The Big C and physiotherapy

Getting cancer and dying are two of society’s greatest fears. But thanks to medical advances a cancer diagnosis isn’t necessarily terminal. As physiotherapists we can affect and improve a person’s life with our interventions, our exercises, our compassion, and by listening, regardless of whether someone is going to survive their cancer or not. Those who are living with and beyond their cancer diagnosis are commonly alluded to by the somewhat negative epithet ‘survivor’. There are around 2.8 million ‘survivors’ in the UK, a figure that is set to rise to four million by 2030. But these people are not living well. Patients describe pain due to scar, muscle and fascial tightness, abnormal movement patterns and weakness due to surgery, chemotherapy and radiotherapy. Joint aches from both chemotherapy and hormone therapies and loss of balance are common. They describe lymphoedema, peripheral neuropathy, numbness and generally feeling about 90.  

Many individuals suffer with fatigue, insomnia, a loss of identity and confidence plus high levels of isolation, anxiety and depression, which can lead to suicide. Often people report an enduring fear of recurrence and they believe they are the only ones experiencing these feelings.

Treatment regimes can increase the risk of cardiovascular disease, diabetes, osteoporosis and obesity, both in the short and longer term. For years after, they may be in our care for something that appears unrelated to cancer.

Patients ask for information on safe and individualised physical activity and healthy lifestyles, how to maintain independence, go to work, carry out hobbies and maintain as normal a life as possible.  

As physiotherapists we have the knowledge to help but often we are blocked by fear and lack of confidence. In future more and more individuals with a diagnosis of cancer  will be accessing our services so it is vitally important that we better understand their current and future needs, and how we can manage and prevent further complications.  

Just because someone has had cancer treatment, they should not have to put up with side effects that can be treated, thereby improving their quality of life. Some of these individuals may have been treated years ago yet we can still make a difference. The body and mind are adaptable and flexible – we just have to show how. 

So just because someone has had cancer it should not give us reason to believe there is nothing we can do – there is so much we can do. There is a wealth of both oncology and palliative care specialists in groups such as the Association of Chartered Physiotherapists in Oncology and Cancer Care (ACPOPC) who have the experience, skills and knowledge to support those interested in understanding more.  

• Clare Lait is a specialist cancer physiotherapist at Gloucestershire Care Services NHS Trust