第350回順天堂医学会学術集会「リハビリテーション医療の最前線」
Cancer Rehabilitation: An Update
キーワード:
cancer rehabilitation,
physical activity,
quality of life (QOL),
social reintegration,
supportive care
2021 年 67 巻 1 号 p. 17-23
詳細
2021 年 67 巻 1 号 p. 17-23
Cancer rehabilitation is classified into the following four categories: (a) Preventive rehabilitation performed in early-stage cancer. (b) Restorative rehabilitation performed for the management of cancer- and cancer treatment-induced impairments and disabilities. (c) Supportive rehabilitation performed for the management of impairments and disabilities secondary to progressive and recurrent cancer. (d) Palliative rehabilitation performed to maintain quality of life (QOL) in patients at the end-of-life stage. Therefore, cancer rehabilitation can be performed for all patients with cancer.
Usually, it is possible to predict postoperative impairments and establish perioperative rehabilitation goals for patients with cancer. Compared with patients who undergo surgery, patients who receive chemotherapy or radiotherapy tend to have advanced cancer, lower motor function, and a poorer general health condition. Therefore, establishing rehabilitation goals and planning rehabilitation programs is often challenging for such patients.
The Japanese Association of Rehabilitation Medicine cancer rehabilitation clinical guidelines show the effectiveness of rehabilitation during and after chemotherapy and radiotherapy. However, high-intensity and high-frequency exercises performed by participants in the reports were used as evidence. These exercises are often inappropriate for patients with advanced cancer, and exercises suitable for these patients are being developed.
The importance of exercise in cancer survivors is being recognized in recent times; it is known that colon and breast cancer survivors with high physical activity levels show better prognosis.
Reportedly, one out of two Japanese individuals has cancer. Innovations in cancer therapy have improved the prognosis of patients with cancer. Currently, it is being acknowledged that patients should learn to live with cancer; cancer tends to affect even young adults and reintegration into society is important. Rehabilitation plays an important role in supporting social reintegration.
