Rebeca Bermudez, physical therapist with HOPE Women’s Cancer Center, answers questions about physical therapy.
Q: What issues do physical therapy address?
A: There are three primary areas I focus on when assisting women who are being treated for cancer:
- Pain, fatigue and weakness. Patients who have undergone treatment often have weakness in their arms and legs, as well as general fatigue and pain. And with side effects like nausea and weight loss, they can grow weaker and weaker. Exercise can help combat this.
- Lymphedema. Women who have had lymph nodes removed under the arms, due to breast cancer, or in the pelvic area, due to gynecological cancers, can experience serious swelling in the nearby limbs, or even in the lower abdomen or pubic area. One of the goals of physical therapy is to reduce this swelling.
- Pelvic floor dysfunction. Treatment of gynecological cancers, like cervical, ovarian and uterine, can create a number of problems in the pelvic area, including bladder dysfunction, urinary incontinence, bowel dysfunction and sexual dysfunction. Radiated tissue becomes very weak, fragile and painful, so patients are taught to strengthen those areas and make necessary compensations.
Q: When should physical therapy start?
A: I’d like to see patients before treatment, particularly before surgery. The more patients know going in, the more they can start exercising in a way that can help them not be as fatigued after treatment. But every patient is different, and patients are referred to physical therapy at different stages during their treatment and recovery, based on their doctor’s or surgeon’s recommendations.
Q: What can patients do on their own to condition themselves?
A: Patients who know they’ll be undergoing cancer treatment soon can go ahead and start conditioning themselves on their own. I typically recommend the following:
- Walking. This is an exercise program that benefits all patients, regardless of the type of cancer they have or the type of procedure they’ll be undergoing. Patients should walk at a pace where they are still able to talk throughout the duration of the exercise.
- Chest stretches. Patients with breast cancer can benefit from stretches, such as wall stretches, that address tight chest muscles. You should feel the stretch across your chest and hold that stretch for 30 to 60 seconds. Don’t hold the stretch so long that it becomes painful.
- Lower extremity stretches. For women undergoing pelvic procedures, I recommend hip flexor stretches, which require getting into the lunge position, where one foot is in front of the other, and the back leg is straight. Lunge stretches should be held for a duration of 30 to 60 seconds, or however long it remains comfortable.
Rebeca Bermudez is a physical therapist with HOPE Women’s Cancer Center.