Dance has been my passion for as long as I can remember. The sensation of the motion and freedom of expression it sanctions is a feeling I can never get enough of. I became and continue to be an avid dancer; taking lessons in many styles and spending long hours at the studio. Through this medium I was introduced to the ornate healing process of the human body. As I watched injured friends initially broken and in pain come out of a physical therapy office reinvigorated and revived, my interest was sparked in this methodology, setting me on a course to inquire extensively about this career. During this time, my grandmother was diagnosed with cancer, causing her to become inactive, weak, frail, and eventually loose the battle. Watching this slow and steady decline was dispiriting, as she visibly displayed both muscle and weight loss; I wondered if exercise had the potential to improve these side effects.
Even before entering this program, these events began to meld together to produce questions of whether physical therapy was solely for muscular and skeletal damage. I began to speculate if an effect comparable to the recovery of my friends at dance was achievable for individuals with cancer. I knew physical weakness, fatigue, and pain were all capable of being improved through specialized exercise, and these are major symptoms of those undergoing cancer treatments. When I was provided the opportunity through Honors Mentorship Program, this mounting curiosity urged me to fabricate the essential question: “How are physical and manual therapy methods effective for increasing strength and diminishing pain in cancer patients, and in what ways can the impacted families and I assist in the process?” Utilizing this question, I strove to learn whether or not physical therapy can have a consequential impact on patients enduring cancer and the individual areas it is capable of promoting improvement. Furthermore, I was inclined to inquire about the extent of effectiveness these therapies can achieve and if they are worthwhile and recommended for patients. Becoming knowledgeable in the answers to these questions will allow me to further my education in physical therapy as I hope to attend college for this career in the very near future. Additionally, it will provide me with the capability of helping others, who, like my grandmother, find themselves in this onerous situation.
What I Know or Assume
Before embarking on this investigation, my knowledge was rather limited, with personal observations producing the majority of my information. However, I was confident that these experiences and the research I had conducted in light of my developing curiosity provided me with a substantial understanding of physical therapy that would allow me to further my research with minimal surprises. Through my inspection of fellow dancers and the healing processes they underwent, I deduced that physical therapy was capable of showing improvement in several areas including strength, endurance, pain reduction, and increasing the range of motion. I also knew that exercise released endorphins in the brain, elevating happiness and raising the demoralized spirits of recovering patients. I quickly discovered, however, that many revelations were to come throughout the course of my study.
After starting my mentorship at a Physical Therapy office, I was briskly faced with the realization that I had much to learn. I had initially assumed that there would be a direct correlation between patient involvement in physical therapy and the extent of their healing. I had reasoned that the physical therapy process itself directly resulted in reparative outcomes. As is generally the case, however, the genuine answer failed to be as clear and concrete as my optimistic self had previously assumed. There are numerous other factors affecting this process, provoking an intricate and exceedingly interesting result contrary to the straightforward assumptions I permitted myself to consider. In reality, I learned that physical therapy assisted in the restoration of health and allowed for the alleviation of weakness, pain, and fatigue. This fostered the recovery of patients, optimizing their improvement; however, it is incapable of assuming responsibility for the actual healing as it maintains a backseat role to the healing the body provides.
While many of my initial thoughts and ideas required adjustments, some of my presumptions remained accurate and were corroborated through further investigation. I knew there was a multiplicity of factors that placed individuals at a greater risk of cancer, including an unhealthy diet and lack of exercise. On account of inactivity being one of the components that elevates the prospect of cancer, I inferred that an increase in physical activity could assist in the averting of the illness along with the betterment of the condition. I assumed that through exercise and strength, the body would be greater equipped for the strains of treatment and would therefore permit a more significant opportunity at healing. When I commenced my mentorship and began avidly researching this topic, I found ample support for this conjecture. I knew, however, that I must continue my search in inquiring the truth regarding my essential question, as there was still a copious of information to uncover. My immense passion for dance and physical therapy compelled me to plunge deeper and farther into the investigation.
