Oncology
doi: 10.25005/2074-0581-2024-26-1-86-98
MODERN VIEW ON REHABILITATION OF CANCER PATIENTS
1Department of Oncology and Diagnostic Imaging, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan
2Republican Scientific Oncology Center, Dushanbe, Republic of Tajikistan
The literature review evaluates the rehabilitation measures in the country's oncological institutions, assesses regulations in other countries, and scientific publications related to the rehabilitation of cancer patients. Studies were analysed using electronic databases PubMed, Medline, Science Direct, Scopus, Web of Science, e-Library, RSL. Over 47,900 sources were found, of which 50 papers over the past ten years were selected and included in the article. The criteria for inclusion were the rehabilitation of cancer patients, stages of rehabilitation, pre-rehabilitation, nutritional support, psychological assistance, and quality of patients’ life.
Considering the urgency of the problem, WHO 2017 took the initiative and adopted the Rehabilitation 2030 program, which provides expanding global access to high-quality rehabilitation as an essential health service for people with non-communicable diseases. According to summarized data, rehabilitation is based on the following principles: stage-by-stage process, consistency, complexity, and individual approach. The stages of medical rehabilitation of cancer patients include pre-rehabilitation; stage I – a period of specialized treatment; stage II – rehabilitation in a hospital setting after discharge; and stage III – early and late rehabilitation periods.
An analysis of the situation in Tajikistan showed that in oncology-related institutions, rehabilitation of cancer patients is carried out within the framework of existing protocols for individual nosology, where a set of measures for the stages of rehabilitation is not sufficiently developed. A practical assessment of the effectiveness of rehabilitation is not set up. The stereotype about limiting the use of physiotherapy and sanatorium-resort treatment for cancer patients persists. There are no regulations for comprehensive rehabilitation of cancer patients. The need to optimize treatment results, prolong the survival of patients with various functional disorders, and improve the quality of life dictates the necessity for the development and systematic implementation of comprehensive rehabilitation of cancer patients.
Keywords: Cancer patients, rehabilitation, stages of rehabilitation, pre-rehabilitation, nutritional support, psychological assistance, quality of life.
References
- Kaprin AD, Starinskiy VV, Shakhzadova AO. Sostoyanie onkologicheskoy pomoshchi naseleniyu Rossii v 2021 godu [The state of cancer care for the population of Russia in 2021]. Moscow, RF: MNIOI im. P.A. Gertsena – filial FGBU «NMITs radiologii» Minzdrava Rossii; 2022. 239 p.
- Mahmud RA, Alam K, Dunn J, Gow J. The changing relationship between health burden and work disability of Australian cancer survivors, 2003-2017: Evidence from a longitudinal survey. BMC Public Health. 2020;20(1):548. https://doi. org/10.1186/s12889-020-08710-9
- Kaydarova DR, Chingisova ZhK, Shatkovskaya OV. Pokazateli onkologicheskoy sluzhby Respubliki Kazakhstan za 2017 god: statisticheskie i analiticheskie materialy [Indicators of the oncological service of the Republic of Kazakhstan for 2017: Statistical and analytical materials]. Almaty, Kazakhstan; 2018. 114 p.
- Sanginov DR, Khuseynov ZKh, Khuseynov IN. Onkologicheskaya sluzhba Tadzhikistana: sostoyanie, problemy i perspektivy [Oncological service of Tajikistan: Status, problems and prospects]. Evraziyskiy onkologicheskiy zhurnal. 2020;8(4):219-29.
- Gegechkori N, Haines L, Lin JJ. Long-term and latent side effects of specific cancer types. Med Clin North Am. 2017;101(6):1053-73. https://doi.org/10.1016/j. mcna.2017.06.003
- Uzkeser H, Karatay S, Erdemci B, Koc M, Senel K. Efficacy of manual lymphatic drainage and intermittent pneumatic compression pump use in the treatment of lymphedema after mastectomy: A randomized controlled trial. Breast Cancer. 2015;22(3):300-7. https://doi.org/10.1007/s12282-013-0481-3
- Bogolyubov VM (red.). Meditsinskaya reabilitatsiya. Kniga 1 [Medical rehabilitation. Book 1]. Moscow, RF: BINOM; 2010. – 416 p.
