Physiatric evaluation of the cancer patient

As time goes on, so do the advancements in medical treatment. Today we are faced with a population of cancer patients living longer and developing unique problems as a consequence of both treatment and progression of disease. The physiatrist is in a unique position to enhance independence and quality of life of cancer patients. Often this is simply a matter of applying well-established physiatric principles to a unique population. However, few physiatrists in clinical practice have the opportunity to treat large numbers of cancer patients, especially in an acute care setting. Experience is key for optimal physiatric management of the cancer patient. The purpose of this article is to familiarize physicians and therapists with evaluation and subsequent application of rehabilitation principles to cancer patients. It is beyond the scope of this manuscript to discuss all the specifics of the cancer patient's rehabilitation; however, references are available.1-4Functional deficits in the cancer patient can arise from disease progression as well as its treatment. The scope of complications include: osseous disease, myelosuppression, multiple manifestations of neurological deficit, deconditioning, pain syndromes, lymphedema, gait abnormalities, amputation, cardiopulmonary complications, psychiatric issues, and others. A survey of 50 rehabilitation consultations seen over a 6-month period reveals the diversity of problems (see Table 1). Although a small sample, it correlates with our experience. Of note, many patients had more than one disability, as illustrated in Table 2.