Authors (including presenting author) :
Lee YT(1), Chan W (2) , Mak MY (1)
Affiliation :
(1)Department of Physiotherapy, Tuen Mun Hospital, (2)Department of Clinical Oncology, Tuen Mun Hospital
Introduction :
Many cancer survivors experience cumulative cancer and cancer treatment related morbidity burden. They may be left with long-term physical and functional sequelae even after their malignancy are treated. Cancer rehabilitation mitigates the adverse effects of cancer and its treatment. It helps to maintain or restore function, reduce symptom burden, maximize independence and improve quality of life in this medically complex population. However, these potential benefits have not been fully realized and cancer rehabilitation is also not well integrated into oncology care into oncology clinical practice.
Objectives :
Based on available evidence and current trends in cancer rehabilitation published in the literature, an attempt is made to (1) review the latest evidence of cancer rehabilitation (2) describe the service gaps of cancer rehabilitation in HA and (3) highlight the enablers and barriers to the implementation of cancer rehabilitation.
Methodology :
PubMed and Google Scholar databases were searched using the following keywords and their combination: “cancer”, “rehabilitation”, “exercise”, “training”, “effect”, “framework”, “barrier”. Reference lists of selected publications were also hand searched for any other relevant articles. Only articles that were peer-reviewed, published in the last 10 years, and in English were selected for review. Information regarding the current local practices of cancer rehabilitation was gathered from Specialty Group on Oncology and Palliative Care under Physiotherapy Central Coordinating Committee meeting in 2018.
Result & Outcome :
Result: For the period of 2008 to 2018, 56 relevant articles were identified. Current evidence supports the beneficial effects of exercise before, during, and after cancer treatment, across all cancer types, and for a variety of cancer-related impairments. However, current cancer rehabilitation service is under-developed in HA when compared with the recommendation. In general, prehabilitaiton is sparse. Exercise training program for the patient during the course of anti-cancer treatment is lacking. The opportunity of intensive inpatient or outpatient rehabilitation training after acute cancer care is limited. Exercise program for long-term cancer survivor is inadequate. To facilitate cancer rehabilitation, appropriate and timely use of screening protocols and tools are suggested. Triggering rehabilitation referral by procedures, diagnoses, or threshold scores may also be considered. The barriers to integrating rehabilitation into oncology care include 1. Insufficient capacity of the existing workforce 2. Challenges in screening for rehabilitation needs 3. Lack of awareness of the benefits of rehabilitation among patients and caregivers. Other barriers reported in literature related to the clinicians include: inadequate training or exposure to rehabilitation interventions, focusing solely on cancer treatment, believing that effective treatment alone will reverse disablement, too busy to single out rehabilitation issues. Conclusions: There has never been a more urgent need to integrate rehabilitation into the oncology care continuum for improving health outcome of cancer survivors. Cancer rehabilitation is suggested to be embedded as part of standard practice in cancer care.
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