Oncology Rehab
Cancer rehab is a process that helps cancer patients obtain and maintain the maximal possible physical, social, psychological, and vocational functioning within the limits created by cancer and its treatments.
STAGES OF CANCER REHAB:
- Preventative (prehab): pre-surgical or pre-chemo/radiation
- Restorative: post-surgical or post-chemo/radiation
- Supportive: therapy during active cancer treatments
- Palliative: increased disability expected in the progression of the disease
PREHAB is important to establish baseline measurements such as strength, activity tolerance, oral diet tolerance, cognition, balance, QOLS (quality of life scale), UE/LE measurements, and document prior level of function ahead of any surgical intervention or deficits caused by treatment. We are able to measure and fit women for their post-surgical bras. Past medical history is obtained at this visit for help in determining what systems may be affected by cancer treatment. Education on home exercise program, energy conservation techniques and any adaptive devices (such as walkers or canes for safe ambulation) or home modifications also take place during the prehab phase of treatment.
RESTORATIVE and SUPPORTIVE therapy is completed post op and during actual cancer treatment when many toxicities can occur. Exercise has been proven beneficial for the following reasons:
- Strengthen myocardium
- Increase cardiac output
- Decrease resting heart rate and lower exercise heart rate
- Strengthen intercostal muscles to improve breathing
- Enhance motor unit recruitment for decreased muscular toxicity
- Improve coordination
- Improve peripheral neuropathy and increase motor neurons for improved balance
- Improve appetite
- Improve weakness and fatigue
- Increase red blood cell production, blood volume and hemoglobin concentration in patients with myelosuppression
- Decrease severity of swallow impairment for those impacted by head and neck cancer
FOCUS ON PHYSICAL and EMOTIONAL deficits throughout the rehab process. Frequency can fluctuate from 1 to 3 times weekly during and after treatment. There is no “one size fits all” plan of care.
PORi Certified Staff
PORi (PHYSIOLOGICAL ONCOLOGY REHABILITATION INSTITUE) was founded in 2014
- Researched based/evidence based
- Courses are designed to teach participants about the impact of cancer and cancer treatment on the Dermal, Myofascial, Skeletal, Lymphatic, Neural, Gastrointestinal, Myofascial, Urogenital, Pulmonary, and Cardiovascular systems.
- Cancer Rehabilitation is not routinely taught in PT/OT/SLP curricula and often patients are being referred to “generalist” PT/OT/SLP who do not have the specialized knowledge to treat this complex patient population. PORi aims to set the standard of care for this complex and rewarding patient population.
Alisha Ettleman, OTR/L
Alisha Ettleman is a certified oncology rehabilitation therapist in chemotoxicity and cancer exercise management. Her goal is to use the clinical skill sets and techniques learned to effectively deliver well-structured, specialized oncology rehabilitation therapy (both as prehab and rehab) to address the effects of chemotoxicity including deficits such as chemo induced peripheral neuropathy, balance/vestibular issues, weakness and debilitation and cancer related fatigue. Patients may be seen anywhere from 1-3 times a week for an individualized session aimed at assisting patients to remain independent and functional throughout their cancer process
Wendi Stenzel, OTR/L, CLT
Wendi Stenzel is a certified oncology rehabilitation therapist in breast cancer rehabilitation and a Certified Lymphedema Therapist. Wendi provides therapy to breast cancer patients in all phases of their cancer treatment or surgeries and implants. The treatment techniques are based on the PORi total body systems approach, which includes myofascial trigger point release, joint mobilization, scar tissue management, neural mobilization, decreasing pain, and functional use of the arm. This also includes an extensive program for lymphatic drainage, exercises, and compression garments designed to reduce lymphedema.
Maggie Devine, MA, CCC-SLP
Maggie Devine is a certified oncology rehabilitation therapist in head and neck cancer rehabilitation. Maggie provides therapy to head and neck cancer patients across the phases of their cancer journey including prehab, during treatment, following treatment, and treats patients who underwent treatment in the more distant past. Maggie treats a variety of functional impairments from head and neck cancer such as dysphagia (swallowing disorders), voice and resonance disorders, dysarthria (speech disorders), cognitive communication disorders, aphasia (language disorders), and considers respiratory changes and abnormalities as well. Treatment frequency varies depending on the patient and the extent of the functional impairment. Maggie enjoys working with the patient and their care team to minimize functional impairments and maintain the highest quality of life.