Breast Cancer Rehabilitation: Strategies for Survivors

Breast cancer is one of the most prevalent forms of cancer worldwide, affecting millions of individuals each year. 

According to the Centers for Disease Control (CDC), in 2020, the United States recorded 239,612 new cases of female breast cancer among women. 42,273 fatalities were attributed to this disease. This equates to 119 new cases per 100,000 women and 19 deaths per 100,000 due to female breast cancer. Cancer ranks as the second most common cause of death in the U.S., trailing only heart disease. It accounts for one out of every five fatalities in the country. Comprehensive breast cancer rehabilitation strategies can enhance the patients’ quality of life and facilitate their transition to survivorship. 

While advancements in medical treatments have improved survival rates, the journey of breast cancer does not end with treatment completion. Survivors often face physical, emotional, and functional challenges. Breast cancer survivors can benefit from rehabilitation strategies that cater to each survivor's unique needs. 

Related: Cancer Rehabilitation Across the Lifespan, 2nd edition 

Physical rehabilitation and exercise 

Physical activity plays a role in breast cancer rehabilitation, helping them maintain strength and endurance. Exercise has been shown to alleviate treatment-related side effects, improve physical function, and enhance overall well-being. Aerobic exercises such as walking, cycling, or swimming help improve cardiovascular health and stamina. These activities can also combat fatigue, a common side effect of cancer treatment. To avoid overexertion, it is recommended to start with low-intensity exercises and gradually increase intensity. 

Resistance training helps rebuild muscle strength and bone density, which may have been compromised during cancer treatment. Strength exercises targeting major muscle groups, such as squats, lunges, and arm curls, can be incorporated into a survivor's workout regimen under the guidance of a trained professional. 

Monitoring vital signs and the rate of perceived exertion are ways to get quantitative information about how the survivor’s body is reacting to the exercise. 

Flexibility and balance exercises 

Stretching and balance exercises improve flexibility, posture, and coordination, reducing the risk of falls and injuries. Yoga, tai chi, and Pilates are excellent options for enhancing flexibility and balance while promoting relaxation and stress reduction. 

Lymphedema management 

Lymphedema, characterized by swelling in the arms or torso, is a common complication following breast cancer surgery or radiation therapy. Rehabilitation strategies for lymphedema management include manual lymphatic drainage, compression therapy, exercise, and skincare. Proper education and monitoring are essential to prevent and manage lymphedema effectively. Lymphedema treatment is a specialty area requiring specialized training from a skilled healthcare provider.  

Psychosocial and leisure rehabilitation 

OTs can assess a survivor’s current desire and ability for leisure activities. Peer support, encouragement, and shared experiences, fostering a sense of community and belonging. Survivors may need help replacing the role of being a patient with being well. This can require a reassessment of daily activities that involve more participation in leisure and social activities. Assessments such as the Canadian Occupational Performance Measure (COPM) can be used to gather information about what is important to the survivor. 

Breast cancer rehabilitation strategies: mindfulness, meditation, and self-care 

Mindfulness-based interventions, including mindfulness meditation and guided imagery, promote relaxation, stress reduction, and emotional well-being. These practices encourage present-moment awareness and acceptance, helping survivors cope with the uncertainties of cancer survivorship and cultivating a sense of inner peace and resilience. 

Healthcare providers can recommend the following: 

• Taking breaks when you need them 
• Setting realistic expectations for activity engagement 
• Setting social boundaries 
• Utilizing social supports 
• Engaging in leisure activities 
• Engaging in mindfulness activities 
• Maintaining a healthy lifestyle that includes exercise, proper nutrition, and stress management. 

Conclusion 

Breast cancer rehabilitation for survivors encompass a holistic approach addressing physical, psychosocial, and functional aspects of recovery. By integrating exercise therapy, psychosocial support, and functional interventions, survivors can enhance their physical function, emotional well-being, and overall quality of life. Empowering survivors on their journey to recovery requires collaboration among healthcare professionals, survivors, and support networks, fostering resilience, hope, and renewed vitality.