The Search
Upon the inception of my essential question, I delved into a thorough exploration of the physical therapy process as it related to cancer. I was immediately bombarded with the immense magnitude of information that substantiated physical therapies’ effectiveness on cancer patients. I incessantly questioned my mentor about his schooling in regards to cancer, finding that it was discussed in the classroom and while he himself had never treated an individual with this disease, his Uncle had gone to physical therapy for this precise reason with consequential results. I supplemented these questions with an interview of my mentor as can be found later in this section of my report. He continually surprised me throughout the course of the discussion, giving affirmative and favorable answers regarding the effects and utilization of physical therapy. It had prodigious impacts on both health and happiness, a concept I had neglected to consider until now. Through both our conversations and this interview, I began to realize the impact physical therapy could make if further promoted in hospitals and other centers facilitating care.
This discernment rejuvenated me in my search as I maintained an unremitting influx of information, all of which seemed to point toward the favorable ramifications of specialized exercise. Throughout my mentorship, I had the pleasure of consulting many doctorate students striving to achieve their clinical hours for graduation under my mentor. I eagerly questioned them on the teaching they received regarding cancer and any knowledge they were provided concerning my essential question. This supplied me with notable unbiased information directly from professors and professionals in this field teaching physical therapy implications.
Independent of these discussions with experts and students, I searched with unabating enthusiasm for further facts and studies relevant to my project. I was remunerated with a plethora of reliable articles. All of these articles pointed to the positive results of physical therapy, and despite my meticulous search, I remained unable to find reputable sources demonstrating possible negatives. I used three of these articles to create annotated bibliographies, and build a better understanding of the medical purpose and effects of exercise on cancer patients. The article The Role of Physical Therapy in Cancer was one that I utilized. It summarized several independent studies by organizations and their findings. Each study autonomously came to the conclusion that physical therapy resulted in the betterment of the condition and prevention of reoccurrences. One such conclusion stated that, “post-diagnosis, physical activity reduced breast cancer deaths by 34%, all causes mortality by 41% and disease recurrence by 24%” (World Confederation). I was continually faced with figures such as this providing ample evidence to answer my essential question.
What I Discovered
My rigorous search of the mechanisms and science behind my essential question has permitted me to draw several conclusions, some in consensus with my initial assumptions, and others in contradiction. Firstly, the utilization of physical therapy with cancer patients was much more common than I had previously assessed. Numerous hospitals have physical therapists that visit their cancer patient’s daily. This was ascertained in discussion with one of the physical therapy students receiving clinical hours. He had worked as a physical therapist exclusively for cancer patients in hospitals, and was familiar with several other hospitals that provided this same care. I was accurate; however, in my previous proposal that physical therapy would enable a reduction in pain, and an increase in strength, endurance, and motion. Even so, the extent of this impact on patients was something I had never fathomed before this inquiry. There is an eminently lofty correlation between specialized physical activity and the recovery of those with cancer. I discovered that physical therapy has the ability to improve motor abilities in individuals that had a brain tumor removed or cancer affecting neurological systems. It also allowed for immense pain reduction through the flushing out of chemical imbalances in muscles and tissues from inactivity and chemotherapy rounds. While the influence of this exercise is staggering, the improvements remain in the four categories I initially suggested, corroborating my previous assertion.
Two findings were chiefly prominent in my research. Unlike my initial predictions, physical activity did not cause the body to heal, it simply facilitated the process and amplified the results. While exercise expedites remedial practices, the body is the sole initiator of healing. Secondly, one of the most crucial benefits physical therapy offers is in the mind. Alongside the physical recovery of patients, exercise and therapy has also been confirmed to improve the mental condition of patients. The surge of endorphins through exercise provokes happiness, and the gains achieved physically amplify hope in demoralized patients.
The conclusions I have drawn regarding the critical importance of exercise will allow me to disseminate the information and increase awareness on the impact of physical therapy. I now firmly believe that the benefits should be stressed to patients and their family members, and its continued use highly encouraged, even when outside the hospital. Throughout this program I have established a deeper passion for helping individuals through this vocation. My knowledge has extended far beyond its initial confinements, providing me with newfound zeal to diligently pursue this career.
