Nicole L. Stout, DPT

Rehabilitation services are underutilized for cancer patients, an analysis of care guidelines has found.

Behavioral therapy to alleviate pain and exercise to reduce fatigue may help to improve cancer patients’ quality of life, for example. But these and other services often aren’t included in cancer patients’ plans of care,  said Nicole L. Stout, DPT, of West Virginia University School of Public Health and WVU Cancer Institute.

A systematic review of current guidelines showed that less than 10% of cancer patients with demonstrated functional impairments are referred to rehab, Stout said. “It’s very underutilized,” she explained.

While treatment guidance typically encourages rehab referrals, there are a number of reasons more physicians aren’t doing so, Stout and colleagues said. One is that cancer diagnosis and treatment has progressed so much in recent years.

“Quite frankly, most people in the past didn’t survive a cancer diagnosis,” Stout said. “In the late 1970s, only about 30% to 40% of people who had cancer would live beyond five years. Today that number is over 70%.” For some of the most common cancers, such as breast and prostate cancer, 90% of people now live beyond five years and perhaps their full lifespan. 

It’s not good enough to tell patients they must learn to live with pain and fatigue, Stout concluded. “The evidence for rehabilitation has just grown so significantly to show us that we can really help these people.”

Full findings were published in CA: A Cancer Journal for Clinicians.