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The importance of physical, psychological and social approaches and strong health care communication skills in cancer rehabilitation
Commentary by Dr. Ricardo Caponero
As survival rates improve, cancer rehabilitation continues to play a critical role in optimizing health and quality of life for survivors. Cure is the main goal, but quality of life in survivors is a paramount issue. The development and promotion of a combination of exercise, psychosocial and survivorship programs are very important; they need a very committed focus as well as exploration of the current state and future directions of cancer rehabilitation.
People with cancer look to rehabilitation services for strategies to cope with impairments resulting from cancer and its treatments, including changes in physical and cognitive abilities, independence and activities of daily living, as well as physical activity participation levels.
Cognitive symptoms can have a major impact on individuals’ personal and professional lives. Several studies have demonstrated only a weak association between self-reported cognitive symptoms and objective cognitive impairment on formal neuropsychological testing, but premorbid intellectual quotient and fatigue seem to be important predictors of baseline cancer-related cognitive impairments.
The use of global quality of life (QoL) measures for comparing treatment arms in randomized clinical trials, at least for patients with metastatic colorectal carcinoma, does not provide information of clinical relevance. Further consideration of how to better assess the net effect of new agents on patients’ QoL is urgently needed.
We have been mastering our medical approach, but we must not forget the physical, psychological, social approaches and, of course, strong health care communication skills.