by Kelly McCue

Kelly McCue, RN, MSN, CNS, OCN, CHPN
Kelly McCue, RN, MSN, CNS, OCN, CHPN

Breast cancer is the 3rd most common cancer in the world and is the most common cancer seen in women. It’s not surprising then that many of the patients seen at Brattleboro Memorial Hospital’s Oncology department are breast cancer patients. The treatment approach for breast cancer is varied and may include surgery, chemotherapy or radiation. Many times a woman may receive a combination of these treatments. The oncology team, along with the patient, determines the best treatment approach based upon a number of factors including the type of cancer and how early it was discovered.

Fortunately, with increased awareness among women to perform self-exams and regular screening by mammography, many breast cancer cases are discovered early. Thanks to early diagnosis and advances in treatments the survival rate from breast cancer has improved over the past several decades.

Along with these improvements in diagnosis, treatments and survival rates there has been a steady shift in how oncology patients are viewed. The National Comprehensive Cancer Network and the Commission on Cancer is now emphasizing how survivorship is a distinct part of oncology care and has its own needs. As more patients are surviving long term after cancer treatment it has become clearer that some patients are left to deal with side effects after treatment. Many of these side effects are amenable to rehabilitation; in fact oncology rehabilitation is a growing and advancing field.

Depending upon the treatment given for breast cancer a patient may deal with a variety of issues. Many folks are familiar with the side effects of chemotherapy such as hair loss or nausea. But many people do not know that chemotherapy may also cause loss of appetite or even balance issues. A number of patients feel an overwhelming sense of fatigue. Some patients may complain of memory issues or difficulty concentrating. Radiation or surgery can limit how well a patient can move their arm or perhaps cause swelling in the arm called lymphedema. Patients may feel that they shouldn’t complain or don’t want to bother the doctor telling them about the difficulties they are having each day. But it is important that your oncology team knows about any side effects you may be having. If your doctor doesn’t ask, be sure you bring up the subject because there are things that can help and there is no need to suffer in silence.

Many of the difficulties that may be caused by cancer itself or by cancer treatments can be helped with oncology rehabilitation. Some patients may benefit from rehab while they are still undergoing cancer treatment. For others it makes more sense after their cancer treatment is completed. Various health care disciplines can be involved in the rehab process. A nutrition consult may help to ensure that you are getting adequate nutrition despite having a decreased appetite. A speech therapist can help with teaching you strategies for dealing with forgetfulness or difficulty concentrating so that you can better manage your day to day activities. A specially trained physical therapist can help manage swelling, or lymphedema, in the arm or provide proactive education that can lessen the chances of having this side effect. An occupational therapist can help manage symptoms of fatigue, teaching energy conservation or assisting in obtaining equipment to help you take care of day to day activities. The roles of rehab are varied and are individualized for each patient. Some patients undergoing cancer treatments may have many needs and others may have none. The beauty of rehab is that it is tailored to your needs and can work hand in hand with you and your oncology team.

Some patients may feel that they just don’t think they can handle cancer treatment and rehab when they are first diagnosed. But even one rehab session can provide valuable information for managing symptoms that can help you deal with cancer and make its treatment easier. Rehab can help offer patients a sense of control over their treatment and healing process. And when you feel in control you can have less anxiety about your diagnosis and can devote more time to healing optimally. Talk to your doctor about a rehab referral if you are experiencing side effects from treatment.

BMH is launching our oncology rehab program, the STAR Program®, this month. An open house will be held on May 22 from 5-6 PM on the first floor of the Richards Building for anyone wishing to meet the staff and learn more about oncology rehab.

Kelly McCue, RN, MSN is the Administrator and Nurse Navigator for the BMH Comprehensive Breast Care Program. She can be reached at 802-251-8437.

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