Why physical therapy may be part of cancer care

Cassi Terpening, DPT, in the therapy gym at Upstate's Institute for Human Performance. Some appointments may be held at the Upstate Cancer Center. (PHOTO BY WILLIAM MUELLER)

Cassi Terpening, DPT, in the therapy gym at Upstate’s Institute for Human Performance. Some appointments may be held at the Upstate Cancer Center. (PHOTO BY WILLIAM MUELLER)

Cancer and its treatments can leave patients feeling nauseated, tired and out of condition, but research shows that exercise during treatment can help them feel better and function better.

“The goal of physical therapy is to assist the patient with cancer to maintain their quality of life by managing the physical effects of the disease and/or its treatment,” said physical therapist Cassi Terpening, DPT. She and the other physical therapists first perform a thorough evaluation and then create a plan of care based on the patient’s impairments and goals. Every program is highly individualized, and changes can be made from session to session if needed. The therapists are sensitive to how the patient is feeling. “If they’re feeling very ill, we take it very easy,” Terpening said. They also consult with other members of the patient’s care team, which may include doctors, nurses, nurse practitioners, physician assistants, nutritionists and respiratory therapists.

Services can be provided when patients are diagnosed, during treatment or once they enter survivorship. The course of treatment also varies. Some patients may be seen one time, and others may benefit from weekly sessions.

Patients can meet with physical therapists at the Upstate Cancer Center for evaluations and treatments. A fully equipped therapy gym is located across campus at the Institute for Human Performance, and at outpatient sites in Manlius, East Syracuse and Syracuse. Therapy may include strengthening or balance exercise using free weights, resistance equipment or Pilates equipment.

“Research involving cancer patients is showing that too much rest is not good, and physical activity is important,” Terpening said, citing a recent study from the Netherlands. “Moderate exercise, as tolerated, is very helpful.” If a patient is deconditioned, “we start very slow, and slowly try to build up,” she said. If fatigue is a problem, conserving energy throughout the day, such as sitting down while cooking, is important so that some energy is available to exercise.

Walking is one activity that is safe for almost everyone, and it can be a comfortable way to increase the activity level for people who view exercise as daunting, she said.

“The patient and I both decide when to end the treatment. When they are moving better, pain is managed and fatigue is better managed, they can continue independently” she said. “At discharge I always tell people, if there are any changes, questions, concerns in the future that they are welcome to return.”

Hear Terpening’s radio interview about physical therapy for cancer patients. This article appears in the summer 2015 issue of Cancer Care magazine.

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