New supplement outlines prospective surveillance model for breast cancer

Experts recommend surveillance approach to rehabilitative care

A new supplement in the journal Cancer outlines an innovative model to address a wide range of physical issues faced by women with breast cancer and offers hope for improved function and full participation in life activities for patients through rehabilitation and exercise. A panel of experts proposes a prospective surveillance model (PSM) that could reduce the incidence and severity of breast cancer treatment-related physical impairments. The model was developed over the past year by a panel of internationally known experts, with the support of the American Cancer Society and input from national healthcare professional organizations and advocacy groups.

The supplement says the current model of care for people with breast cancer focuses on treatment of the disease, followed by ongoing surveillance to detect recurrence. That approach, says the supplement, lacks attention to patients' physical and functional well-being. Breast cancer patients experience common impairments including pain, fatigue, upper extremity dysfunction, lymphedema, weakness, joint arthralgia, neuropathy, weight gain, cardiovascular effects, and osteoporosis. And even when these impairments lead to functional limitation, rehabilitation referral is lacking.

The supplement points to evidence that supports the implementation of a prospective surveillance model for early identification and treatment of physical impairments that may prevent or mitigate many of these functional concerns as well as provide a venue to point patients towards exercise and other health promoting activities. The goals of the model are to promote surveillance for common breast cancer-related physical impairments and functional limitations, to provide education to facilitate early identification of impairments, to introduce rehabilitation and exercise intervention when physical impairments are identified, and to promote and support physical activity and exercise behaviors through the trajectory of disease treatment and survivorship.

The PSM is ultimately coordinated with disease treatment from diagnosis through follow-up to create a more comprehensive, multi-disciplinary approach to survivorship care. The purpose of the supplement is to invite consideration of the model as a means to achieve reduced impairment, improved function, and increased participation in exercise.