 

 

 

     Despite any stage of treatment and any type of breast cancer, I care. I hope you feel that you can reach out as you are and I will meet you there. Together we can get you feeling just a bit more like yourself again where ever you are at in your cancer journey.

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