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[Current Status and Future Perspectives of Cancer Rehabilitation]
1Dept. of Rehabilitation Medicine, Keio University School of Medicine.
Abstract:
As cancer becomes more of a chronic condition, cancer rehabilitation care aimed at maintaining and improving patients' quality of life(QOL)is becoming increasingly important. Cancer rehabilitation care addresses both disabilities caused by cancer itself and those that arise during the treatment process. Cancer rehabilitation is divided into four phases-preventive, restorative, supportive, and palliative. During the perioperative period, prehabilitation starting before surgery aims to prevent complications and promote recovery, while during chemotherapy and radiation therapy, the focus is on preventing inactivity and maintaining/improving physical and social functioning. For patients with advanced cancer, addressing cancer cachexia and bone metastases is crucial. Cachexia is managed through a multidisciplinary approach combining exercise therapy and nutritional management, while for bone metastases, early detection and appropriate use of orthoses help prevent pathological fractures. In the terminal phase, support focuses on maintaining QOL while prioritizing the wishes of patients and their families. Since the enactment of the"Cancer Control Act"in 2006, the infrastructure for cancer rehabilitation has been developing, and in 2010, "Cancer Patient Rehabilitation Fee"was newly established in the medical fee schedule. In terms of human resource development, professional training is being conducted through cancer rehabilitation training programs and cancer professional development plans. Going forward, there is a need for stage-specific treatment approaches, individualized care according to life stages, and strengthened multi-professional collaboration in advanced cancer care. With the increase in elderly cancer patients, cancer becoming a chronic condition, and more patients living with cancer, maintaining functional capacity and extending healthy life expectancy have become more important goals than just extending survival time. The provision of comprehensive, evidence-based rehabilitation care has become essential.
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