Pelvic 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 Prehab Include?

The prehab phase starts after diagnosis prior to treatment; according to prehab research, a rehab plan has important impact here on decreasing bladder and bowel dysfunction and limiting other complications . Diagnostics are often included in this stage and can involve blood work (cancer markers, complete blood counts), tissue biopsies (retroperitoneal or visceral lymph node dissection) and/or detailed imaging.

Diagnostics allow your medical oncology team to obtain important information such as your cancer type, stage, grade and whether your tumour is estrogen or progesterone sensitive. Furthermore a genetics assessment is may be warranted to determine whether. Further blood testing for biomarkers and genetics such as HBOC genes (BRCA1/2) or Lynch genes (MLH1, MSH2, MSH6, EPCAM amongst others) may be offered to better personalize your treatment plan. This may include risk assessment of family within the genetic line and provide probability of other cancers. The above steps will allow your medical oncology team to personalize your treatment pathway. A prehab plan can lessen hospital stays, improve post-operative outcomes, optimize pelvic function and provide a sense of control right from the start.

What does the Treatment Phase Include?

Other treatments may follow or come prior to surgery such as systemic chemotherapy; Taxol, Carboplatin or HIPEC (hyperthermic intraperotineal chemotherapy) to name a few. Radiation may also be part of the treatment pathway taking the form of brachytherapy or external radiation. Targeted therapies such as Avastin or Lynparza, immunotherapies such as Keytruda or hormone therapies such as aromitase inhibitors (Anastrozole, Letrozole) may also be included in your treatment regime.

The treatment phase is often paired with a symptom burden. Depending on the cancer type, stage, grade and cell cycle, a personalized treatment plan will be discussed with your medical oncology team. A personalized rehab plan according to your cancer stage, type and treatment stage can help.

Can a Rehab Plan help during Chemotherapy?

​Systemic chemotherapies may cause NADIR (blood cell changes), cardio-toxicity, neuropathies and fatigue amongst other conditions. Targeted chemotherapies work more specifically on receptor blockers, enzyme inhibition or cell membrane infiltration but they too may cause symptoms such as mucosal irritation, gastritis, soft tissue inflammation and joint arthralgia. The most reported symptoms are chemotherapy induced fatigue, chemotherapy induced peripheral neuropathies, nausea and malaise.

Despite this being a very difficult phase filled with fatigue, a personalized rehab plan can better health and provide you with tools that work. We also offer vestibular assessments for any concerns with dizziness or unsteadiness and neuropathy assessments for any concerns relating to sensory changes of the hands/feet.

Can a Rehab Plan help during Radiation?​

Treatment planning may involve radiation to the pelvis. Mobility of the viscera and tissues around the area is very concerning during radiation and post. A rehab plan promotes tissue extensibility and healthy pelvic function. Post radiation, while in the proliferation phase of healing, rehab is very important to prevent the onset of pelvic 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, diagnose any concerning neuropathies and optimize your pelvic function through out this stage.

Can a Rehab Plan help during Hormone Therapy?​​

Hormone therapy may be part of your treatment pathway and leads to a very individualized symptom burden. There is a lot of variation in how patients respond to these treatments, so reading blogs and worrying ahead of time isn’t a good idea. The most reported symptoms from a survey of over 6000 cancer patients was fatigue, hot flashes and joint pain. Together we can work together to better manage fatigue, joint arthralgia, sleep hygiene and any other concerns that you may have. There are rehab tools available that work.

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 scans indicating that the cancer has not metastasized. A patient may have been on medications such as Letrozole, Anastrozole and other hormone therapies for 3-4 months, or taking medications such as biophosphinates or keytruda and still be considered to be in ‘recovery’.

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

Whatever symptom burden you hold, perhaps it’s some remaining lower extremity weakness, scar stiffness, nerve pain, dizziness or fatigue with exertion, 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.