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Physiotherapy in Rehabilitation of Breast Cancer Patients

Breast cancer is 2nd most common cancer found in Indian females. The treatment for breast cancer depends on the extent of the spread of the disease to the breast and the lymph nodes. Most commonly, the treatment is surgical management followed by chemotherapy and radiation for many patients.

Physiotherapy plays an important role in the management of breast cancer. Here we are going to focus on information about some of the post-operative complications like wound infection, pain, shoulder stiffness and postural disturbances. Wound infection can occur if proper skin care and hygiene is not maintained. Physiotherapists can help you to get to know the precautions to be followed to prevent wound infections.

Pain that is experienced by patients post operation is of two types mainly. One is known as post-mastectomy pain syndrome, which is experienced after the complete removal of the breast. In this, some women feel as if they still have that breast (phantom breast) and that gives them an uncomfortable feeling. The other type of pain is the one where patients have suture site pain. This pain can be felt over the chest wall, in the armpit and/or arm on the same side.

Pain is a factor which hampers the use of the hand on the operated side affecting the activities of daily living like dressing, combing hair, eating etc. This pain if not taken care of turns into chronic pain and in turn leads to shoulder stiffness due to limited shoulder movements.

Pain also elicits a guarding response, which leads to postural changes in the patient. These changes are temporary but if not taken care of they can become permanent changes. Some of the postural changes include drooping of the shoulder and bending of the trunk on the operated side.

Traditional physiotherapeutic modalities are contraindicated in pain management of breast cancer patients. Hence, physiotherapist tries to alleviate pain by advising pain relieving positions, mobility exercises, stretching exercises, hand pumping exercises etc. Music therapy also has been shown to reduce pain levels. Posture correction exercises are advised to be started as soon as possible to prevent postural disturbances and/or to correct them.

In this manner, physiotherapy plays an important role in rehabilitation part of breast cancer patients, which ultimately helps in improving post-treatment quality of life.

Ref: Susan Harris et al, Clinical practice guidelines for breast cancer rehab, Cancer, 2012.


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