Rehabilitation

Part of your recovery from breast cancer surgery might include physical and occupational therapy to help you regain strength, adjust to any new physical limitations, learn safe ways to perform everyday activities and regain arm and shoulder flexibility. 

Phases might include:

• Before surgery, when your therapists gather baseline information and measurements of arm and torso to see how well you complete routine activities and move, as well as your strength. They also talk to you about safe activities after your surgery, range-of-motion and breathing exercises for returning to daily activities like dressing and bathing.
• After surgery, your surgeon determines when you may begin therapy.

You are a candidate for rehabilitation if you have trouble:

• Fastening your bra in the back
• Reaching overhead cabinets
• Putting a gallon of milk on the top shelf of the fridge
• Pushing a vacuum cleaner
• Carrying a bag of groceries
• Pushing or pulling an object like a heavy door
• Grasping and holding a coffee cup, steering wheel or doorknob
• Buttoning a blouse or typing on a computer

You are also a candidate if you have:

• Swelling in the arm or hand
• Tightness or pain that limits movement or function
• Loss of strength or range of motion

Your therapist will measure motion, strength, girth and function, comparing the numbers to pre-surgery measurements to create your individual program. This phase is designed to improve movement, strength and function. 

• Strength and fitness, for women who need help regaining physical fitness. Exercise benefits for oncology patients include improved aerobic fitness and strength, enhanced quality of life and decreased fatigue. A therapist creates a prescription of aerobics, strength training and flexibility exercises based on guidelines from the American Cancer Society and the American College of Sports Medicine.

It’s important to start an exercise program slowly and increase activity over time, based on your physician’s recommendations. When the time is right, you can also participate in The Strength After Breast Cancer Exercise Program run by our breast cancer rehabilitation therapists.

Hartford HealthCare Rehabilitation Network’s lymphedema program is recognized by the Lymphatic Education & Research Network as one of four Centers of Excellence for Conservative Care in the world.

Lymphedema, common in cancer patients, is caused by damage or blockage of the lymphatic system. When lymphedema is identified early, special therapists can provide education and treatment to help reverse or minimize its progression. In more advanced cases, therapy can help to slow progression of the disease, reduce symptoms of heaviness, fullness and discomfort in the impacted part of the body, and reduce the risk of related infections. 

Lymphedema therapists partner with you to provide long-term support through regular checkups and use of compression garments. 

Phases might include:

• Before and after cancer interventions, you’ll meet with a rehabilitation specialist to learn more about recovery, return to activity, appropriate exercise and lymphedema symptoms, including risk reductions practices. If you start to notice changes in symptoms and have concerns about lymphedema, talk to your therapist.
• Throughout treatment, you’ll have access to physical therapy services to help them return to daily activities, perform recommended exercises and watch for complications like lymphedema.
• Lymphedema Support Group sessions are led by a behavioral psychologist and lymphedema therapist so you can connect with others facing the same condition in a supportive, therapeutic environment.

The interdisciplinary cancer care team includes a speech-language pathologist (SLP) to assist in early identification and intervention, monitoring, maintenance and rehabilitation of your speech and swallowing functions.

Speech-language pathologists play a central role in the screening, assessment and creation of an individualized treatment plan that includes speech and swallowing therapy for people with head and neck cancer.

Research shows that even people with normal swallowing before radiation can benefit from meeting with SLPs for proactive measures and education on how treatments can impact their speech and swallow function. These problems can lead to symptoms like food sticking in the throat, and food or liquid going down the wrong pipe or up the nose when swallowing. This can lead to pneumonia or other health problems.

Phases of therapy might include:

• At diagnosis of head and neck cancer, the speech-language pathologist can become involved in your care before surgery or before treatment begins. Services can include: counseling and education on the functions of voice, speech and swallowing; assessment to determine your baseline abilities; clinical swallow evaluation and/or a fiber-optic endoscopic evaluation.
• Help after treatment based on the cause of the problem, such as anatomical changes from surgery, decreased saliva, changes in taste, difficulty opening the mouth due to trismus, or problems protecting the airway, causing coughing and choking during meals. The speech-language pathologist assesses needs, and shares swallowing exercises, compensatory swallowing strategies or diet modification recommendations. The goal is for you to continue to eat and drink during and after treatment. 

Treatment may include:

• Oral motor exercises
• Oral strength exercises
• Respiratory muscle strength training programs
• Pharyngeal strengthening exercises
• Dysgeusia management
• Xerostomia management
• Changes to the consistency of foods in the diet to increase efficiency and safety while promoting solid nutrition
• Voice changes may also occur after surgery or radiation. The speech-language pathologist can teach you how to use your voice efficiently so you do not strain the muscles.

In helping you with lung cancer, our goal is to teach breathing techniques, stretching, postural training/correction, energy conservation tips, aerobic exercise and strength training guidelines to help in the healing process.

Phases of therapy can include:

• Before surgery, our team of therapists helps you stay active, or become as active as possible. Physical activity has been shown to reduce symptoms, improve quality of life, increase exercise tolerance and decrease length of hospitalization and post-surgery complications for lung cancer.
• After surgery, physical and occupational therapists can also help decrease your pain level after surgery with manual treatment techniques and exercise. Again, physical activity is encouraged because it can help minimize the side effects of cancer treatment and surgery.

Any exercise program should be gentle and progress slowly, especially if you were inactive before the diagnosis. All patients must be cleared medically before starting an exercise program.