Interview with Dr. Blake Buchanan
HMP Interview Questions 1. Have you ever had a patient or known of a patient using physical therapy techniques for cancer related issues?
Yes, my Uncle had cancer and underwent physical therapy to improve strength and endurance during treatments. I’ve also heard about it being used for post mastectomies for those with breast cancer. The movement and stretching of the area decreases the extent of scarring on patients.
Reflection: I have personally seen my grandmother undergo chemotherapy while fighting breast cancer. She became very frail and weak, and in looking at Dr. Buchanan’s response it seems that had she been going to physical therapy her strength and endurance would have been improved. This would have allowed her to be stronger and happier during her treatments. I however have never known anyone going through cancer treatment and physical therapy. The reduction of scarring on patients going through post mastectomies is very intriguing. The movement allows for greater blood flow to the location of the incision therefore allowing the scarring to be minimized.
2. Have you come across the idea that physical and manual therapies may be able to reduce pain in cancer patients and potentially aid in their treatment? If so, what have you heard?
Yes, the types of therapy and the issues the therapy targets are different depending on the kind of cancer. Brain cancer and having the removal of a tumor may affect person’s motor skills. This is something that through physical therapy can be minimized and improved. In some cases with bone cancer, amputation is used. Physical therapy can then help the patient with the loss of a limb. Another example is in patients undergoing chemotherapy. Physical therapy can increase their strength and endurance while undergoing these fatiguing treatments.
Reflection: Different types of cancers require different treatments. It therefore makes sense then that the objective of the physical therapy would be different depending upon the specifics of the cancer. I find it very interesting how when taking out a brain tumor mobility and motor skills can become more difficult. Physical therapy is able to help these connections and improve the strength and ability for motion of the patients. It may not be able to bring it back to the patients initial abilities, however it brings large improvements.
3. In school, was the idea of cancer patients using physical therapy ever introduced or mentioned?
It was briefly mentioned mainly focusing on the improvement of strength, motion, balance, endurance, and pain. These are the issues that physical therapy is able to improve in an individual and therefore can be applied to cancer patients. The idea was just briefly mentioned however and was never discussed in large detail.
Physical therapy is able to increase those basic aspects Dr. Buchanan mentioned and if those are needed in a patient than physical therapy will be useful. I find it interesting that it was mentioned so briefly during his time at school perhaps because the situation is treated just as any other physical issue. While I was interviewing Dr. Buchanan there was a grad student getting his clinical hours at the office. He contributed, saying that cancer patients’ using physical therapy was hardly mentioned at all. This makes me wonder that if it were given more notability during college if it would be more common in the physical therapy world.
4. Do you believe that physical and manual therapies have the capability of improving the condition of cancer patients?
Yes, while it does not have the capabilities to cure cancer, physical therapy improves the physical and mental condition of cancer patients. It improves their strength and endurance, making them stronger and more prepared for further treatments. The movement contributes to mental health and stability as well, lowering depression and depressive states in patients.
Reflection: It was no surprise to me that physical and manual therapy would have little impact on the actual curing of cancer. However, I wasn't expecting it to have almost as big of a mental healing aspect as a physical one. In looking back at the idea I can see how it would lower depression in patients. Exercise is known for releasing stress and promoting happiness, and this can have a large impact on the lives of cancer patients.
5. Can these therapy methods reduce the pain for those undergoing chemotherapy or other cancer treatments?
Pain reduction is very possible, however the degree of pain reduction depends on the kind of cancer and the treatments used. For example, chemotherapy zaps the immune system and while strength and endurance can be increased reducing some pain, physical therapy is not capable of improving the immune system. Moving the body and muscle tissues will effect pain reduction the most. Flushing the system is one of the only ways to reduce pain in patients. In the example of inflammation being one of the causes for pain, there is a chemical imbalance and moving the muscle tissue is what flushes it out.
