Cancer Rehab: How Does It Help Patients?
Diagnosis, treatment, side effects – she had endured it all, but now the patient had one more goal.
“Her goal was to walk down the aisle with her daughter at her daughter’s wedding,” says Diana Margarita Maria Molinares Mejia, M.D. Dr. Molinares is a physical medicine and rehabilitation (PM&R) physician with the Cancer Rehabilitation program at Sylvester Comprehensive Cancer Center, part of the University of Miami Health System.
The mother-of-the-bride faced a dilemma, however. The rigors of battling her disease left her unable to walk.
Enter cancer rehabilitation. “Our mission is to improve independence, function, and quality of life – from diagnosis to survivorship or end-of-life care,” Dr. Molinares says. “Most medicine is disease-centered. Cancer rehab is different in that it is patient-centered; it adjusts to the goals of the patient.”
And what about that mother-of-the-bride? Was she able to fulfill her goal and experience something parental dreams are made of?
Dr. Molinares is happy to report, “She was able to walk again and is preparing for the wedding.”
Why does cancer rehab get lost in the shuffle?
With so much emphasis on early screening, treatment, and beating cancer, rehabilitation is often an afterthought. “At the beginning of their diagnosis, most patients are so overwhelmed and so focused on treating the cancer they don’t even know that cancer rehab services exist. I encounter patients, especially breast cancer survivors, who think, ‘I had cancer, chemo, and radiation. Now I’m cancer-free, but now I have all these other side effects,” Dr. Molinares says.
That’s where rehab comes in. Sylvester’s multidisciplinary rehabilitation team addresses everything from “chemo brain” to anxiety, swallowing disorders to sexual dysfunction, and spasticity to lymphedema.
A multidisciplinary, multimodal approach
As South Florida’s only lymphatic program to achieve Center of Excellence status, Sylvester’s program exemplifies what Dr. Molinares calls a “multidisciplinary, multimodal approach.” To help manage their lymphedema, patients can work with an oncologist, plastic surgeon, and massage therapist.
If a patient has cognitive impairment, they could see a speech/language pathologist and/or neuropathologist. People recovering from head and neck cancers practice therapeutic exercises to improve swallowing, chewing, and jaw opening under the guidance of a physical therapist and speech/language therapist. Music therapists, exercise physiologists, and acupuncturists help patients cope with stress and anxiety.
Cancer rehabilitation may also use medication to relieve pain and other side effects.
Cancer rehabilitation encompasses four principles or phases:
- Preventative: “We help improve patients’ baseline function before their treatment or surgery. I tell patients, ‘It’s like a marathon, you have to train,” Dr. Molinares says. Her team enhances the patient’s health through a personalized exercise program, nutritional counseling, psychosocial support, and, if needed, smoking cessation.
- Restorative: This phase addresses the side effects of treatment to restore as much function as possible, as in the mother-of-the-bride example.
- Supportive: A natural next step, the supportive phase allows patients to maintain the benefits of whatever function they regain. “Symptoms are not linear; if a patient has a new surgery, new side effects, or gets an infection, symptoms can be up and down like a roller coaster.”
- Palliative: For patients with terminal cancer, this phase will train their family members so they can safely care for their loved one and will also coordinate end-of-life care so the patient can experience the best possible quality of life for the longest period of time.
Does insurance cover this care?
“We are a subspeciality with a medical component, so yes, cancer rehabilitation is usually covered by insurance. Certain therapies, such as acupuncture or exercise physiology, are not always covered, but Sylvester has philanthropic resources to help with those expenses,” Dr. Molinares says. Patients should check with their insurance provider about coverage.
Dealing with cancer can feel like a long, lonely battle, but it doesn’t have to be done alone. Dr. Molinares and her team assist patients throughout their journey. “Cancer rehabilitation is patient-focused; I love the relationship we have with the patient.”
Learn more about Sylvester’s Cancer Rehabilitation Services.
Nancy Moreland is a regular contributor to the UHealth Collective. She has written for several major health care systems and the CDC. Her writing also appears in the Chicago Tribune and U.S. News & World Report.
Tags: cancer recovery, Dr. Diana Margarita Maria Molinares, rehabilitation, surviving cancer, Sylvester Comprehensive Cancer Center
