The Tribune

In a series marking National Rehabilitation Awareness Week Sasha Daneah Anderson looks at treatment of a known disease.

Most things “deadly” are compared to cancer, and in today’s society we are conditioned to fear this disease.

We have such an intense fear of cancer, not realising that this same fear is attracting exactly what we do not want. Fear is similar to cancer because it eats us up inside, silently, until it is too late. Cancer, like fear, does not discriminate and attacks the old, young, rich, poor, man, woman, healthy, and sick.

How does a healthy person attract cancer? This concept calls for self-evaluation and the need for us to look in the mirror and confront ourselves. Is our health in top shape like we think it is? Is our health the best it can be? Are we taking preventative measures to ensure cancer does not sneak up on us overnight?

The best group of people to help in answering these questions is the rehabilitation team.

Cancer is formed due to internal and external factors. Internal factors include hereditary and abnormalities of the immune system. External factors include radiation exposure, cigarette smoke and infectious organisms. As I wrote on Monday, the rate of disability is increasing as The Bahamas becomes more populated, as people age and because of the increase in motor vehicle use. It is the same with chronic disease cancer, which is increasing among Bahamians. Bahamians are unconsciously adapting to lifestyle behaviours such as smoking and high-fat diets. As a result, there is more demand for health care systems and rehabilitation services.

Fortunately, specific cancer treatments exist, including surgery, radiation and chemotherapy. As positive as the idea of treatment is, a patient’s ongoing cancer treatment can be physically and emotionally draining. The treatment process can have a major effect on normal day-to-day to functioning and without proper support and guidance from a Rehabilitation Counsellor, this negative side effect can take over, leaving the patient hopeless and treatment unsuccessful. Without hope, clients with cancer may not have the drive to continue with treatment and give up. That is unacceptable, especially when the means to a successful treatment is attainable.

Four objectives to improving rehabilitation support to cancer patients include Psychosocial Support, Optimal Physical Functioning, Vocational Rehabilitation Counselling and Optimal Social Functioning. If those with cancer are living longer, why not make it possible for these clients to experience a quality of life? Helping clients with cancer have the best life possible in their individual environment is an essential part of the therapy. Further, rehabilitation in clients with cancer uses the same general principles as those with stroke, traumatic brain disease and heart disease. Each individual with this chronic disease is different, which calls for a more individualised treatment process.

Moreover, four phases in the rehabilitation process include Prevention, Restoration, Support, and Palliation (the reduction of something severe). Preventative strategies focus on the patient’s physical functioning prior to treatment. Restorative strategies are used to bring patients back to their original level of functioning after treatment. Rehabilitation for supportive methods is performed to help patients adapt to permanent disabilities. If a patient reaches a phase in which the goal is palliation, there may be increasing disability as the disease progresses.

The goals of palliation include pain control, psychological support and prevention of contractures and bed sores as a result of inactivity.

Further, most clients with cancer who experience physical problems also have psychological issues. They will benefit greatly from an intervention by a rehabilitation team. Although it has been proven that many with cancer can benefit from rehabilitation, there is still an underuse of these services. This may be due to lack of awareness by clinicians and unrecognised eligibility of clients.

To improve this, clinicians in The Bahamas can seek education on when to refer clients to rehabilitation services. Clinicians should be trained to assess outcomes such as side effects from the treatment and the disease itself, performance status and the ability to perform activities of daily living and psychosocial needs.

Finally, as cancer treatments become more advanced and patients start to live longer, rehabilitation issues become more apparent as clients begin to ease back into their daily lives and activities. It is important that practitioners who encounter a client with cancer make assessments on their functional outcomes during and after cancer treatment. Although many survivors will eventually seek the help to re-integrate into the community, clients whose process with cancer is poor can benefit from rehabilitative services to improve their quality of life and palliation from the cancer effects.

The goal of experts is to make the experience from the cancer diagnosis more positive and less dominated by side effects and poor functioning. An early intervention from the rehabilitation team can make all the difference.

TOMORROW: geriatric rehabilitation

Sasha Daneah Anderson is a Rehabilitation Counsellor born and raised in Nassau. Educated at St Anne’s Anglican High School and College of the Bahamas, she graduated from Emporia State University, Kansas, with a Master of Science degree in Rehabilitation Counselling. She can be contacted at sander12@g.emporia.edu