October is International Breast Cancer Awareness month so I thought I’d take this opportunity to raise awareness on something that many people don’t even realise exists in the cancer treatment space…

Physiotherapy

I’m sure we can all agree that seeing a physio after you’ve had any kind of orthopaedic surgery is almost a given. Similarly if you’re recovering from a neurological injury or illness (brain injury, stroke, Parkinsons) then a physio would probably be on your radar. And even those with respiratory or cardiac conditions will likely have seen a physio at some point. 

In cancer treatment it isn’t yet an expected part of someone’s recovery journey. And this needs to change because we can have such a positive impact! 

Cancer rehabilitation is a comprehensive treatment approach designed to help a person regain, maintain, or maximise their physical function and emotional wellbeing after a cancer diagnosis. The provision of physiotherapy; including health behaviour change interventions, hands-on treatment, and therapeutic exercise prescription is designed to empower a person back to function and activity. It can be appropriate at any stage of a person’s cancer journey - pre-treatment/surgery, during ongoing treatment and in the recovery and survivorship phases.

In New Zealand, there is currently no routine referral from cancer services to physiotherapy for rehabilitation. This is due to many factors, but ultimately, the current structure is difficult for health care professionals, patients and their whānau to navigate. This results in people with cancer needing to advocate for themselves in order to access cancer rehabilitation services.

The provision of cancer rehabilitation is almost entirely reliant on patient’s being able to pay for treatment themselves or through their insurance. Some financial support can be gained through charitable funding. Fortunately, a substantial number of the major cancer charities in New Zealand currently recognise and support oncology rehabilitation through funding via The Pinc & Steel Cancer Rehabilitation Foundation. Breast Cancer Foundation of New Zealand, Bowel Cancer New Zealand, Talk Peach (gynaecological cancers), Prostate Cancer Foundation and Leukaemia and Blood Cancer Foundation each commit funds to rehabilitation to be delivered by cancer physiotherapists who have undertaken additional, post- qualification, specialised training.

Table 1; below outlines many of the proven benefits of physiotherapy and physical activity on psychological, physical, and social outcomes in cancer. (Image from Physiotherapy in Cancer Care, PNZ 2024)

We know the research supports the involvement of physiotherapists in a person’s cancer journey but it’s also important to hear from those who have experienced it as well. I asked some of our recent clients to share their thoughts on how they came to know about physio, what impact it has had on them and what they would say to anyone who might be considering it: 

“I had cording following lymph node removal and I was scared by the possibility of getting lymphedema.  I sought out a hospital/community physio who took baseline measurements and gave information, including on The Pinc and Steel Foundation which I followed up.  I was pleased to find that I could get funding for further sessions and I'm very grateful for that. I found my physio very easy to talk to. She seemed genuinely interested in me and my welfare. She was knowledgeable and helpful in coming up with short exercise and flexibility programmes that suited the phase of treatment I am in.I have the satisfaction of knowing that I'm doing what I need to for my best recovery. So, for other women, I could say that seeing a cancer rehab physio is a gentle way of actively promoting your own recovery.”

“I came to physio a year after my Breast Cancer diagnosis. I was about 6 weeks post a bilateral mastectomy with reconstruction and my plastic surgeon recommended physio and Pinc and Steel classes.  I was keen to start to increase my fitness again after chemo and surgery but I didn’t know where to start. My first visit to physio really highlighted that I needed to get back to basics and learn what my new limits were. I couldn’t even do an abdominal crunch without shaking. This was not only frustrating but eye opening. In subsequent sessions I was able to work on my flexibility and get to know my body better. Pinc and steel classes over 6 week gave me back my confidence and I was able to push myself to do more and more every week. I have felt so supported by my physio all the way. She has been able to develop a program of exercises to suit me and my situation and I don’t think I would be at this same point in my journey without her guidance. I would definitely recommend others seeking out treatment, it’s been an important part in my road to recovery and feeling like ‘me’ again.”

“I was an existing client at AP and found out about the cancer rehab service through my physio. I was looking to improve my overall flexibility and strength, plus build some resilience in my body again. My physio was gentle and measured, her advice was very personalised even though I was in a group class. My mental wellbeing has been the most marked improvement. I would definitely recommend the classes to others - enjoy the expertise, the banter and the supportive atmosphere.”

“My thoughts on the Cancer rehab Physio classes are that anyone offered the opportunity as I was should take it up, if not for the physical benefit which is well worth it but for the fact that they are great fun and it is beneficial to connect with people who have faced the same challenges.”

“After a partial mastectomy and radiotherapy, I had constant pain in my right chest and always sore in my underarm where lymph nodes were removed. I mentioned this to my oncologist on each 6 monthly visit and was told I need to learn to live with it.  Sadly, at no stage was I ever offered or advised there was any help out there until one of the physios at AP mentioned the option of their cancer rehab service. My goal was to learn how to manage the pain, gain strength in my arm and be able to get more movement given it is my dominant arm.  I was happy to try anything.I also became aware that it had affected my breathing considerably. Chest breathing had become a habit as a protection measure for pain.  

Everyone I came into contact with to get set up for the programme were incredibly helpful and positive which was so encouraging and positive for your mental health.  You were not alone.I am beyond grateful to be a part of this group.  My personal journey has been mind blowing.  The specialised exercises have given me a new lease on life, not only has the pain in my arm and chest improved 100% I have been given the tools to learn how to breathe more efficiently. It has given me so much confidence in my daily life.”

Hearing this from our clients makes me extremely proud of the cancer rehabilitation we can provide at AP. Our service is appropriate for anyone with a cancer diagnosis and at any stage in their journey. We have a range of 1-1 or group class options available and are able to link you up with the appropriate charities if you require financial assistance. 

If you’d like to find out more you can read about the service on our website or book a complimentary cancer rehab information call with Kirsten to discuss your needs.

If you’d like to support someone you know or make a donation to The Pinc and Steel Foundation you can do so here