- Gameeva EV, Stepanova AM, Tkachenko GA, Gridnev OV, Sviridov SV, Shestopalov AE. Kompleksnaya reabilitatsiya onkologicheskikh patsientov [Comprehensive rehabilitation of cancer patients]. Sovremennaya onkologiya. 2022;24(1):90-6. https://doi.org/10.26442/18151434.2022.1.201476
- Jimenez YA, Cumming S, Wang W, Wang W, Stuart K, Thwaites DI. Patient education using virtual reality increases knowledge and positive experience for breast cancer patients undergoing radiation therapy. Support Care Cancer. 2018;26:2879-88. https://doi.org/10.1007/s00520-018-4114-4
- Smith SR, Zheng JY, Silver J, Haig AJ, Cheville A. Cancer rehabilitation as an essential component of quality care and survivorship from an international perspective. Disabil Rehabil. 2020;42(1):8-13. https://doi.org/10.1080/09638288 .2018.1514662
- Sleight A, Gerber LH, Marshall TF, Livinski A, Alfano CM, Harrington S. Systematic review of functional outcomes in cancer rehabilitation. Arch Phys Med Rehabil. 2022;103(9):1807-26. https://doi.org/10.1016/j.apmr.2022.01.142
- Petrozhitskaya AA, Tandelov RK, Bystritskaya RK, Morkhov KYu. Vozmozhnosti reabiltatsii patsientok so zlokachestvennymi opukholyami zhenskikh polovykh organov [Current available rehabilitation techniques for patients with gynecology canncer]. Zlokachestvennye opukholi. 2022;12(2):35-42.
- Khasanov RSh, Ozol SA, Gilzyatuddinov IA, Gataullin IG, Rabbaniev IF, Karpenko LG. Sovremannye printsipy reabilitatsii onkologicheskikh bol’nykh (obzor literatury) [Modern principles of rehabilitation of cancer patients (literature review)]. Povolzhskiy onkologicheskiy zhurnal. 2013;4:49-55.
- Dietz JH Jr. Adaptive rehabilitation of the cancer patient. Curr Probl Cancer. 1980;5(5):1-56. https://doi.org/10.1016/S0147-0272(80)80002-X
- Okamura H. Importance of rehabilitation in cancer treatment and palliative medicine. Japanese Journal of Clinical Oncology. 2011;41(6):733-8. https://doi. org/10.1093/jjco/hyr061
- Lapid MI, Atherton PJ, Kung S, Sloan JA, Shahi V, Clark MM, et al. Cancer caregiver quality of life: Need for targeted intervention. Psycho-Oncology. 2015;25(12):1400-7. https://doi.org/10.1002/pon.3960
- Crevenna R, Palma S, Licht T. Cancer prehabilitation – a short review. Memo. 2021;14:39-43. https://doi.org/10.1007/s12254-021-00686-5
- Singh B, Hayes SC, Spence RR, Steele ML, Millet GY, Gergele L. Exercise and colorectal cancer: A systematic review and meta-analysis of exercise safety, feasibility and effectiveness. International Journal of Behavioral Nutrition and Physical Activity. 2020;17(1):122. https://doi.org/10.1186/s12966-020-01021-7
- Moran J, Wilson E, Guinan E, McCormick P, Hussey J, Moriarty J. Role of cardiopulmonary exercise testing as a risk-assessment method in patients undergoing intra-abdominal surgery: A systematic review. British J Anaesth. 2016;116(2):177-91. https://doi.org/10/1093/bja/aev454
- Mason C, Alfano CM, Smith AW, Wang CY, Neuhouser ML, Duggan C, et al. Long-term physical activity trends in breast cancer survivors. Cancer Epidemiol Biomarkers Prev. 2013;22:1153-61. https://doi.org/10.1158/1055-9965.epi13-0141
- Piraux E, Caty G, Aboubakar Nana F, Reychler G. Effects of exercise therapy in cancer patients undergoing radiotherapy treatment: A narrative review. SAGE Open Med. 2020;17(8):2050312120922657. https://doi. org/10.1177/2050312120922657
- Schmitz KH, Campbell AM, Stuiver MM, Pinto BM, Schwartz AL, Morris GS. Exercise is medicine in oncology: Engaging clinicians to help patients move through cancer. CA Cancer J Clin. 2019;69(6):468-84. https://doi.org/10.3322/ caac.21579
- Guercio BJ, Zhang S, Ou FS, Venook AP, Niedzwiecki D, Lenz HJ. Associations of physical activity with survival and progression in metastatic colorectal cancer: Results from Cancer and Leukemia Group B (Alliance)/SWOG 80405. Journal Clinical Oncology. 2019;37(29):2620-31. https://doi.org/10.1200/jco.19.01019
