Physiotherapy in the primary care oncology team

Abstract

As the incidence of cancer rises, medical advancements have made it possible to have increased survival rates among cancer patients. However, many experience persistent treatment-related side effects that negatively affect their quality of life. At the first international Oncology Physiotherapy Conference in 2018, it was agreed that undergraduate physiotherapy training provides a strong foundation for oncology rehabilitation. However, management of specific side effects such as cancer-related fatigue (CRF), chemotherapy-induced peripheral neuropathy (CIPN) and lymphoedema, necessitates additional oncology-specific knowledge and skills. Cancer-related fatigue is one of the most common and distressing symptoms during cancer treatment. Evidence supports the effectiveness of non-pharmacological interventions, such as exercise, to manage CRF, while pharmacological options remain limited. Referral to physiotherapy should thus be considered as a primary approach. Research also supports the use of physiotherapeutic interventions such as exercise and sensorimotor integration in the treatment of CIPN. Physiotherapists upskilled as lymphoedema therapists can deliver Complex Decongestive Therapy (CDT), the gold standard in treating lymphoedema. The Lymphoedema Association of South Africa (LAOSA) promotes standardised care through a 135-h certification process. Exercise for cancer patients should be promoted by all members of the multidisciplinary team, and referral to professionals such as physiotherapists should occur early in the treatment journey. This article aims to sensitise primary healthcare providers to the integral role physiotherapists play in the management of patients with cancer who experience CRF, CIPN and lymphoedema.