Bill Klaproth: Physical therapy is often required after cancer treatment to recover your strength and reduce your pain. Here to talk with us about the benefits of physical therapy for cancer patients is Dargan Ervin, a physical therapist at Tidelands Health. Thank you so much for your time today. Why is physical therapy important after cancer treatment?

Dargan Ervin: What we see in the industry now, and I've been doing therapy for quite a number of years, is that with the advances in cancer treatment, we’re seeing a great increase in both survival rates and longevity after cancer treatments, but the effects of the chemo and the effects of the radiation can be profound in limiting mobility and flexibility to get around. Therapy is very important to try to help return function and particularly stay functional so folks can get back to living after going through the treatment.

Bill: So true. Is everyone a good candidate for physical therapy after treatment?

Dargan: It's just dependent on the impact that either the chemo or the radiation has on them. A lot of times with the radiation treatment, you certainly have extreme fatigue and you can have joints that are fibrous and essentially with the radiation, it can be some tissue trauma or damage. You can't raise your arm over your head or you don't have the strength to walk across the room, they're an excellent candidate because what we try to do is improve mobility and improve strength and certainly improve safety if folks are having trouble getting around.

Bill: How do you come up with a plan then for each person? I know it’s very individualized. How do you work with people like that?

Dargan: When we have someone who’s referred to us for therapy, we do an evaluation and then identify what are their biggest impairments. Several months ago, I had a lady who had just started chemotherapy for lung cancer and someone who was very vibrant and active and could walk a mile or two a day prior to therapy, she was at the point where after two or three rounds of chemotherapy, she could not get out of the chair or the bed without her husband helping her. What we devised was a plan of how we work on your transfer, how do we work on coming to stand and then working to progress into walking. Four to five weeks, she was able to walk around her house and was actually getting out in the yard. It’s totally based on meeting the patient where they are and developing a plan to hopefully get them back to where they want to be.

Bill: Whatever they need, that will dictate the type of therapy you prescribe for them?

Dargan: Yes, absolutely. The other big concern with folks when they get very weak is the fall risk. We’re seeing that more and more in therapy for a variety of reasons because you don’t want to go through all this, beat the cancer and suffer a fall where you can break a hip or a shoulder or have a head injury. It’s totally based on what their primary limitations are and where their risks are for some type of other injury or problem.

Bill: I want to hear you explain that. I'm thinking of physical therapy as lifting weights and stretching. It can be more than that, right? Or is that the main type of therapy that you perform?

Dargan: It goes back to meeting the patient where they are because if you can't roll over or come to sitting on the side of the bed, weight training isn't important. There's bed mobility training, there are balance activities on the side of the bed, you're supposed to be able to progress to some weight training. In fact, the American Cancer Society recommends physical activity on a regular basis that does include some strength training at least twice a week and 150 minutes of exercises every week. You want to be able to get to that, but sometimes you can see the effects of the treatments is just so tough on the human body and so tough on an individual that they're not able to get there, but that’s certainly something you want to work up to.

Bill: Generally, how long does a physical therapy program last?

Dargan: For the most part, it could be four to six weeks, but it’s totally dependent on how bad the impairments are that a patient is suffering and what kind of progress they're making, and as long as they can demonstrate some potential that they can continue to improve, therapy can still be indicated for periods longer than that.

Bill: Let me ask you this then, just so people know what to expect. Who would be on the physical therapy team?

Dargan: It’s not just physical therapy that is important in cancer patients. Occupational therapy where the occupational therapist would deal more with activities of daily living, do we need any special tools to get dressed or any special devices we need to help you with cooking or housework. In end cases where we have trouble swallowing or loss of speech function, speech therapy is also very much indicated with folks who in the course of chemoradiation may have some impairments related to speech or swallowing.

Bill: That’s really interesting and really important the work that you're doing there. What else do we need to know about physical therapy after cancer treatment?

Dargan: Certainly, there's probably going to be some misery and fatigue. One of the things we also see after chemo is there's some peripheral neuropathy, some weakness in the ankles and in the hands, which physical and occupational therapy can work with, but hopefully the families can be an advocate and know that if my family member is having trouble getting around, ask for a referral. When you look at the associations, the National Comprehension Cancer Network, they have clinical practice guidelines that physical activity and referral to physical therapy is really a part of and we certainly want to make practitioners more aware of that and families more aware of that if someone is at risk for falling or very weak. The other things that can happen to are sometimes family members in attempting to help someone who is very weak can actually injure themselves and we certainly don't want to have the family member getting hurt trying to provide aid. If we can improve the function of the person going through treatment, it's going to help everybody out. You're going to reduce the risk of caregivers getting hurt as well as help the primary patient be a little more in better shape and function better and function safer.

Bill: You encourage patients to be their own advocates and request physical therapy if they feel they need it. What should they do?

Dargan: Call the doctor and ask for it. I have seen referrals come from the oncologist directly or their primary care doctor. I've had one patient that I saw about a year ago who had effects in her shoulders residual to radiation therapy, so she was long past the oncology section of it and she talked to her primary care physician and said I've got a lot of shoulder stiffness and a lot of shoulder pain and her primary care physician ordered the therapy and we got great results with improving her mobility and decreasing her pain in her shoulder.

Bill: Why should someone choose Tidelands for their physical therapy needs?

Dargan: There are a lot of great providers out there, but here at Horry County cover from North Myrtle Beach through Myrtle Beach, Horry and Georgetown counties, even over into Andrews, and so we have a wide network of outpatient offices and skilled physicians, oncology physicians and oncologists and family practitioners and physical therapists and rehab professionals as well. I think we have a very strong team covering a very wide area here in Horry County.

Bill: Thank you so much for your time today. We appreciate it. For more information about Tidelands Health physicians, services and facilities, visit tidelandshealth.org. That’s tidelandshealth.org. This is Better Health Radio. I'm Bill Klaproth. Thanks for listening.