- Schmid D, Leitzmann MF. Association between physical activity and mortality among breast cancer and colorectal cancer survivors: A systematic review and meta-analysis. Annals of Oncology. 2014;25(7):1293-311. https://doi. org/10.1093/annonc/mdu012
- Nelson G, Bakkum-Gamez J, Kalogera E, Glaser G, Altman A, Meyer LA. Guidelines for perioperative care in gynecologic/oncology: Enhanced Recovery After Surgery (ERAS) Society recommendations – 2019 update. Int Journal of Gynecol Cancer. 2019;29(4):651-68. https://doi.org/10.1136/ijgc-2019-000356
- Kazaure HS, Martin M, Yoon JK, Wren SM. Long-term results of a postoperative pneumonia prevention program for the inpatient surgical ward. JAMA Surg. 2014;149(9):914-8. https://doi.org/10.1001/jamasurg.2014.1216
- Goerling U, Jaeger C, Walz A, Stickel A, Mangler M, van der Meer E. The efficacy of short-term psycho-oncological interventions for women with gynaecological cancer: A randomized study. Oncology. 2014;87(2):114-24. https://doi. org/10.1159/000362818
- Do J, Cho Y, Jeon J. Effects of a 4-week multimodal rehabilitation program on quality of life, cardiopulmonary function, and fatigue in breast cancer patients. Journal of Breast Cancer. 2015;18(1):87-96. https://doi.org/10.4048/ jbc.2015.18.1.87
- Muscaritoli M, Arends J, Bachmann P, Baracos V, Barthelemy N, Bertz H. ESPEN practical guideline: Clinical nutrition in cancer. Clin Nutr. 2021;40(5):2898-913. https://doi.org/10.1016/j.clnu.2021.02.005
- Shpata V, Prendushi X, Kreka M, Kola I, Kurti F, Ohri I. Malnutrition at the time of surgery affects negatively the clinical outcome of critically ill patients with gastrointestinal cancer. Med Arch. 2014;68(4):263-7. https://doi.org/10.5455/ medarh.2014.68.263267
- Kabata P, Jastrzębski T, Kąkol M, Król K, Bobowicz M, Kosowska A. Preoperative nutritional support in cancer patients with no clinical signs of malnutrition – prospective randomized controlled trial. Support Care Cancer. 2015;23(2):365- 70. https://doi.org/10.1007/s00520-014-2363-4
- Trépanier M, Minnella EM, Paradis T, Awasthi R, Kaneva P, Schwartzman K, et al. Improved disease-free survival after prehabilitation for colorectal cancer surgery. Annals of Surgery. 2019;270(3):493-501. https://doi.org/10.1097/ sla.0000000000003465
- Lee Y, Yu J, Doumouras AG, Li J, Hong D. Enhanced Recovery After Surgery (ERAS) versus standard recovery for elective gastric cancer surgery: A meta-analysis of randomized controlled trials. Surgical Oncology. 2020;32:75-87. https://doi.org/10.1016/j.suronc.2019.11.004
- Zhang D, Sun K, Wang T, Wu G, Wang J, Cui Y, et al. Systematic review and meta-analysis of the efficacy and safety of enhanced recovery after surgery vs. conventional recovery after surgery on perioperative outcomes of radical cystectomy. Front Oncol. 2020;10:541390. https://doi.org/10.3389/ fonc.2020.541390
- Noba L, Rodgers S, Chandler C, Balfour A, Hariharan D, Yip VS. Enhanced Recovery After Surgery (ERAS) reduces hospital costs and improve clinical outcomes in liver surgery: A systematic review and meta-analysis. J Gastrointest Surg. 2020;24(4):918-32. https://doi.org/10.1007/s11605-019-04499-0
- Hébuterne X, Lemarié E, Michallet M, de Montreuil CB, Schneider SM, Goldwasser F. Prevalence of malnutrition and current use of nutrition support in patients with cancer. J Parenter Enteral Nutr. 2014;38:196-204. https://doi. org/10.1177/0148607113502674
- Cencioni C, Trestin I, Piro G, Bria E, Tortora G, Carbone C. Gastrointestinal cancer patient nutritional management: From specific needs to novel epigenetic dietary approaches. Nutrients. 2022;14(8):1542. https://doi.org/10.3390/ nu14081542
