Physical Therapy for Breast Cancer Treatment

Breast cancer statistics are alarming.

  • The rate of new cases of breast cancer increases  by just more than 1 percent per year since the 1940s.
  • In 2005, an estimated 211,240 new cases of invasive breast cancer were diagnosed in women.
  • One in eight women either has or will develop breast cancer in her lifetime.

Despite those statistics, there is good news: Strides have been made in the detection and treatment of breast cancer. Even though new cases increase yearly, mortality rates have decreased significantly. If detected early, the five-year survival rate is 95 percent. There are more than 2 million breast cancer survivors in the United States today.

Discovering you or someone you love has breast cancer can be a terrifying experience, but new hope comes from the expanding array of life saving cancer treatments tailored to fight the complexity of each individual cancer. The ideal treatment plan is different for each woman depending on several factors, including the stage of the cancer, tumor size, lymph node involvement and hormonal (menopausal) status. Treatment plans usually consist of a combination of surgery, radiation, hormonal therapy and chemotherapy. 

Once the initial cancer treatment is over, the breast cancer survivor must take steps to ensure her healthiest future and highest quality of life possible. Seeking regular medical care is of utmost importance. Being aware of possible post-treatment complications and intervening early if complications arise are also important steps in this process.

Post-treatment complications may include:

  1. Pain at the incision site, shoulder girdle and neck caused by tension along the incision with movement of the arm on the involved side or muscle spasms. Additional issues arise when the woman limits the use of her arm out of fear of pain, such as loss of motion in the shoulder and increased risk of lymphedema.
  2. Lymphedema is a chronic condition that is characterized by swelling of a body part. The condition occurs when lymphatic fluid can no longer travel effectively through a segment of the lymphatic system and instead accumulates in the surrounding tissues causing swelling. It occurs most often when lymph nodes are removed to determine how far the breast cancer has spread. An estimated 30-40 percent of breast cancer survivors will develop lymphedema following their surgery, though it can take years to develop. Lymphedema can lead to difficulty using the involved arm and decreased body image. A good way to monitor this gradual swelling is to take periodic circumference measurements of the arm on the involved side. You may also notice it in the fit of watches, jewelry or clothing.
  3. Scar tissue formation can restrict motion, cause pain and increase the risk of lymphedema. It may also cause deformity of the breast and surrounding tissue and decreased body image.
  4. Women develop faulty postures, or protective postures, such as rounded shoulders, to avoid pain or tightness of the skin. Over time, poor posture can lead to poor shoulder movement, upper back, neck and low back pain. Faulty postures can also develop following reconstruction procedures that use abdominal or other trunk muscles to reconstruct the removed breast tissue, which can lead to headaches and spinal problems.
  5. Weakness, muscle imbalance and general deconditioning from lack of activity.
  6. Osteoporosis can be caused by chemotherapy and lead to early menopause in premenopausal patients, accelerating bone loss.

The initial phase following a diagnosis of breast cancer is overwhelming and rightfully consumed with the fight to live. Many complications can be overlooked as minor issues, but they can become major obstacles in the performance of everyday activities, if not addressed. Complications can lead to loss of movement or strength in the arm, problems with scar healing and difficulty performing usual activities of daily living such as dressing, toileting, reaching overhead or behind the back, bed mobility, driving, lifting and other functional activities. This can limit a woman’s ability to return to work, social activities and exercise and can impact her overall quality of life.

Early intervention can help breast cancer survivors reduce or avoid these complications. There are several interventions that can be incorporated into an at-home exercise program.

Breast cancer treatment interventions can include:

  • Progressive range of motion and stretching exercises
  • Scar tissue massage
  • Posture education and correction
  • Manual therapy and modalities to reduce pain, inflammation and swelling
  • Strengthening exercises

Palmer Physical Therapy for Women female physical therapists with expertise in treating women following cancer treatment and surgery can customize an exercise program to each woman’s needs and alleviate some of the fears she may have regarding movement or returning to activity.

Women are surviving breast cancer! Being educated about treatment options and possible complications are key to helping each breast cancer survivor preserve her functional quality of life and optimize her overall health.

Susan Palmer, PT at Palmer Physical Therapy in Wichita KS

Susan Palmer, PT is a 1995 graduate of Wichita State University. Her background is in orthopedic physical therapy, and she received additional education in physical therapy for cancer treatment and women’s health issues (Herman & Wallace training).

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