After chemo, it's not time to take it easy; aerobics and a 5K?

  • Article by: JEREMY OLSON , Star Tribune
  • Updated: December 2, 2013 - 5:24 PM

Taking it easy might not be best for cancer patients, Twin Cities-area doctors suggest.

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Physical therapist Martha Sullivan worked with cancer patient Jackie Fischer at Courage Kenny Institute in Minneapolis last week

Photo: GLEN STUBBE • gstubbe@startribune.com,

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Holly Flynn didn’t exactly feel like jogging or taking aerobics class after she finished chemotherapy and radiation treatment for breast cancer earlier this year.

“The thought of going to one more appointment, one more class, one more anything — it seems so incredibly overwhelming,” said Flynn, 38, of Savage.

Trouble is, inactivity often ends up harming cancer patients. While seven in 10 patients with common cancers survive long-term, treatment leaves the majority with physical limitations — fatigue, limited mobility in their arms and legs, or other problems — and those often lead to depression and stress as well.

But Flynn took advantage of a new therapy called cancer rehabilitation, adopted by Allina Health and a handful of other Minnesota medical providers, designed to help people overcome the mental and physical aftereffects of cancer and its harsh treatments. Minneapolis-based Allina has trained 100 caregivers at clinics around the metro area on how to detect patients who could benefit from cancer rehab and what kinds of services to offer them.

“People think you sort of revert back to fine after cancer treatment. ‘You’re done! Congratulations!,’ ” said Dr. Nancy Hutchison, who directs Allina’s cancer rehab program. “The truth is, that is when you are at your worst, because … cancer treatment makes you sick.”

Research also has found lower recurrences of cancer in people who stay fit after their treatment.

Rehab is a familiar concept in orthopedics — when patients need to rebuild ankles, knees or other joints — and is ­commonly used to help patients regain strength after strokes or heart attacks. But it has been a novelty in cancer care until recently, sometimes because of “nihilism,” Hutchison said — the sense that can develop in both cancer patients and doctors that nothing will help.

Studies suggest that at least six of every 10 cancer survivors could benefit from post-treatment rehab services, but that only one in 10 receives them.

A new model of care

Cancer rehab has gained popularity since 2009, when Dr. Julie Silver at Harvard University created “STAR,” the nation’s first hospital certification program in the specialty.

The concept emerged after Silver completed treatment for her own breast cancer and found, to her surprise, that she was unable to resume her usual activities as a mother and doctor. She entered cancer care in her mid-30s and exited, she says, as if she were a woman in her mid-60s.

In the past, Silver said, many cancer survivors had to ­identify their own disabilities.

“ ‘Gee, I can’t lift my arm over my head’ or ‘I can’t go back to work because I’m in so much pain,’ ” Silver said.

“Imagine if we had stroke survivors and [doctors] just sent them home to figure it out on their own. That’s not a very good model of care, and that’s what was happening with ­cancer.”

It wasn’t that long ago that Flynn was in that place — finished with cancer treatment but exhausted and wondering if this was the best she was ever going to feel.

She was pregnant with her youngest child when she underwent chemotherapy in 2012, and then after the birth in September that year, she underwent more chemo and radiation, along with a double mastectomy when the cancer returned. The surgery left her unable to raise one arm above her head, but physical therapy helped her regain that mobility within two weeks. Since then, she has worked out on her own and participated in a Pilates class designed for cancer survivors. She returns for additional cancer rehab from Hutchison’s team when other physical problems surface.

Slowly, ordinary tasks are becoming manageable again, like hefting a double stroller out of the back of her SUV or folding and carrying baskets of laundry.

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  • Physical therapist Martha Sullivan worked with cancer patient Jackie Fischer at Courage Kenny Institute in Minneapolis last week.

  • Physical therapist Martha Sullivan worked with cancer patient Jackie Fischer. Studies suggest that at least six of every 10 cancer survivors could benefit from post-treatment rehab; only one in 10 receives it.

  • Physical therapist Martha Sullivan worked with cancer patient Jackie Fischer at Courage Kenny Institute, Minneapolis, Wednesday, November 27, 2013 ] GLEN STUBBE * gstubbe@startribune.com

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