Reflection: Its very interesting how proper exercise and motion can have such a large impact on pain in a person. The idea of it “flushing out” chemical imbalances or other pain causers is very intriguing. I have noticed before how exercise and motion seems to cure an ache or a tight spot; however, I didn't realize that it actually flushed out the chemical imbalances in muscles. I would be very interested to learn more about this, and I can see how this would improve the pain that cancer patients experience.
6. If pain reduction were achievable from physical and manual therapies, would it affect the recovery of cancer patients?
It improves the overall well being of the patient. It decreases stress and depression and that will lead to a higher recovery rate in individuals. However, it will not allow for more treatments or direct healing of the cancer. It improves the patient physically and mentally increasing both strength and happiness.
Reflection: I initially believed that it would allow for greater recovery from chemotherapy treatments, therefore allowing easier treatments and potentially more of them. This turned out to only be only half correct however. It does increase patients mental and physical health, however it doesn’t cause direct treatment for cancer or an increase in the number of chemotherapy sessions the patient can properly handle.
7. Do you believe that physical and manual therapies have the potential to be incorporated into treatment methods for cancer patients in the medical world?
Yes, in many instances they already have. They can have large impacts on the happiness of patients undergoing stressful treatments. The exercise is also largely beneficial to maintaining strength and avoiding fragility often resulting from treatment.
Reflection: I had never heard of cancer patients undergoing physical therapy even though many places do recommend the practice. In learning of this I hope that a greater number of health facilities offer this practice as exercise and physical therapy is very beneficial for cancer patients. Fragility is a common outcome to the treatments they undergo and physical therapy has a large impact on lessening this outcome.
8. If you had a family member or friend suffering from cancer and undergoing treatment, would you recommend them going to physical therapy? Why or why not?
Yes, my Uncle received physical therapy while battling cancer and his mental and physical stability was at a much higher level than others undergoing the same treatments. He was able to preform higher levels of physical activity. From a medical view it allows for many improvements, and even if patients choose not to pay for physical therapy exercising on their own would be very beneficial.
Reflection: In looking back to my grandmother battling cancer I would now highly recommend physical therapy to her. It would have been able to lessen her stress and improve her strength and endurance, something she was greatly lacking. Dr. Buchanan recommended exercise outside of physical therapy if the patient chooses not to participate. This makes sense due to the many benefits of exercise, and I agree that family members and/or friends should help the cancer patient remain active during the treatments.
9. Do you think there could be any potential dangers of going to physical and/or manual therapies while receiving chemotherapy or other treatments for cancer?
Theoretically no there should not be any dangers as long as the therapist listens to the patient and knows how hard to push the individual. If the patient is doing the exercises incorrectly and the doctor doesn’t correct it or the doctor is doing exercises too hard for the patient then dangers are possible. However, if there is good communication then there is should be no potential for danger.
Reflection: I initially thought there might be potential dangers in exercise for certain kinds of cancers or during certain treatments. He was very insistent however that as long as proper care is given there can be no risk of injuries or worsening of the situation. I do wonder how often physical therapists don't provide this proper care however. I now understand that if there is good communication, exercise is always a positive when specifically for the patient’s diagnosis.
10. Should physical therapy be incorporated into more treatment plans for those with cancer?
It absolutely should be included more in medical treatments of cancer. Exercise is always beneficial when used correctly, so there is no reason not to promote physical activity in patients. Exercise in general improves the health of people, and when specialized to the treatments a cancer patient is undergoing, the result is consistently positive.
Reflection: Exercise has many benefits in reducing stress and improving the happiness of patients and physical strength. There is therefore no reason to not go to physical therapy while going through cancer treatments or simply exercising individually. I wonder since there this is so effective and helpful in patients why it isn’t used/encouraged more frequently. I had never heard of physical or manual therapy being used for those with cancer in the past, and that seems a bit odd as there seems to be consistent benefits with little to no dangers. I hope that there will be further inclusion of physical therapy with cancer treatments.