MORGANTOWN, W.Va. – Cancer treatment is all about preserving the life and the quality of life of the patient, but often that is not the case when it comes to rehabilitation.
A team of researchers at West Virginia University’s School of Public Health, the Cancer Institute, found that rehabilitation recommendations are included in cancer-treatment guidelines from around the world. The guidelines recommended rehab for a variety of cancer types and the consequences of cancer treatment. However, Dr. Nicole Stout, one of the researchers, said there is a great disconnect that exists between guidelines and reality.
Sixty-nine of the guidelines that we looked at made those recommendations, and so we really feel as if though this is a part of standard cancer care. The problem is we’re not always seeing patients be referred for the rehabilitation services that they need. There’s a bit of a disconnect, and one of the things that’s so important in cancer care is following the guidelines because it’s the best evidence that should be guiding us and our treatment plans through the whole continuum of care.Dr. Nicole Stout – Research Assistant Professor, WVU School of Public Health and Cancer Institute
Stout said of the 69 guidelines that indicated rehabilitation was an effective treatment method, seven recommended that cancer patients be referred to rehabilitation services but gave no additional guidance. The other 32 suggested specific rehabilitation assessments and interventions.
Right now, Stout and her colleagues are looking to analyze these global guidelines and then synthesize them, or draw from the data and make their own assessments and conclusions. Stout said she recognizes it’s a big undertaking, but it’s an important one that’s part of the mission along with the World Health Organization (WHO).
“It’s called Rehabilitation 2030,” Stout said. “What they’re looking at is chronic disease. They’re called non-communicable diseases, so it’s a different emphasis. Things like heart disease and obesity and, of course, cancer and how do we better. How do we improve the quality of rehabilitation services for these individuals with non-communicable diseases? Because rehabilitation can be so effective.”
Stout said the WHO wants to bring together teams like hers to learn what would be best practice in cancer rehabilitation. This only marks one of the first steps in this grand undertaking, but when it’s all said and done, the goal is to have enough evidence to fill in the gaps in treatment by creating a comprehensive global guideline that will actually be adhered to.
In the meantime, Stout said, patients must become their own advocates if they feel any pain, discomfort, or any side effects from their treatment. She called it “one of the most critical things” a patient can do but said it could be hard because patients are often unaware that rehabilitation is an option.
But still, Stout encourages patients to at least try to be their own advocate.
“I encourage patients, when they experience things like pain, weakness, fatigue, memory problems, please be your own advocate and say ‘I need to see a rehabilitation specialist, I need to someone that can help me overcome this problem that I am having that is limiting me from getting through my day and completing the activities that I do every day,'” Stout said. “So I encourage patients not just to ask ‘hey do you think it’s a good idea for me to see someone,’ but to advocate for themselves. ‘I need to see someone because of this pain in my shoulder, this issue that I am having with incontinence.’ All of those things can be remediated with rehabilitation.”
A lot of people, if not most, intuitively think cancer patients receive rehabilitation across the board, but that is far from reality right now, Stout said. There is an ongoing struggle for rehab to become standard practice in the U.S. and across the world, but that is precisely what the team of WVU researchers and the WHO is trying to accomplish.
Stout said there’s a great sense of satisfaction with working on this research project because she and her colleagues know that they can help drastically improve patients’ health outcomes if they succeed.
“That’s really the most important part of it for me, for our team, is knowing that what we do will change the way patients are treated,” Stout said. “And this shouldn’t be an exception. It shouldn’t be some people are lucky enough to get rehabilitation, and others are not. We’d love to see this more ubiquitous across all cancers because when a patient looks at you and says, ‘my doctor may have saved my life with cancer treatments, but you, in rehabilitation, you gave me my life back,’ that’s what it’s all about. There’s really nothing more satisfying to us than seeing this translated into practice and really changing and improving the way patients get care.”
You can read the WVU team’s full findings in their review called: A Systematic Review of Rehabilitation and Exercise Recommendations in Oncology Guidelines.