Physical Therapy and Rehabilitation Specialist Assoc. Dr. Seçil Pervane said, "Lymphedema, which occurs as a result of fluid accumulation in the tissues due to a blockage in the lymphatic system, needs to be diagnosed and treated early. If left untreated, it can appear as a progressive and functionally limiting condition in the oncologic rehabilitation process. Awareness on this issue is very important for us. We want our patients to come to us before they undergo surgery so that we can organize their exercises to better protect them in this regard."
Physical Therapy and Rehabilitation Specialist Assoc. Prof. Dr. Seçil Pervane from Ankara Romatem Clinic made statements about oncological rehabilitation. Assoc. Prof. Dr. Pervane said, "In the world, especially in the last 30-40 years, cancer is recognized much earlier in developed and developing countries, thus prolonging the life and survival periods of cancer patients. Accordingly, patients may be accompanied by various problems and other conditions that develop due to various processes. As physical therapy and rehabilitation physicians, we come into play in this process. After our patients are diagnosed with oncology, that is, cancer, after they receive the necessary treatments to continue their lives, this may be surgery, radiotherapy and chemotherapy applications. After that, in short, after receiving their acute treatments, they face some problems and we step in during this process to ensure that our patients live a more functional, healthier and better life and we accompany them until the end of life. Especially in recent years, new treatments, cellular therapies, gene therapies and immunotherapies have prolonged the life span of patients."
Assoc. Prof. Dr. Pervane said, "Due to long-term treatments in oncology patients, the functional status of patients deteriorates, sometimes there is loss of muscle strength and calcification develops in their joints because they stay in bed for a long time. We should be involved in preventive health services from the very beginning of the process so that these do not develop, and we should prescribe exercises so that our patients do not have muscle loss during the process and calcification in their muscles does not develop calcification in their bones and joints. And if necessary, if these have developed, if the patient has been a little later in applying to us or has not had the opportunity to do so during the process, we should be with him/her for the rest of the process to restore what he/she has lost or to prevent further loss. Because there is a lot we can do in the process. Pain management is very important for patients to facilitate their daily lives and to have a better, better quality time and life. We have very powerful weapons at our disposal. Whether it is physical therapy rehabilitation agents, medical treatments or complementary medicine applications, we can also include some treatment methods such as acupuncture. We can also relieve our patients in this regard."
Stating that 1 out of every 7 women in Turkey and in the world is diagnosed with breast cancer, Assoc. Prof. Dr. Pervane said the following:
"Patients with breast cancer may have some problems in their lymph nodes and pathways after surgery, chemotherapy and radiotherapy. Depending on these problems, the patient's arm, sometimes shoulder, hand and sometimes torso may swell. This is a condition that we encounter in 1 out of every 4 women who undergo surgery or other treatments for breast cancer, and its name is lymphedema. Lymphedema does not only occur after breast cancer. After bladder cancer, ovarian and uterine cancers or cervical cancers in women. Again, it can occur due to the removal of the lymph pathways in that area. Likewise, it can be reached after skin cancers that we call malignant melanoma. In fact, lymphedema can occur not only due to cancers, but even due to biopsies taken. In this process, patients may complain of pain with the addition of swelling, edema, weight and sometimes other accompanying conditions in the troubled area. If these patients do not undergo early diagnosis and treatment, swelling in the arms, legs or torso, perhaps even in the genital area, and related functional losses may occur. Even if the patient is completely oncologically cured, that is, treated, that physical appearance can cause distress to the patient and those around them.
In this respect, early diagnosis and treatment of this condition, which we call lymphedema, is very important. Because if lymphedema is left untreated, it can appear as a progressive and functionally limiting condition. We have a lot to do about lymphedema, but since the awareness of lymphedema in Turkey has started to increase especially in the last 10 years, we can still reach some of our patients very late. In this respect, awareness on this issue is very important for us. We want our patients to come to us before they have surgery so that we can organize their exercises to protect them better. If the patient comes to us before the surgery, when we explain to our patient from the very beginning the limitation of movement, which we call this limitation in the shoulder, or the pain or limitation of movement in the elbow, or the swelling that may occur later, which will occur in the first stage of the surgery, he both does the exercises for this, learns what he should do as a protector, and learns where to come if there is a problem in his arm or leg if it swells. In outpatient clinics conducted by physical therapy doctors affiliated with oncological rehabilitation, we especially want to see our patients even before surgery, or we want to see them in the first 2 days or the first 4 days after surgery."
Assoc. Prof. Dr. Pervane said about the treatment methods, "There are new devices we use in physical therapy applications. We may not be able to apply each of these to oncological rehabilitation patients, that is, to a person with cancer. Because some of them do not cause cancer cells to spread, we go for a much more gradual protective approach. This is where the expertise of the job comes into play. Knowing what not to do is as important as knowing what to do to the patient. But in recent years, we have very good technologies and there are a lot of studies on them. We can apply very new technologies to our patients in a controlled and safe manner. Also, in recent years, there have been large exercise units coming to our rehabilitation units. Not just a single exercise. We have various devices that can perform each exercise for each limb in the most accurate way. We also use these devices to strengthen the muscles in these patients. At the same time, if lymphedema has developed, we also have state-of-the-art devices. We can also receive treatments where we can adjust the pressure related to it. Oncologic rehabilitation is a team work. There are many things to do. The important thing is to provide the patient with maximum well-being with minimum effort. Just having the surgery, receiving chemotherapy and radiotherapy is of course very important for the continuation of life, but then the rehabilitation teams have a lot to do. I ask them to trust us in this regard."
Source : DHA News
