Physiotherapy and Cancer Rehabilitation

     Physiotherapy and Cancer Rehabilitation.

My name is Lorenda Hattingh. I am a physiotherapist and the founder of Dynamic Focus Physiotherapy in Nanaimo, BC. I have a keen interest in Cancer rehabilitation. In my journey to improve my knowledge and acquire specialized training in oncology rehabilitation, I discovered how passionate I am about the field. Over the last year since completing the PORi Certificate in Oncology Rehabilitation and Breast Cancer Rehabilitation Courses, the positive outcomes my patients with cancer experienced motivated me shift my main focus into Oncology Rehabilitation.

When a person is diagnosed with cancer and cancer treatment is initiated, physiotherapy is not a healthcare field that comes to mind for most. Treatment is usually met with Oncologist, Radiologist, Surgeons, Nurses and other specialists. 

These professionals play a crucial role in the treatment and management of cancer. I believe we have to consider the role of physiotherapists in Cancer Rehabilitation and management. 

The disease itself requires a team of medical specialist thus the rehabilitation and management requires professionals with the knowledge of how cancer affects the body but more importantly how the treatment of cancer ( surgery, radiation, chemotherapy, etc) affects every body system.

Statistics suggest there are over a hundred thousand cancer survivors in Canada each year. With an increasing survival rate the need for comprehensive rehabilitation services is growing. Survivors need ways to improve their “Survivorship” - Julia Osborne PORi

The cancer journey is gruelling. Treatment leaves a person weak, exhausted, with a decreased immune systems and an additional list of side-effects. Patients are warned about side-effects and some advice is given on how to manage the symptoms, but if getting out of bed is more than what you have energy for, how do you follow recommendations to do daily physical activity etc?

Let’s look at health problems associated with cancer treatment.                       

Post Surgical: 

  • Pain and inflammation
  • Scar tissue formation
  • Decrease Range of motion due to pain & scarring
  • Weakness
  • Lymphedema

Post and during Chemotherapy and/or Radiation treatment: 

  • Joint pain & stiffness
  • Chemotoxicity that affects the heart
  • Shortness of breath
  • Fatigue & decreased endurance
  • Nerve pain due to Peripheral Neuropathy
  • Decrease Range of motion due to Radiation fibrosis
  • Cancer Related Fatigue
  • Lymphedema

Physiotherapist have in-depth knowledge on injury management, post surgical rehabilitation, tissue healing and exercise prescription. As a physiotherapist I work extensively with the body systems impacted by the cancer treatment: Neurological, Muscular, Skeletal and Lymphatic. There is strong evidence that supports the claim that conservative management through physiotherapy can decrease the symptom burden, improve function and improve a patients quality of life.

Each person’s treatment experience is different and the impact on the body systems changes as the cancer treatment progresses (surgery, chemotherapy and/or radiation), an individualized assessment from a physiotherapist with experience & training in oncology rehabilitation is essential. Your individualized rehabilitation plan will assist you to recover from the surgical condition and continue to assist you to manage the physical side-effects as you move through the cancer treatments.

What can physiotherapy do?

Pain & Stiffness: A variety of strategies are available. At my clinic it may include soft tissue mobilization, joint mobilization, therapeutic stretching, Myofascial release, therapeutic strengthening and/or dry needling.

Peripheral Neuropathy: Physiotherapy assist in the management of nerve dysfunction through the use of modalities, massage and taping techniques.

Cancer Related Fatigue: Aerobic training, strength training and daily physical activity  during and after cancer treatment decreases the effect of Cancer related Fatigue

Deconditioning: Maintaining or improving endurance and cardiovascular function is very difficult during and after cancer treatment. An individualized conditioning program managed by your physiotherapist will help you battle deconditioning.  I started a group exercise class at my clinic to assist cancer survivors to improve their endurance and cardiovascular function.

Lymphedema: Due to the extra load and injury to the lymphatic system during surgery, chemotherapy and radiation, lymphedema is a common side-effect. Managing Lymphedema to optimize the recovery of the lymphatic system can be achieved through manual lymph drainage, soft tissue stretching, range of motion exercises and patient education to watch for warning signs.

When to start?

My recommendation is to initiate rehabilitation as early as 2-3 weeks after surgery, thus addressing the functional range of motion, pain & inflammation and assist through all phases of tissue healing after surgery and radiation. The treatment focus and goals change as the person progresses through the cancer treatment. The good news is that it is never too late to start rehabilitation for cancer related impairments.

If you experience fatigue, difficulty with endurance or limitations in daily tasks, joint pain or other cancer related side-effects, contact a physiotherapist with experience in cancer rehabilitation.

Thank you for taking the time to read my blog. For more information, go to my website: or 

call Dynamic Focus Physiotherapy (250) 821-1399

Have a great day.

Lorenda Hattingh (BPhyst)

New Cancer Strength & Conditioning Classes!