Innovative model of breast cancer rehabilitation

e Prospective Surveillance Model, an innovative new model of breast cancer rehabilitation, is featured in a special supplement to the American Cancer Society's journal, Cancer released on April 6, 2012. The model addresses the numerous physical issues faced by women with breast cancer and offers hope for an improved quality of life for all women with breast cancer through rehabilitation and exercise.

APTA members Nicole L. Stout, MPT, CLT-LANA, clinician and researcher at the Walter Reed National Military Medical Center in Bethesda, Maryland, and Jill Binkley, PT, MClSc, CLT, executive director of TurningPoint Women's Healthcare, a non-profit breast cancer rehabilitation organization in Atlanta, Georgia, were among a panel of internationally known experts who developed the model over the past year.

According to APTA spokesperson Stout, "This model is novel in that it takes a preventive approach to managing pathological conditions resulting from cancer by promoting early identification and treatment of known side effects of cancer treatment in an effort to preserve and restore function. It's an ideal model for secondary prevention and an emerging standard of care."

The goal of the Prospective Surveillance Model for cancer rehabilitation is to identify impairment at the earliest onset, to alleviate impairment, or prevent it from progressing. Soon after diagnosis, a physical therapist will perform a preoperative examination to establish a baseline level of function. Follow-up examinations are then conducted postoperatively at 1 month and then 3-month intervals, for up to 1 year.

An excerpt from the lead paper by Stout et al in this special supplement states, "The current medical model of care for breast cancer is focused on disease treatment followed by ongoing surveillance for local or regional recurrence. This approach lacks attention to the impact of treatment on patients' physical and functional well-being. Breast cancer treatment can lead to physical impairments and functional limitations, including pain, fatigue, upper extremity dysfunction, lymphedema, weakness, joint arthralgia, neuropathy, weight gain, cardiovascular effects, and osteoporosis. A growing evidence base of scientific literature supports prospective surveillance, for early intervention and exercise to prevent or mitigate many of these concerns."

The panel of experts and national organizations involved in developing the model will continue to raise awareness about the model, with the goal of increasing the number of women that receive rehabilitation and exercise in order to maximize quality of life for the one in eight women who will be diagnosed with breast cancer in their lifetime.