Stubblefield Michael D
Kessler Institute for Rehabilitation, National Medical Director for Cancer Rehabilitation, Select Medical, 1199 Pleasant Valley Way, West Orange, NJ 07052(∗).
PM R. 2017 Sep;9(9S2):S317-S323. doi: 10.1016/j.pmrj.2017.05.010.
Breast cancer survivors can experience multiple neuromuscular, musculoskeletal, pain, and functional disorders as a result of their cancer and its treatment. Common disorders include shoulder dysfunction, postmastectomy syndrome, chemotherapy-induced peripheral neuropathy, axillary cording, lymphedema, and a host of others. Cancer rehabilitation is a process that helps breast cancer and other survivors to obtain and maintain the highest possible physical, social, psychological, and vocational functioning within the limits created by cancer and its treatments. There are good data supporting the safety and efficacy of cancer rehabilitation in the treatment of many breast cancer-related impairments, including shoulder dysfunction and lymphedema, among others. Despite the goals and efficacy of cancer rehabilitation, there is a marked underuse of services. The reasons for this phenomenon are many, but broadly result from a lack of knowledge about cancer rehabilitation on the part of patients and referring clinicians, limited access to services, and suboptimal adherence. This article explores underutilization of cancer rehabilitation in breast cancer survivors and provides an opportunity to consider ways to improve this gap in care.
乳腺癌幸存者可能会因癌症及其治疗而出现多种神经肌肉、肌肉骨骼、疼痛和功能障碍。常见的疾病包括肩部功能障碍、乳房切除术后综合征、化疗引起的周围神经病变、腋窝条索状粘连、淋巴水肿等等。癌症康复是一个帮助乳腺癌患者和其他幸存者在癌症及其治疗所造成的限制范围内，获得并维持尽可能高的身体、社会、心理和职业功能的过程。有充分的数据支持癌症康复在治疗许多与乳腺癌相关的功能障碍方面的安全性和有效性，包括肩部功能障碍和淋巴水肿等。尽管癌症康复有其目标和疗效，但服务的使用明显不足。造成这种现象的原因有很多，但大致上是由于患者和转诊临床医生对癌症康复缺乏了解、获得服务的机会有限以及依从性欠佳。本文探讨了乳腺癌幸存者中癌症康复服务利用不足的问题，并提供了一个机会来思考改善这一护理差距的方法。
