Table 4: Provider Roles in Oncology Rehabilitation Professional What they Do
Physician (physiatrist or other type of medical or osteopathic doctor)
The doctor who leads the team will decide what diagnostic tests should be done and what treatment should be prescribed.
Physical therapist The physical therapist is primarily involved in helping someone recover strength, flexibility, endurance, and mobility. They also treat pain and some can manage conditions such as lymphedema. Many physical therapists specialize in certain types of medical problems such as orthopedic or neurological conditions. Occupational therapist The primary goal of occupational therapy is to help someone resume daily activities such as bathing, dressing, and working. Occupational therapists devote considerable efforts to improving the functional use of the arm including, helping to improve arm strength, coordination, and range of motion. They can also treat pain, and some are certified in lymphedema therapy.
Speech and language pathologist Rehabilitation nurse
This type of therapist concentrates on problems that have to do with language comprehension or expression as well as swallowing issues. These healthcare specialists are always available in inpatient rehabilitation settings, but they often work in outpatient settings as well. Rehabilitation nurses perform all of the usual nursing functions but also focus on helping patients with bowel and bladder function, addressing sexuality issues, and providing education and support for the family. Rehabilitation nurses also can help patients regain the ability to move, speak, and swallow by reinforcing what the therapy team is working on. This professional evaluates whether a patient can return to work, and if so how best to accomplish this. This may involve the use of special equipment such as a one-handed computer keyboard. If it is necessary for a cancer survivor to work in an entirely new occupation, vocational retraining may be offered. These therapists are not always found in rehabilitation settings, but many hospitals have at least one therapeutic recreational therapist on staff. This specialist helps people to embrace leisure and educational activities that are part of having a good quality of life. These activities may include cooking, gardening, and playing sports. Most rehabilitation settings will have some type of mental health counseling available. This might include a consultation with a doctor who specializes in psychiatry or an evaluation with a psychologist or clinical social worker. These specialists have a lot of experience in helping people psychologically adjust to a life that may be different from what they had previously experienced. This is a specific type of mental health specialist who is responsible for conducting testing to determine cognitive problems in people who are experiencing issues with memory, concentration, and other brain functions. A registered dietician helps to figure out the best diet for someone going through cancer treatment and/or rehabilitation. A dietician can offer guidance on how to gain or lose weight and improve energy through nutrition. This professional has training in how to fit and make braces. Braces are sometimes necessary for people who have some weakness or paralysis. This rehabilitation professional is an expert at making and fitting artificial limbs—usually after an amputation. This person acts as a liaison between the rehabilitation team, the insurance company, the patient, and the family. Case managers can answer questions related to insurance and assist patient with getting the best possible care. Case managers may be found in both inpatient and outpatient settings.
Vocational rehabilitation specialist
Therapeutic recreational therapist
Mental health counselor
Neuropsychologist
Registered dietician
Orthotist
Prosthetist
Case manager
Note . Livestrong.org, n.d.) Oncology rehabilitation programs address both disease-related and treatment-related impairments and functional limitations. They focus on reducing the severity of symptoms and long- term problems. The goals of an oncology rehabilitation program are to control pain, manage swelling/lymphedema, increase flexibility, improve strength, increase endurance, improve mobility, restore function, and minimize disability. According to the American Society of Clinical Oncology (2019), comprehensive rehabilitation programs can address the following impairments: General physical impairments:
● Fatigue. ● Deconditioning. ● Somatic pain. ● Difficulty returning to premorbid activities. ● Visceral pain. Specific physical impairments: ● Autonomic dysfunction. ● Back pain. ● Balance dysfunction. ● Bowel dysfunction. ● Cervical range of motion limitations. ● Chemotherapy-induced peripheral neuropathy.
● Joint pain, diffuse (e.g., arthralgias). ● Musculoskeletal pain (e.g., myalgias). ● Neuropathic pain. ● Weakness.
● Chest/thoracic pain. ● Cognitive impairment. ● Compression neuropathy.
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