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Cancer rehabilitation is the medical speciality that treats what treatment leaves behind: weakness, a stiff shoulder, a swallow that no longer works, a bladder that leaks, a limb that swells. It is delivered by a named set of professions, it has randomised evidence behind several of its parts, and in the largest study to measure it only three in ten of the impairments that needed it were treated.
Cancer rehabilitation is not a synonym for exercise and it is not physiotherapy alone. It is a model of care in which a person's function is treated as a clinical problem with a diagnosis, a measurement and a treatment plan, the same way a blood count or a scan is.
Who does it. A cancer rehabilitation team is built from six professions, and in most countries each is a separate referral. Rehabilitation medicine, called physiatry in the United States and rehabilitation medicine in the United Kingdom, is the medical speciality that diagnoses the impairment and prescribes the programme. Physiotherapy treats strength, range of movement, balance, breathing and the pelvic floor. Occupational therapy treats the activities themselves: dressing, washing, cooking, working, driving, and the fatigue management that makes those possible. Speech and language therapy treats swallowing and voice, which after head and neck treatment are the same therapist's problem. Dietetics treats the weight, the protein intake and the feeding tube. Clinical psychology treats the fear, the low mood and the body image that determine whether any of the rest is attempted. Lymphoedema services, prosthetics and orthotics services and vocational rehabilitation sit alongside them.
What it is for. Silver and colleagues set out the organising idea in 2013: screen for impairment all the way along the care pathway and treat what is found, rather than waiting for disability to arrive. Their review states the case plainly: "Research has also demonstrated that the majority of cancer survivors will have significant impairments and that these often go undetected and/or untreated, and consequently may result in disability." They also note that "more cancer survivors have a reduced health-related quality of life as a result of physical impairments than due to psychological ones", which is the finding that most changes where attention should go.
What it achieves, and what it does not. The parts of the discipline have been tested separately rather than together, and this page grades each of them in its own record: prehabilitation before surgery, swallowing therapy during head and neck radiotherapy, pulmonary rehabilitation after lung resection, pelvic floor training after prostate surgery, vestibular rehabilitation after skull base surgery. Some of those are strong, one of them is a well-conducted negative trial, and several rest on single small studies. No randomised trial has tested the whole multidisciplinary model against usual care with survival or disability as its endpoint, and it is unlikely one ever will, because the parts are not withheld in the same way a drug is. Occupational therapy is the clearest example of the evidence problem: a 2021 systematic review of occupational therapy after discharge found nine studies covering 531 people with cancer, and concluded that "Small sample sizes and methodological quality precluded any formal analysis".
What comes back, and when: that depends entirely on which impairment, and each record here states it. The general shape is that function treated early recovers further than function treated late, and that the single biggest determinant of outcome in the published data is not the therapy but whether the referral was made at all.
An impairment is a diagnosable, measurable problem with a treatment. Rehabilitation medicine works by naming it (shoulder abduction to sixty degrees, six-minute walk distance of 280 metres, a swallow that penetrates the larynx), prescribing a graded programme against that measure, and reassessing. The measurement is what distinguishes it from advice to keep active.
Query for this technology: (TITLE:"Cancer rehabilitation: the discipline that puts function back" OR ABSTRACT:"Cancer rehabilitation: the discipline that puts function back") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Cancer rehabilitation: the discipline that puts function back, not a curated reading list.
Shares Voice after the larynx is removed, Facial reconstruction and facial prostheses: ears, orbits and noses, Limb salvage, amputation, and the rehabilitation that follows either, Breast reconstruction: implant and autologous, immediate and delayed, and what women report afterwards and the tags rejuvenation, survivorship, rehabilitation.
Shares What the randomised trials of prehabilitation found, operation by operation, The exercise prescription after cancer: the dose the guidelines state, Nutrition support and cachexia management, Geriatric assessment and the tags rejuvenation, survivorship, rehabilitation.
Shares Stoma reversal after rectal cancer surgery: who gets the bowel joined up again, Pelvic floor rehabilitation after prostate and rectal surgery and after pelvic radiotherapy, Recovery after pelvic exenteration, Nutrition support and cachexia management and the tags rejuvenation, survivorship.
Shares Trials of structured cognitive rehabilitation for cancer-related cognitive impairment, Going back to driving, lifting and exercise, The exercise prescription after cancer: the dose the guidelines state, Quality of life and the tags rejuvenation, survivorship.
Shares Facial reconstruction and facial prostheses: ears, orbits and noses, Head and neck reconstruction: the free flap, and what it gives back, Swallowing therapy around head and neck radiotherapy, Survivorship care and late-effects surveillance and the tags rejuvenation, survivorship.
Shares The exercise prescription after cancer: the dose the guidelines state, Quality of life, Survivorship care and late-effects surveillance, Late effects and survivorship toxicity and the tags rejuvenation, survivorship.
Shares Pelvic floor rehabilitation after prostate and rectal surgery and after pelvic radiotherapy, Recovery after pelvic exenteration, Survivorship care and late-effects surveillance, Late effects and survivorship toxicity and the tags rejuvenation, survivorship.
Shares Balance, dizziness and falls after cancer treatment, The exercise prescription after cancer: the dose the guidelines state, Survivorship care and late-effects surveillance, Late effects and survivorship toxicity and the tags rejuvenation, survivorship.