OSTEOPATHY, MOVEMENT THERAPY
FIX OSTEOPATH, SANJA MARETIC SHARES INSIGHT INTO HOW ALLIED HEALTH CARE PROFESSIONALS CAN HELP CARE FOR WOMEN WITH BREAST CANCER.
Breast cancer is one of the most common forms of primary cancers in women today. Numerous presentations, including Axillary web syndrome, Post mastectomy pain syndrome, Brachial plexopathy, Costochondritis and impaired shoulder mobility are just some of the neuroimmune and musculoskeletal compromises women with breast cancer may face whilst undergoing or recovering from breast cancer treatments.
The toll on women ‘s lives is profound: fragmented and splintered identities are spoken of in qualitative research, literature, and poetry, with echoes of feelings such as “falling out of time” or being in an “unfamiliar body” as women ask themselves the question: “Will I ever glow again?”.
So, what is the role of allied health care practitioners in caring for women living with a diagnosis and treatment of breast cancer?
Firstly, it is always important to work in conjunction with the wider oncology team. Breast cancer rehabilitation management should really start from the day of the diagnosis and continue after treatment has ended, supporting the individual in looking after their physical and mental well-being, dealing with the annihilation that cancer often leaves behind.
Movement and exercise are the most important component in the care package for breast cancer and the evidence for it is insurmountable. Physical rehabilitation is a rich multimodal approach to rehabilitation varying from mobility strategies, sensory-motor training, cognitive exercises, cardiovascular, resistance and strength training, as well as restorative yoga and Pilates. Breast cancer rehabilitation does require specificity and close monitoring so if you are undergoing breast cancer treatment and would like to explore adjunct care to your medical treatment, please do get in touch with an osteopath, physiotherapist or massage therapist with interest and training in this field.
Each of aforesaid modalities has its purpose in combating side effects of breast cancer treatment such as cardio-toxicity, cancer related peripheral neuropathy, fatigue and “chemo brain” (cognitive dysfunction such as memory lapses). Additionally, supporting and preserving lymphatic and bone health often compromised by radiotherapy and the use of hormonal therapies such as Aromatase Inhibitors are particularly important when menopause is to be considered.
Movement as a therapy also has an added potential to give the woman a sense of control during times when little else seems to be under her control. Physical activity can be a way she enshrines ownership of her body.
The touch of surgical beams and cold hospital beds whilst waiting to receive radiotherapy can feel anything but humane, so working in a field where human touch is part of the job can and should feel like a privilege. A body that has been objectified by treatments that are done “to” the body, and confronted with its own mortality, can really benefit from communicable therapeutic touch.
When it comes to manual therapy, safety and precaution is essential, especially when working with women with post-surgical scar tissues and/or breast reconstruction, or in the context of lymph nodes removal and possible subsequent “cording”. If there is lymphedema present, co-allying with a lymphedema specialist would certainly be of value.
Further self-care strategies may encompass restorative yoga, breath work, self-manual therapy (especially scar management), exercise, daily walks in nature, prioritising rest, good nutrition, mindfulness and imagery based therapies, amongst many others. This is particularly helpful if the woman is experiencing hot flushes and insomnia, secondary to hormonal therapy, as well as chronic pain, fatigue and mental health problems. Giving self-care tools can be a way of taking them out of the realm of “patient-hood” back into the world of “personhood” and agency.
Hopefully, all these mentioned therapeutic acts can help women to co-create agency and re-discover the meaning, bearing in mind that meanings are personalised and therefore not always embroidered with positivity and happiness, but are as diverse as human nature itself. Caring for women with breast cancer is about sharing the weight, not in a form of taking on the pain, but taking away some of the unnecessary obstacles along the way that have a potential to amplify the suffering.
It is a way of showing them they need not to be alone.
