Physiotherapy and breast cancer: treatment
Physiotherapy and breast cancer should go hand in hand, as it can help to recover quality of life as soon as possible after undergoing surgery.
Physiotherapy and breast cancer: lymphedema
Lymphedema does not usually develop suddenly. The first symptoms may be:
- the feeling of heaviness or stiffness in the arm of some areas of the same, mainly those that support pressure such as the front of the arm and the elbow region.
- Inflammation that does not subside with rest;
- less flexibility in the joints;
- changes in skin texture, etc.
Recognizing these early symptoms can prevent lymphedema from worsening, as it allows for the early implementation of complex decongestive physiotherapy treatment.
Physiotherapy and breast cancer: complex decongestive therapy
One of the most widely accepted treatments in Physiotherapy for breast cancer patients is 'complex decongestive therapy'.
This comprehensive approach includes:
- manual lymphatic drainage,
- compression of the inflamed limb,
- physical exercise,
- shoulder rehabilitation,
- deep breathing exercises to promote venous and lymphatic flow,
- scar treatment,
- skin care
- and patient education in self-care.
Complex decongestive therapy occurs in two phases:
The first phase is intensive, and the therapist aims to reduce inflammation and symptoms. This phase can last from 1 to 4 weeks and may consist of 2 to 20 treatment sessions.
Once a plateau of improvement is reached, the second phase of self-care and risk reduction will begin. As demonstrated in various scientific studies, physical exercise, physiotherapy, and breast cancer form a positive alliance for improvement, both in terms of prevention and continued treatment in the medium and long term. Therefore, another activity to help cope with the cancer process is physical activity, which improves pain and fatigue, two very common side effects of treatments.
Physiotherapy and breast cancer: approaches
It is advisable to start with the physiotherapy treatment Once the oncological treatment is complete, we will be in the first phase of 'complex decongestive therapy' and, after assessing each case, the following approaches will be carried out:
- Manual lymphatic drainage: A massage technique performed on the skin with the hands, using slow, rhythmic, harmonious, and very gentle movements. These movements should be performed following the flow of the lymphatic ducts, repeatedly, to promote lymphatic movement and thus reduce inflammation in the area being treated.
- Multilayer bandage: A bandage designed to improve venous and lymphatic return in the treatment of venous ulcers. Inflammation control with a cuff and glove.
- Exercises: Respiratory, diaphragmatic, upper and lower thoracic, and movement-related exercises are used to promote shoulder mobility and prevent pectoral muscle retraction, as well as reduce edema. These exercises aim to increase range of motion, especially in abduction and external rotation, as well as muscle strength, while always avoiding pain as much as possible and facilitating active and/or passive mobilization. Gentle, consistent physical activity is important, as it will prevent the onset of muscle atrophy caused by chemotherapy and help maintain a good quality of life.
- Scars: This will be treated with massage and mobilization to provide elasticity and prevent adhesions. Stretching and hydration of the scarred area is recommended to improve circulation. Axillary scars often present adhesions that can be treated with massage and ultrasound, which will also improve shoulder mobility. Movement restrictions and/or loss of sensation in the breast are usually temporary and progressive in terms of recovery period.
Tips to reduce the risk of lymphedema
- Protect your arm from injuries such as cuts, burns, punctures, etc., which can cause infections.
- Avoid both extreme cold and heat in the treated area.
- Keep your arm slightly elevated and do not wear tight clothing.
- Always maintain hygiene and hydration in the area.
Other changes to take into account are:
Nervous system disorders
Chemotherapy can cause peripheral neuropathy in certain cases , an alteration of the nervous system that causes difficulties in using the hands.
Another side effect of chemotherapy treatments is dysesthesia, or altered sensory perception , especially of touch. Patients may experience an exaggerated reaction to pain, touch, changes in temperature, and so on, and we also treat this with physiotherapy.
Respiratory system disorders
Due to surgery or chemotherapy toxicity. These are exercises designed to restore breathing capacity.
Pelvic floor disorders
Cancer treatments can cause vaginal dryness and atrophy. Sexual dysfunctions are also treated.
Article published by Inmaculada Camisón Duque , physiotherapist at the Women's Unit of the Ruber International Hospital.
If you found this article interesting and would like to be seen by a specialist in Gynecology and Obstetrics, the Women's Unit at Ruber International Hospital has a specialized department in this area. You can request more information by calling 91 387 51 72/73/74 or schedule an in-person appointment with top specialists.
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