Head and Neck Cancer Services may Include:

• 60 min one:one cancer rehab initial assessment with a cancer physio

• Baseline assessment: function, balance, range of motion, strength, aerobic and neurovascular systems

• Vestibular assessment for dizziness

• Neuropathy assessment for sensation loss

• Personalized rehab plan tailored to your rehab phase and 45-60 min cancer rehab follow ups according to your support level

• Pool therapy*

• Manual therapy etc. (soft tissue/joint work, lymphatic techniques and IMS )*

• Direct medical access to a cancer physio via email

• Monthly e-newsletter “Empowered with Rehab”

• Correspondence with oncologist, family physicians and insurance providers as needed, along with required medical reports*

• Online rehab platform access (instructional videos, rehab plan and symptom tracking app).

  *Offered in-clinic only, self-manual techniques provided via Telehealth

  *Medical reports may have an extra fee

What Does The Treatment Phase Include?

The treatment phase varies, for most patients it starts with an excision of the tumour, a full, functional or partial neck dissection, for others it starts immediately with radiation or induction chemotherapy. Often radiation occurs before chemotherapy for H/N patients or can be done concurrently. Depending on the tissue type, staging, grading and cell cycle a personalized treatment plan will be discussed with your medical oncology team. The need for a personalized rehab plan according to your cancer stage, type and treatment pathway can help reduce impairments.

Can a Rehab Plan help Post-Operatively?

Often H/N cancer pathways involve complex surgeries such as thyroidectomies, laryngectomies, partial or total neck dissections to name a few. Also often the treatment pathway can include reconstructive surgeries of varying degrees, often using muscle graphs from other areas of the body. Post-operative rehab plays a very important role in this population more than any other area as the complexity of the anatomy of the head and neck make for more complexity, surgeries in this area can impact many head and neck functions.

Can a Rehab Plan help with Chemotherapy?

Induction chemotherapies such as cisplatin and carboplatin are often used and may cause mylosuppression and NADIR, resulting in changes in blood count and cancer related fatigue. Treatment may also result in cardio-toxicity, pain or neuropathies. Cisplatin and the vinka alkaloids class of medications may cause vestibulotoxicity leading to dizziness or unsteadiness.

Targeted chemotherapies work more specifically on receptor blockers, enzyme inhibition or cell membrane infiltration but they too may cause symptoms such as mucosal irritation, joint arthralgia and soft tissue inflammation.

Many symptoms can present each requiring a rehab plan to help lessen the symptoms and optimize function. Although fatigue is often very burdening in this stage, exercise is medicine and can make the chemotherapy more effective. To optimize treatment and battle fatigue, some personalized exercise prescription is recommended. If dizziness, unsteadiness or other vestibular concerns are presenting as a burden, we offer vestibular assessments during and after chemotherapy. If hand or feet sensory changes are a concern, we also offer neuropathy assessments during this phase.

Can a Rehab Plan help with Radiation?

Treatment planning often involves radiation. Mobility of the neck, jaw and/or shoulder can be a concern during radiation and post, a rehab plan allows tissue extensibility to be maintained while preserving function. Post radiation, while in the proliferation phase of healing, rehab is very important to prevent the onset of radiation fibrosis syndrome. The risk continues to 2 months post radiation where rehabilitation continues to have a vital role. There are many tools that you can use to promote wound healing, increase tissue extensibility and preserve range of motion.

When does Recovery Start?

Typically the term ‘recovery’ is applied in a cancer journey when a patient has completed treatment (surgery, chemo and radiation), and has completed one scan indicating there isn’t any upcoming treatments needed in the coming months as the cancer has not metastasized. A H/N cancer patient can still be awaiting final reconstructive surgeries and be considered to be in this phase.

The term ‘recovery’ can be sensitive for some patients as the cancer journey continues in many ways. Recovery can still involve diagnostics, long term medications and a heavy symptom burden, which can make the term ‘recovery’ feel misleading.

Whatever symptom burden you hold, perhaps it’s some remaining shoulder stiffness, cervical stiffness, scar myofascial adhesions, neuropathies or fatigue, there are rehab supports available

When can I Return to Work?

The discussions around returning to work can be exciting but often patients find themselves stuck here feeling a bit overwhelmed. Sometimes the focus on survivorship and treatment can mean that rehabilitation was put a side and once treatment is over, you may be left with unmanaged symptoms and feeling alone.

Returning to work may seem like a daunting task when you are feeling de-conditioned or left with complications from treatment. Together we can work with your insurance provider to create a manageable graded return to work providing the needed documentation. Even without a heavy symptom burden, returning to work can involve a steep adjustment that is best suited with a gradual return.

Together we can advocate for a gradual return to work on a date, and duty schedule that you feel prepared for.

​How Can I start Rebuilding Strength or Return to Sport?

Completing treatment is a feat and often only after some time spent in recovery, patients have the mental and physical energy to start finding themselves again. This can take the form of returning to a sport they once enjoyed, or setting new goals of returning to exercise.

At times there are some side effects and symptoms that aren’t in the forefront but upon exertion come to the surface. This can look like breathlessness, exacerbated fatigue after exercise, increased neck or shoulder pain or push/crash cycling that makes exercise difficult. Maybe you just want clinical support to return to exercise and sport effectively and safely. Together we can set goals and provide you with personalized exercise programming to get you feeling more like yourself again!​

Whatever your phase, stage or grade, know that help is here. Here at the cancer physio, we care.