Scientists identify remedial recommendations in cancer treatment management

Cancer treatment is not just the shrinkage or removal of a tumor. It also involves maintaining or improving the patient’s quality of life.

Rehabilitation services – such as behavioral therapies to relieve pain and exercise to reduce fat – are a valuable way to do that. But they are often not included in cancer patient care plans.

“Rehabilitation has been an undergraduate degree in cancer treatment,” said Nicole Stout, a research assistant professor with the University of West Virginia School of Public Health and the WVU Cancer Institute. “It didn’t go to mind.”

In a new systematic study, Stout and her colleagues identified the rehabilitation recommendations included in cancer treatment management from around the world. The guidelines recommended rehabilitation for several types of cancer and the effects of cancer treatment. But the researchers found a disconnect between what the guidelines recommended and what many doctors do.

Their results are reflected in CA: A journal for cancer clinicians.

“When we look at the evidence, somewhere between 2% and 9% of patients who have manifested functional deficits are about to receive a rehabilitation,” Stout said. “It’s very rare.”

She said there are many reasons for this. Suddenly, one of the most important reasons is how well we have discovered and treated cancer.

“In fact, most people in the past did not survive being diagnosed with cancer,” she said.

“In the late 1970s, only about 30% to 40% of people with cancer would live longer than five years. Today that number is over 70%. And for some of the most common cancers – such as breast and breast cancer. prostate – 90% of these people live longer than five years and go on to live their whole lives.It is not good enough for us to say, ‘Well, look: you have to live with pain and fatigue. ‘And the evidence for recovery has just grown to show that we can help these people. “

Treats the whole person

As a medical field, rehabilitation focuses on the ability to function – or, the ability of a person to think, speak, move and perform the innumerable other tasks that make up everyday life. . It covers a wide range of treatments, from music therapy to transcutaneous electrical nerve stimulation.

While rehabilitation is often associated with learning to walk again after a stroke or joint surgery, it can also be crucial to prevent complications before they arise.

“There’s no such thing as a little pain or a little swelling or a little limited movement in your joint,” Stout said. “Today it may be a little bit, but in three weeks or three years, those things can escalate.”

Where are all the patients?

To be included in a Stout study, guidelines had to meet a number of criteria. For example, they had to be published between January 1, 2009 and June 1, 2019. They had to deal specifically with cancer patients. And they had to be confirmed by a professional oncology or rehabilitation body.

Sixty-nine guidelines met all criteria. Of those, 37 suggested that cancer patients should be referred to rehabilitation services but did not provide further guidance. The remaining 32 recommended specific rehabilitation assessments and interventions.

For us at the end of rehabilitation of things, we are always asking, ‘Gosh, why aren’t these doctors sending more of their patients to rehabilitation? Then we do this systematic review, and we see 69 guidelines, and we are like, ‘Those guidelines are there. Why aren’t we seeing more patients being referred? How do we implement the guidelines? “

Nicole Stout, Research Professor, University of West Virginia School of Public Health, WVU Cancer Institute

‘Greatest hits album’ of recovery suggestions

To make this guidance more effective, the World Health Organization has launched the 2030 Rehabilitation campaign, which is supported by the Stout review.

As part of the initiative, the WHO is identifying specific recommendations for rehabilitation in a number of medical subjects, including oncology. The WHO will then compile the “biggest hits” of those directives into one device, Stout said.

“This is where the WHO’s overarching goal schedule will have a significant impact as it combines all of these outcomes in one place and breaks them down by type of disease or disease. kind of weakening, “she said.

By providing one reliable source of guidance, this may increase the likelihood that physicians will refer their patients to rehabilitation services.

In the meantime, Stout suggests that patients act as their own advocate.

“I encourage patients not to ask, ‘Do you think we should do anything about the swelling I get? ‘”She said. “They have to tell their doctor, ‘I’m getting inflammation. I need to get in touch to see a rehabilitation specialist.’ And you know what? The doctor and the nurse, they’ll do it.”