TOPIC:
Why Physical Therapy?
After my lumpectomy and the removal of several lymph nodes, Dr. Nancy Taft recommended that I receive physical therapy. The medical purpose was to prevent lymphedema, the swelling of the hand and arm that can occur after the removal of any lymph nodes.
Having now completed chemotherapy, Herceptin, radiation and my course of physical therapy, I can state without hesitation that physical therapy helped me successfully complete treatment in other ways, in addition to preventing lymphedema. Not everyone will encounter the same issues I did during treatment, but whatever issues arise during chemotherapy, physical therapists are likely to be able to provide information, resources, assistance, and specific strategies to help.
When looking for physical therapy providers, ask to be referred to a therapist that has expertise in what you are dealing with such as breast cancer/prevention of lymphedema or general weakness. They can even help with things like urinary incontinence by helping you strengthen the pelvic floor muscles.
If after therapy starts, you do not feel comfortable with your assigned therapist for any reason, ask to try another therapist. This is often done and is not a problem. Sometimes therapists themselves will suggest a different personality or communication style “match.”
Be sure to find a provider that accepts what your insurance considers “reasonable and customary” payments so that you will not have to pay out of pocket for the difference between the amount billed and amount covered by your plan.
Communication with a physical therapist is KEY. Let the therapist know how you feel and what you can tolerate so that they can manage an individualized program that best meets your needs. They cannot know and address what you are experiencing until you tell them. Each of us responds differently, so we need to share our unique experience with our physical therapist.
The therapists were very knowledgeable about how to deal with some of the expected and unexpected side effects of chemotherapy and radiation. Having treated many people in chemotherapy, they were a wealth of knowledge regarding physical, mental, and emotional changes.
I attended physical therapy through a provider that has an all-woman environment. This is one option some women may want to pursue. The “women’s only” environment promoted the sharing of information between therapists and patients. I was able to meet other women who were fighting cancer and communicate in an open environment. I had fewer concerns about my appearance than I might have had if men were there!
Here are some of the direct benefits of physical therapy that I experienced:
Balance issues. These issues can lead to instability on stairs or in crowds. My therapist addressed balance issues as soon as I mentioned them. Within weeks, I no longer experienced balance issues and had simple and effective exercises to do if balance problems came back.
Safety issues. As your body changes, your therapists re-evaluate your functioning and help address these changes and prevent injuries such as falls.
Treatment of Pain. Chemotherapy can bring back pain from older issues. When an old hip injury came back causing pain when walking up stairs and keeping me awake at night, my physical therapy team addressed it immediately. During the course of my therapy, whenever pain occurred in my body, the physical therapist addressed it until the pain was lessened or gone. Sometimes this took several visits, but pain relief was always obtained and most of the time I did not have to take medication for pain.
Functionality. My level of functionality doing my daily life activities was very good during chemotherapy because of physical therapy. When it became difficult for me to do an activity of daily living, my therapist would give me strengthening/stretching activities to do and help me use temporary accommodations or adaptations so I would still be able to do most activities of my daily life. Many people including my oncology nurses commented on how functional I remained during the course of chemotherapy. Thank you, physical therapists!
Pelvic floor issues. Chemotherapy can cause a weakening of the pelvic floor. This can result in various levels of daytime or nighttime incontinence, such as leaking urine. Physical therapists can teach pelvic floor strengthening activities that can prevent or treat incontinence issues.
Safe strengthening. Your therapist will be able to guide you to do as much safe strengthening as you can so that at the end of chemotherapy, your do not feel as weakened as you would without the physical therapy treatments and guidance.
My Team. My physical therapist and physical therapy aide became members of my treatment team. They were always glad to see me, offering encouragement and support. They adapted the activities of each session based on my physical condition, specific issues, my emotional state and my energy level that day. They were great “cheer leaders” for me. At therapy sessions, I was able to do more strengthening, stretching and aerobic activity than I was able to do at home by myself. Their experiences with many people with various types of cancer kept them realistic in their coaching and support. I always felt physically, emotionally and mentally improved after a physical therapy session.
Prevent Lymphedema. Lymphedema can occur in anyone who has had lymph nodes removed. It can occur any time during the person’s lifetime. Physical therapy helped “loosen” my upper body, especially on the side of my lumpectomy, and increased the flow of lymph material so it would leave my body more normally. I learned simple physical movements and deep breathing techniques to help prevent lymphedema in the future. To date (2023) I have had no signs or symptoms of lymphedema.
Be sure to talk to your oncology team and ask to start seeing a physical therapist as soon as possible!