Physiotherapy management of lung cancer
Physiotherapy might not be your first thought if you are diagnosed with lung cancer, but a recent review of high-quality evidence on the subject shows that physiotherapists have much to offer this group of patients.
Dr. Catherine Granger from the University of Melbourne explains that common important symptoms of lung cancer include shortness of breath, cough, fatigue and pain. These often interfere with the ability to do usual daily activities. Because many of these symtpoms are triggered by exercise, many people respond to this situation by reducing their physical activity, which is problematic on several fronts. Patients lose their fitness and their muscle mass, which impairs their ability to exercise and do daily tasks even further. This also makes people less likely to tolerate their treatment well.
It is therefore unsurprising to learn that there is very strong evidence of the benefits of exercise-based rehabilitation in people with lung cancer. This can even occur as "pre-habilitation" - that is, during any waiting period that occurs before surgery if the cancer is operable, which many are. Exercise also helps to combat difficulty sleeping, which is another common symptom in people with lung cancer.
If surgery involves an incision between the ribs, physiotherapists can also offer effective stretches and exercises for the shoulders and trunk afterwards, to ensure that strength and mobility return. For patients whose mobility as already deteriorated, mobility training (focussing on any deficiencies such as balance or strength) can also be provided. In patients with advanced disease who elect to opt for palliative management, physiotherapists can offer various means to support relief of pain and breathlessness.
With hundreds of papers published on this broad-ranging topic, the evidence has to be navigated carefully. Precautions to exercise and other physiotherapy interventions need to be considered. Dr. Granger provides expert guidance in a free full-text article published in Journal of Physiotherapy.
> From: Granger, J Physiother 62 (2016) 60-67. All rights reserved to Australian Physiotherapy Association. Click here for the Pubmed summary.
