Ohio State physical therapists are teaming up with cancer patients early in their treatment processes to improve the speed and effectiveness of recovery. “The new model — the new goal — is to intervene earlier, before surgery or treatment begins, so that we can set up our patients for even better success down the road,” says Karen Hock, PT, MS, CLT-LANA, the OSUCCC – James associate director of Ambulatory Oncology Rehabilitation. “Physical therapy has been proven to reduce many symptoms related to surgery and cancer treatment, and the sooner we get started, the better.” Hock and her team of 16 physical therapists, all who specialize in treating cancer patients, are national leaders in this new trend, and their skills and commitment have helped improve quality of life of countless James patients. Pre-treatment evaluation The first step is to evaluate a patient prior to surgery and/or treatment in order to establish what Hock calls “base lines.” For example, with breast cancer patients, Hock and her team “measure shoulder function and take what we call girth measurements of their arms, as well as range of motion of the shoulders and posture assessment.” The shoulder movement measurements assist in the physical therapists' work with patients to help them return to where they were before surgery in terms of strength and flexibility. The girth measurements are important in spotting the onset of lymphedema in the earliest post-surgery stages. James physical therapists can then begin specialized treatment and physical therapy immediately in order to reduce symptoms and pain associated with this swelling in the extremities that sometimes occurs after cancer surgery. “These pre-habilitation plans are different because we individualize them to meet the needs of each of our patients,” Hock says. Better balance Another evaluation is the measurement of patients’ balance, as chemotherapy can induce peripheral neuropathy. This causes weakness and numbness in the hands and feet, and can lead to balance issues, including an increased risk of falling. “We work with patients to keep them active and moving and safe,” Hock says. Step pedaling Hock and her team are also working with Ohio State lung cancer physicians in a new clinical trial designed to help patients, who are often elderly, do low-impact, at-home exercises designed to reduce the fatigue associated with treatment and improve strength and aerobic capacity. Each participant in the clinical trial receives a small step-peddler they can use while seated comfortably in a chair or operate with their arms. It’s a gentle exercise that patients can do at their own pace. “This helps patients remain active and independent, and we’ve seen that it helps them better tolerate treatment, which can be difficult for lung cancer patients and cause fatigue,” Hock says. The benefits of PT The list of benefits cancer patients receive from physical therapy is a long one and includes improved balance, the prevention of muscle atrophy, improved blood flow, less dependence on others, reduced anxiety and depression, and the easing of nausea and fatigue symptoms. “Here at The James, it all goes back to our staff of physical therapists,” Hock says. “They’re really invested and believe in what they’re doing, and they’re always looking for ways to improve the quality of life for our patients.”