Rehabilitation usually starts after treatment. However, with sarcoma you may find that it helps to start rehabilitation earlier.
Ask the sarcoma team at the hospital where you are going to have your treatment to refer you to the relevant services.
Before and after surgery
Surgery is one of the most common treatments for patients who have sarcoma. It is very helpful even before the operation to have an idea of what rehabilitation you may need afterwards. It's generally good to keep yourself as mobile and strong as possible before surgery to help make a smooth recovery. However you may be advised to avoid certain movements or not to bear weight through their limb.
As surgery for a sarcoma could involve almost any part of the body, it is difficult to give an exact list of what the rehabilitation may include, but below are some ideas that you may like to consider in advance of your surgery, so that you are prepared:
- Walking aids such as elbow crutches or a walking stick
- Home exercise programme to regain the movement in your limbs and increase your muscle strength. It may also help to put in place an exercise programme before surgery or other treatment, to help you recover faster
- Advice on preventing stiffness and swelling in your joints and limbs
- Specialist massage called connective tissue massage may help with scar healing and prevent soft tissue tightness, once your wound has healed
- Physiotherapy can usually be given in the home or in an out-patient department, but sometimes it is necessary to have intensive physiotherapy as an in-patient for a short period to regain function after the surgery
- You may need special equipment to help you around the home and you may be referred to the occupational therapist for advice
- You will also be given advice about what you are able to do independently or with less supervision to help your progress
During Radiotherapy Treatment
Radiotherapy treatment uses high energy radiation beams to destroy cancer cells. Your treatment for sarcoma might include radiotherapy either before or after surgery. This may involve short daily treatments for several weeks. The treatment is not painful in itself, but there are some side-effects which might occur. Rehabilitation services can help to minimise the impact of these.
Here are some things to consider before you start radiotherapy treatment:
- If you have surgery followed by radiotherapy, there is a short ‘window of opportunity’ before radiotherapy begins to build movement and muscle strength.
- Movement in a joint can usually be maintained with daily stretching. Your physiotherapist will teach you. Do these exercises at least three times a day during the radiotherapy and at least once a day after the treatment has finished.
- Early advice on good skin care can minimise the risk of developing lymphoedema (a type of swelling) after surgery and radiotherapy. Talk to your physiotherapist about this as soon as you can. Some hospitals have a lymphoedema service to help with the management of lymphoedema. Ask your clinical nurse specialist (CNS) for more details.
- Remain as active as possible during treatment. Go about your daily routine as normally as you can, including some physical activity every day, balanced by setting aside time for rest.
- Contact your rehabilitation team or the team at the radiotherapy unit if you have any problems or notice a decline in your function.
During chemotherapy treatment
Chemotherapy treatment uses anti-cancer drugs to destroy cancer cells. Rehabilitation support during chemotherapy can help you remain as active as possible. Here are some things to consider:
- Talk to your physiotherapist about exercises that you can do in bed, sitting in a chair, or ways in which you can maintain as active a lifestyle as possible throughout the chemotherapy.
- Ask the occupational therapist for advice on aids and adaptations which can help make you more independent and can help you manage the tiredness and anxiety which chemotherapy often causes.
- Talk to a dietician about maintaining a healthy diet. This can help if you feel sick or your taste has changed.
- Contact your rehabilitation team or the team at your chemotherapy unit if you have any problems or notice a decline in your function.
Being physically active after cancer treatment is a positive step in helping you to recover. It helps you to manage the side effects of the treatment and also lowers your risk of getting other health problems. To save you from travelling long distances to the hospital, you can ask to be referred to local rehabilitation services for continued support.
Rehabilitation isn’t always short term and many patients benefit from ongoing rehabilitation, even years after their treatment has finished. Talk to your medical team during your follow up appointments if you feel that you need further support.