If You Need: Help With Physical Rehabilitation

Once you are done with your initial cancer treatment, or at any time during your illness, you may need rehabilitation services. Modern treatments are aggressive so they can control the cancer. You may have a temporary or, less often, permanent physical disability that may not allow you to function as you once did.

Physical rehabilitation includes many services designed to help you function as normally as possible. Services are provided under the direction of a doctor who specializes in rehabilitation medicine and are carried out by:

Physical therapists
Occupational therapists
Speech pathologists
Rehabilitation counselors
Social workers

Your doctor may select one or more of these professionals to help you deal with your disability. The rehabilitation therapists can assist you while you are in the hospital or in your own home.

No one likes the idea of a short-term or lasting disability. Sometimes people will have to think hard before they agree to have treatment that may greatly change the way they function. An amputation is one example. But the trade-off, in many cases, is life. The availability of rehabilitation services makes your decision to accept aggressive treatment much easier.

How Rehabilitation Services Can Help

Rehabilitation services can help with:

Physical therapy
* Reduces surgical swelling (edema), such as in the arm after breast surgery (mastectomy or lumpectomy)
* Helps patient regain strength after major surgery
Occupational therapy
* Increases body strength and coordination
* Assesses your ability to return to daily activities
Speech therapy
* Helps patients regain a way to speak, especially after voice box surgery (laryngectomy)
Rehabilitation counseling
* To deal with the emotional impact of a disability
Provide information about:
* Obtaining wigs for hair loss
* Obtaining a prosthesis for the loss of a body part

How Do You Find These Services?

Your doctor will refer you to a rehabilitation center or to a community health center that provides these services. The rehabilitation specialists will then assess your needs. You need your doctor's referral for rehabilitation services to be sure that your insurance will cover the cost of this service.

Sometimes doctors don't mention rehabilitation. They may not be thinking of the changes in your life that cancer has produced. If your doctor does not bring up the subject, ask for a referral or at least an evaluation. You should be sure you are not missing out on a service that could help you continue to enjoy life.

Any kind of rehabilitation service should be given by:

Licensed physical therapists
Licensed occupational therapists
Speech pathologists
Doctors who are board-certified in rehabilitation medicine

Any kind of counseling service should be given by:

Trained rehabilitation counselors
Social workers
Psychologists

In-patient and out-patient service can be found in:

Rehabilitation units within a teaching or local hospital
Rehabilitation hospitals
A home health care agency that provides:
* Physical therapy
* Occupational therapy
* Speech therapy
* Skilled nursing services

Rehabilitation services may also be offered by private therapists. Private practice therapists may not be covered by all insurance companies. Ask your doctor, nurse or social worker for information about services available in your community.

Helpful Hints

Not all insurance groups pay for rehabilitation services. Check your benefits to see what your plan covers. Your state may have a rehabilitation office to help you.

Ask your hospital social worker for help if you are having trouble getting your services covered by your insurance plan. There may be other sources which can help pay for this kind of service.

After any major change in your body, you will probably experience a period of sadness. This is normal, but usually temporary. You will need to adjust to a new self-image. Feelings of sadness are part of your time of adjustment.

If you are having trouble accepting the physical changes caused by cancer and its treatment, you may need a professional counselor. The counselor can help you rebuild your self-esteem despite the physical changes caused by your cancer. A support group may also be helpful. You and your family deserve to enjoy the benefits of your cure or long-term control. Try not to let the stress you feel rob you and them of the joy of your recovery.

The American Cancer Society sponsors several rehabilitation programs:

"Reach to Recovery" for women with breast cancer
"CanSurmount" for cancer patients and their families
Visits from recovered patients who have had an ostomy or laryngectomy

Call your local American Cancer Society office or 1-800-ACS-2345 for information.

This Fact Sheet is adapted from the book, Helping People Cope: A Guide for Families Facing Cancer, Mitten by Joan F. Hermann, ACSW, Sandra L. WojtkovJiak, RN, MSN, Peter S. Houts, Ph.D., and S. Benham Kahn, MD, and supported by the Pennsylvania Cancer Control Program of the Pennsylvania Department of Health; 1990 Revised Edition.

c 1993, American Cancer Society, Inc.

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