- Sousa-Catita D, Ferreira-Santos C, Mascarenhas P, Oliveira C, Madeira R, Santos CA. Malnutrition, cancer stage and gastrostomy timing as markers of poor outcomes in gastrostomy-fed head and neck cancer patients. Nutrients. 2023;15(3):662. https://doi.org/10.3390/nu15030662
- Semiglazova TYu, Tkachenko GA, Chulkova VA. Psikhologicheskie aspekty lecheniya onkologicheskikh bol'nykh [Psychological aspects of treatment of cancer patients]. Zlokachestvennye opukholi. 2016;4(1):54-8. https://doi. org/10.18027/2224-505702016-4s1-54-58
- De Vries M, Stiefel F. Psychotherapy in the oncology setting recent results. Cancer Rec. 2018;210:145-61. https://doi.org/10.1007/978-3/319-64310-6_9
- Chulkova VA, Semiglazova TYu, Pestereva EV, Kluge VA. Psikhologicheskaya reabilitatsiya onkologicheskikh patsientov [Psychological rehabilitation of cancer patients]. Priroda. 2018;6:39-41. https://doi.org/10.37469/0507-3758-2017- 63-2-316-319
- El-Jawahri A, Traeger L, Park ER, Greer JA, Pirl WF, Lennes IT. Associations among prognostic understanding, quality of life, and mood in patients with advanced cancer. Cancer. 2014;120(2):278-85. https://doi.org/10.1002/cncr.28369
- Kim Y, Shaffer KM, Carver CS, Cannady RS. Prevalence and predictors of depressive symptoms among cancer caregivers 5 years after the relative’s cancer diagnosis. J Consult Clin Psychol. 2014;82(1):1-8. https://doi.org/10.1037/ a0035116
- Solopova AG, Idrisova LE, Makatsariya AD, Chukanova EM. Psikhosomatika i psikhoterapiya kak klyuch k effektivnoy reabilitatsii onkoginekologicheskikh bol'nykh [Psychosomatics and psychotherapy as the key to effective rehabilitation of gynecological cancer patients]. Akusherstvo, ginekologiya i reproduktsiya. 2017;11(1):65-73.
- Tkachenko GA. Art-terapiya v kompleksnoy reabilitatsii onkologicheskikh bol'nykh [Art therapy in complex rehabilitation of cancer patients]. Fizicheskaya i reabilitatsionnaya meditsina, meditsinskaya reabilitatsiya. 2019;1(3):37-9.
- Alhamdoun A, Alomari K, Qadire MA. The effects of massage therapy on symptom management among patients with cancer: A systematic review. Int Res J Oncol. 2020;3(2):38-45.
- Ozol SA, Bodrova RA, Kuchumova TV. Opyt reabilitatsii bol'nykh rakom sheyki matki s narusheniem funktsii mochevogo puzyrya posle provedennogo radikal'nogo lecheniya [Experience in rehabilitation of patients with cervical cancer with bladder dysfunction after radical treatment]. V kn.: «Reabilitatsiya i sanatorno-kurortnoe lechenie». Moscow, RF; 2012. p. 73
- O`Connor D, Lennon O, Wright S, Caulfield B. A personalized and progressive neuromuscular electrical stimulation (NMES) in patients with cancer – a clinical case series. Support Care Cancer. 2019;27(10):3823-32. https://doi. org/10.26226/morressier.5cdbe0a4618793e647b11f4c
- Legouté F, Bensadoun RJ, Seegers V, Pointreau Y, Caron D, Philippe Lang P. Low-level laser therapy in treatment of chemoradiotherapy-induced mucositis in head and neck cancer: Results of a randomised, triple blind, multicentre phase III trial. Radiat Oncol. 2019;14:83. https://doi.org/10.1186/s13014-019- 1292-2
- Robijns J, Nair RG, Lodewijckx J, Arany P, Barasch A, Bjordal JM, et al. Photobiomodulation therapy in management of cancer therapy-induced side effects: WALT position paper 2022. Front Oncol. 2022;12:927685. https://doi. org/10.3389/fonc.2022.927685
- Kirkpatrick K, Shah JD, Shah K. Neuromodulation for adjunctive treatment in postmastectomy pain syndrome. Cureus. 2023;15(10):e47827. https://doi. org/10.7759/cureus.47827
- Pereira D, Ferreira C, Catarino R, Correia T, Cardoso A, Reis F. Hyperbaric oxygen for radiation – induced cystitis: A long-term follow-up. Actas Urologicas Espanolas. 2020;44:561-7. https://doi.org/10.1016/j.acuro.2020.03.010
