Cancer Survivorship: Treatment-Related Effects Part Two

1. Addressing Lymphedema in Cancer Survivors

Lymphedema is most often associated with breast cancer survivors who are at an increased risk after mastectomy and axillary lymph node dissection. This treatment effect is not isolated to this population and may cause significant issues in other survivors. Any individual who has extensive lymph node biopsy is at elevated risk. Head and neck cancer survivors can have a 40-50% chance of developing lymphedema that can compromise the airway or vision and also cause cosmetic defects. Preventative interventions and early identification are important components of treating this issue. Many cancer rehabilitation programs have created comprehensive lymphedema programs.

2. Addressing Cognitive Dysfunction in Cancer Survivors

Cancer survivors manifest cognitive impairments in areas of memory, attention, and processing speed. These issues influence daily life within realms of education, work, and social interactions. Health care professionals require understanding of the components of the neurocognitive assessment and patterns of cognitive symptoms, along with effective interventions.

3. Addressing Cardiovascular Effects in Cancer Survivors

The specialty of cardio-oncology is continuing to evolve in the treatment of cancer patients and survivors. An extensive amount of research has focused on screening for changes in left ventricular function in patients taking high-risk chemotherapy agents, and well-established guidelines are in place. The true toxic effect to cardiac and vascular structures may only become evident months to years after treatment. Cardiac concerns extend beyond myocardial dysfunction to areas of ischemia, hypertension, and dysrhythmia. Radiation places cardiac structures and vessels at risk for pathologic changes, such as valvular disease, chronic pericarditis, and vessel dissections.

4. Addressing Functional Limitations in Cancer Survivors

The number of cancer survivors continues to increase; however, many of these individuals undergo aggressive treatment that involves multiple modalities of treatment. Side effects of these treatments can be cumulative and can create significant disability. The restorative component of rehabilitation is suited to allow these patients to obtain the highest level of wellness possible. Evaluations that focus on functional limitations are an integral part of a global patient assessment. Physical issues such as decreased range of motion, spasticity, and deconditioning, can be impacted by a well-structured cancer rehabilitation program.