A multi-disciplinary team provides cancer rehabilitation services, and a physiotherapist is an essential number of this team, which is key to successful rehabilitation and management of the patient with cancer and palliative care. A physiotherapist conducts an ongoing assessment of the needs of the patient group and their care, to apply skilled intervention which is vital for the patient to stay as active and independent as possible. In physical therapy patients become proactive participants, hence the absence of physiotherapy intervention would be detrimental to patient care and the ability of the patient and family to cope with the effects of disease or its treatment.

Many common impairments in patients with cancer and who are undergoing treatment are observed, among which fatigue, restriction of range of motion, impaired muscle performance and functional control, nerve palsies, plegia or paresis, difficulty in swallowing, difficulty in breathing, DVT, Lymphedema are very often seen in patients following surgery and /or radiation and chemotherapy. Physical therapy provides helpful strategies to treat these impairments and also to assist the patients in restoring their physical function and strength.

At our hospital, we provide utmost care to the patients who are diagnosed and undergoing treatment. Our rehabilitation protocol:

• Teaching them deep breathing emphasizing maximal inspiration.
• Patients are taught how to do an active and self-assisted range of motion exercises of the involved extremity on the first post-operative day and even during /or radiation and chemotherapy. Swallowing maneuvers and techniques are taught and are advised to do regularly during radiation therapy of head and neck cancers. You should start pelvic floor exercises if prescribed from the fifth post-operative day. In post-operative patients after the incision heals, self-stretching of the extremity can be initiated.
• Measures are taken to avoid DVT following surgery by prescribing compression stockings and active pump exercises of the ankle when the patient regains his consciousness following the surgery.
• Chest physiotherapy, postural drainage positions, and cough technique to clear secretions and to prevent lung complications are performed manually at our hospital.
• Preventive measures to avoid lymphedema are taught to the patient. If the patient develops lymphedema, an advanced treatment modality intermittent pneumatic compression device is used to reduce it.
• To improve exercise tolerance and to reduce fatigue, we advise a home program of aerobic exercises to the patient which includes walking, slow jogging, bicycling.

At the time of discharge, patients are educated regarding self-care and self-management activities are also advised to attend regular follow-ups.