by Alaina Militello, SPT
One in eight women in the United States will be diagnosed with breast cancer in their lifetime. That is one diagnosis every 2 minutes. Although diagnoses are on the rise, medical treatment has advanced so much over the years that survivorship is at an all-time high. With more survivors living longer after initial cancer treatment, the healthcare world is having to shift gears in treatment to focus on increasing longevity and quality of life for these women. When it comes to increasing function and quality of life, who better to consult than your friendly neighborhood physical therapist!
There are many hardships that women face after treatment of breast cancer, both physically and psychologically. One of the most common physical complaints that breast cancer survivors have are an increased sensitivity to pain, largely in the upper extremity on the same side of the affected breast. Lymphedema, or swelling of the extremity, may cause discomfort but more severe pain and discomfort is often due to central sensitization.
Central sensitization is a phenomenon that occurs in the nervous system where activation of the pain centers in the brain are constantly firing and often do not turn completely “off”. This means that ordinary touch in these patients may be painful, and painful sensations become even more painful. Breast cancer survivors with this kind of response will often have features like:
- Pain disproportional to the extent of the injury
- Widespread pain
- Hyperalgesia (persistent elevated pain)
- Altered sensitivity to external stimuli (i.e. light, noise, odors)
Physical therapists are trained in how to differentiate pain responses, between normal and hypersensitive, and then know how to proceed appropriately within their treatment plan. They are also experts in exercise and human movement which allows them to create programs specialized for increasing a survivors’ function and therefore quality of life. Evidence has proven that through exercise, cancer patients can increase peak oxygen consumption, increase physical functioning and well-being, as well as decrease symptoms of fatigue that often follows cancer treatment.
Although physical therapists have a direct effect on the physical hardships of cancer survivorship, there is research out there that shows mind-body exercises, like yoga and dance, can improve self-esteem and body image. Many women following breast cancer treatment are concerned with their appearance and sexuality as a woman because they feel a loss of control between their mind and their body. Mind-body therapies can assist women in gaining a sense of control over their bodies and increase their confidence overall after winning their battle against cancer.
Physical therapy along with these complementary therapies can bring these resilient breast cancer survivors towards a better quality of life and a better outlook in their years of remission.
- De, A. G., Meeus, M., De, T. V., Vos, L., Van, M. K., Geraerts, I., & Devoogdt, N. (2018). Unraveling Self-Reported Signs of Central Sensitization in Breast Cancer Survivors with Upper Limb Pain: Prevalence Rate and Contributing Factors. Pain physician, 21(3), E247-E256.
- Husebø, A. M. L., & Husebø, T. L. (2017). Quality of Life and Breast Cancer: How Can Mind–Body Exercise Therapies Help? An Overview Study. Sports, 5(4), 79.
- McNeely, M. L., Campbell, K. L., Rowe, B. H., Klassen, T. P., Mackey, J. R., & Courneya, K. S. (2006). Effects of exercise on breast cancer patients and survivors: a systematic review and meta-analysis. Cmaj, 175(1), 34-41.
- Nijs, J., Leysen, L., Adriaenssens, N., Aguilar Ferrandiz, M. E., Devoogdt, N., Tassenoy, A., … & Kuppens, K. (2016). Pain following cancer treatment: guidelines for the clinical classification of predominant neuropathic, nociceptive and central sensitization pain. Acta oncologica, 55(6), 659-663.
- Sandel, S. L., Judge, J. O., Landry, N., Faria, L., Ouellette, R., & Majczak, M. (2005). Dance and movement program improves quality-of-life measures in breast cancer survivors. Cancer nursing, 28(4), 301-309.