- Paquette IM, Vogel JD, Abbas MA, Feingold DL, Steele SR. Clinical Practice Guidelines Committee of The American Society of Colon and Rectal Surgeons. The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the treatment of chronic radiation proctitis. Dis Colon Rectum. 2018;61(10):1135-40. https://doi.org/10.1097/DCR.0000000000001209
- National Comprehensive Cancer Network (NCCN): 2018 NCCN Clinical Practice Guidelines in oncology, supportive care: Cancer-related fatigue. Version 2. 2018. Available at: https://www.nccn.org/professionals/physician_gls/pdf/ fatigue.pdf.Accessed:29.03.2018
- Greenlee H, DuPont-Reyes MJ, Balneaves LG, Carlson LE, Cohen MR, Deng G. Clinical practice guidelines on the evidence-based use of integrative therapies during and after breast cancer treatment. CA Cancer J Clin. 2017;67(3):194- 232. https://doi.org/10.3322/caac.21397
- Volodin NN, Kasatkin VN, Tseytlin GYa, Sidorenko LV, Mironova EV, Mitrakov NN. Strategiya mediko-psikhologo-sotsial'noy reabilitatsii detey s gematologicheskimi i onkologicheskimi zabolevaniyami [Strategy for medical and psychological social rehabilitation of children with hematological diseases and oncological diseases]. Onkogematologiya. 2015;1:7-16. https://doi. org/10.17650/1818-8346-2015-1-7-15
Authors' information:
Sanginov Dzhumaboy Rakhmatovich
Doctor of Medical Sciences, Full Professor, Professor of the Department of Oncology and Diagnostic Imaging, Avicenna Tajik State Medical University
Researcher ID: AAH-2351-2021
ORCID ID: 0000-0002-4311-3094
SPIN: 3535-1025
Author ID: 1099938
E-mail: sanginov1952@gmail.com
Khuseynzoda Zafar Khabibullo
Doctor of Medical Sciences, Director of Republican Scientific Oncology Center
ORCID ID: 0000-0002-4823-8531
SPIN: 9316-4084
Author ID: 1111789
E-mail: zafhab@mail.ru
Gayratova Nargis Kurbonalievna
Head of the Department of Mammology and Reconstructive Surgery, Republican Scientific Oncology Center
Researcher ID: JMB-0538-2023
ORCID ID: 0009-0001-5868-8069
E-mail: gayratova76@bk.ru
Niyazov Ilkhomidin Karimovich
Candidate of Medical Sciences, Assistant of the Department of Oncology and Diagnostic Imaging, Avicenna Tajik State Medical University; Head and Neck Surgical Oncologist, Republican Scientific Oncology Center
Researcher ID: AAH-2357-2021
ORCID ID: 0000-0002-2361-043X
SPIN: 7650-2129
Author ID: 805452
E-mail: ilhomnike@mail.ru
Information about support in the form of grants, equipment, medications
The authors did not receive financial support from manufacturers of medicines and medical equipment
Conflicts of interest: No conflict
Address for correspondence:
Niyazov Ilkhomidin Karimovich
Candidate of Medical Sciences, Assistant of the Department of Oncology and Diagnostic Imaging, Avicenna Tajik State Medical University; Head and Neck Surgical Oncologist, Republican Scientific Oncology Center
734026, Republic of Tajikistan, Dushanbe, Sino str., 29-31
Tel.: +992 (918) 874887
E-mail: ilhomnike@mail.ru
Materials on the topic:
- COMPLEX DIAGNOSIS OF CERVICAL INTRAEPITHELIAL NEOPLASIA IN THE REPUBLIC OF TAJIKISTAN
- MODERN METHODS OF LOCAL TREATMENT OF PATIENTS WITH UVEAL MELANOMA WITH LIVER METASTASES
- FIRST RESULTS OF TREATMENT OF CERVICAL INTRAEPITHELIAL NEOPLASIA IN THE REPUBLIC OF TAJIKISTAN
- INFLUENCE OF PLASTIC AND RECONSTRUCTIVE SURGERY ON THE QUALITY OF LIFE OF PATIENTS WITH LOCALLY ADVANCED HEAD AND NECK CANCER
- OUR EXPERIENCE OF IMMUNOHISTOCHEMICAL ASSAY IN BREAST CANCER
- EXPERIENCE OF MULTIVISCERAL RESECTIONS IN LOCALLY ADVANCED AND PRIMARY-MULTIPLE RECTAL CANCER
- COMBINED TREATMENT OF PATIENTS WITH NON-SMALL CELL LUNG CANCER WITH PERSONALIZED PRESCRIPTION OF ADJUVANT CHEMOTHERAPY
- MULTIMODAL APPROACH TO THE TREATMENT OF ESOPHAGEAL CANCER
- ETHNIC PECULIARITIES OF DISTRIBUTION OF ACUTE MYELOBLASTIC LEUKAEMIA IN CHILDREN’S POPULATION IN KYRGYZSTAN
- INDICATORS OF ANTICOAGULATIVE ACTIVITY OF VASCULAR WALL DEPENDING ON STAGE OF BREAST CANCER