Advances In Breast Cancer Rehabilitation The Prospective Surveillance Model

By Richard Jackson, PT, OCS

Treatments for breast cancer typically include surgery, chemotherapy, radiation therapy and endocrine therapy which cause a variety of adverse effects known to affect body structure and function. Pain, fatigue, weakness and lymphedema commonly result from breast cancer treatment.

The Prospective Surveillance Model (PSM) is a proactive approach to examine patients before, during, and after disease treatment for early detection of and intervention for physical problems known to be associated with breast cancer treatment.

This well researched approach has been shown repeatedly to prevent the onset or minimize the effects of many of the problems associated with breast cancer treatment.

Clinics following the PSM have shown dramatic decreases in the onset of physical disabilities post breast cancer treatment.

PSM includes

Preoperative evaluation to establish a physical baseline to detect change over time, and education in the post-operative plan of care. This includes training in post-operative exercises, advice in weight control and advice for returning to activities during and after treatment

Early post-operative rehabilitation including reassessment of baseline measures and initiation of a targeted exercise program. This takes place within one month after surgery and is the key to early detection of physical disabilities. It is much easier to treat small problems before they lead to big problems.

Ongoing surveillance. Patients are followed long term every few months and baseline measures are repeated. As with the early post-operative visits, these visits are aimed at prevention and/or early detection of physical disabilities and progression of exercise programs. If impairments are detected, rehabilitation may be initiated.

PSM is all about prevention. Research has shown that there is a need for ongoing monitoring to detect and treat functional decline and to promote healthy lifestyles throughout treatment and survivorship.

With most patients attaining full life expectancy, they should do so with full functional capabilities and without disability from cancer treatments that can be readily identified and remediated within this prospective surveillance model of care.