ABSTRACT
BACKGROUND: Studies have shown that rehabilitation and fitness throughout cancer treatment interventions have been linked to improved outcomes for morbidity and mortality of cancer patients. This study serves to detail the efficacy of the Cancer Rehabilitation Physical Therapy Fitness and Debility (Ca PT) Program in cancer patients. OBJECTIVE: To describe the clinical population of cancer patients referred to the Ca PT Program and evaluate the efficacy of the program's therapy protocol in improving cardiopulmonary performance and cancer-related fatigue and pain. DESIGN: Retrospective study. SETTING: Outpatient clinics. PATIENTS: One hundred two adults who had been referred from a variety of referral sources and supervised individualized exercise programs. METHODS: Participation in the Ca PT Program. MAIN OUTCOME MEASUREMENTS: The primary outcome measure was a change in baseline-to-discharge scores in the 6-Minute Walk Test (6MWT), a cardiopulmonary performance measure. The secondary measures were changes in baseline-to-discharge scores of cancer-related fatigue and general pain, measured by patient self-report using a visual analogue scale. RESULTS: 6MWT values were significantly higher at discharge (mean 523 yards) than at baseline (mean 436), (P < .001, r = 0.57). Ninety-two percent of cases showed improvement and 58% of cases had a change on the 6MWT that met threshold for minimal important difference. Quality of life factors, fatigue (P < .001) and pain (P < .001) also significantly improved. CONCLUSIONS: The results indicate the Ca PT Program yields significant improvement in cardiovascular fitness, fatigue, and pain in people with cancer history. Personalized physical therapy fitness programs for individuals recovering from cancer treatment should be a standard component of cancer intervention. LEVEL OF EVIDENCE: III.
Subject(s)
Disability Evaluation , Exercise Therapy/organization & administration , Fatigue/rehabilitation , Muscle Strength/physiology , Neoplasms/rehabilitation , Quality of Life , Adult , Ambulatory Care Facilities , Cohort Studies , Female , Humans , Male , Middle Aged , Neoplasms/diagnosis , Physical Fitness/physiology , Retrospective Studies , Task Performance and Analysis , Treatment OutcomeABSTRACT
BACKGROUND: Lymphedema occurs commonly in cancer survivors. It is crucial to properly assess cancer patients in order to distinguish lymphedema from general edema and to initiate evidence based treatment. PURPOSE: To provide evidence based recommendations for screening, evaluating, and treating lymphedema and to establish the role of the nurse in the care of patients with lymphedema. METHODOLOGY: Comprehensive overview with narrative literature review of evidence based lymphedema diagnosis and treatment. FINDINGS: Cancer-related edema represents numerous complex conditions. A variety of interventions are needed to address prevention, early detection, patient education, and effective treatment. CONCLUSION: Lymphedema treatment is complex and multimodal, and is provided by an interdisciplinary team of properly trained professionals. Nurses play a major role in evaluating, treating and educating patients on the signs and symptoms of cancer-related edema and patient self-management. CLINICAL IMPLICATIONS: Evidence-based assessment and treatment should be initiated early to improve outcomes and quality of life in patients with cancer-related lymphedema.
Subject(s)
Delivery of Health Care/methods , Lymphedema/diagnosis , Lymphedema/therapy , Neoplasms/therapy , Edema/diagnosis , Edema/therapy , Female , Humans , Lymphoscintigraphy/methods , Mass Screening/methods , Neoplasms/complications , Risk Reduction Behavior , Treatment OutcomeSubject(s)
Breast Neoplasms/therapy , Lymph Nodes/transplantation , Lymphatic Vessels/surgery , Lymphedema/therapy , Veins/surgery , Anastomosis, Surgical , Axilla , Compression Bandages , Exercise , Exercise Therapy , Female , Humans , Lymph Node Excision/adverse effects , Lymphedema/diagnostic imaging , Lymphedema/etiology , Lymphedema/prevention & control , Manual Lymphatic Drainage , Microsurgery , Risk Assessment , Risk Reduction Behavior , Skin CareABSTRACT
Cancer rehabilitation is a relatively new subspecialty. Its goal is to help patients who have been diagnosed with cancer minimize the physical effects of treatment and disease and regain control over many aspects of their life. This article introduces the concept of cancer rehabilitation and offers examples from a Minnesota clinic of how it can benefit patients at different stages of treatment.
Subject(s)
Neoplasms/psychology , Neoplasms/rehabilitation , Survivors/psychology , Adult , Aged , Breast Neoplasms/psychology , Breast Neoplasms/rehabilitation , Cooperative Behavior , Female , Humans , Independent Living/psychology , Interdisciplinary Communication , Lymphedema/psychology , Lymphedema/rehabilitation , Male , Middle Aged , Patient Care Team , Quality of Life/psychology , Rehabilitation, Vocational/psychology , Sick RoleABSTRACT
The purpose of this qualitative descriptive study was to describe the experience of uncertainty in young adults with cancer. A purposeful sample of 6 young adults between the ages of 19 and 30 years undergoing chemotherapy treatment was recruited. Participants were interviewed twice using semistructured interviews. The investigators used constant comparison to examine the content of the transcript for common words, phrases, statements, or units of text that related to uncertainty. Findings revealed 3 major emerging themes. The first one being "types of uncertainty," which includes uncertainty and efforts at the right place, uncertainty and aspects of treatment, uncertainty and personal abilities, and uncertainty and the feasibility of plans related to life goals. Uncertainty was also found to trigger the development of certainties, which led to the second theme, "certainties: helpful or not?" A third emerging theme, dealing with uncertainty, described a variety of strategies used by young adults that included living on a day-to-day basis, being selfish, believing, getting information, trusting the physician, concentrating on positive things, keeping energy by pacing oneself, choosing social support, and trying to live a normal life. A consequence of dealing with the uncertainty and the cancer journey is the "enlightened path." It emerged and revealed how the cancer journey changed their lives. A number of implications for nursing practice therefore warrant consideration, especially fostering a sense of normalcy by identifying common behaviors, feelings, or needs among these young adults with cancer. Sharing this information and facilitating interactions with other young adults with cancer has the potential to promote coping with uncertainty.
