Cancer rehabilitation occurs across four key phases, each addressing distinct needs:

• Preventative rehabilitation (Prehabilitation or Prehab): Begins at diagnosis, focusing on education, exercise, and nutrition to build resilience before treatment. This phase reduces surgical complications and hospital stays.

• Restorative rehabilitation: Active during/after treatment (e.g., chemo, surgery), aiming to regain function through supervised exercise, nutrition plans, and therapy. It improves strength, mobility, and quality of life.

• Supportive rehabilitation: For chronic or progressive cancer, this maintains independence via community-based exercise (e.g., walking groups), adaptive strategies, and psychological support.

• Palliative rehabilitation: In advanced stages, priorities comfort, symptom management (e.g., pain, fatigue), and caregiver support to maximise dignity and reduce burden.

Prehabilitation prepares patients physically and mentally for surgery, leading to:

• Reduced complications: Exercise and nutrition boost functional capacity, lowering risks like infection or prolonged hospitalisation.

• Faster recovery: Patients regain mobility quicker and experience shorter hospital stays (by ~2 days).

• Psychological resilience: Anxiety management improves coping during treatment.

• Enhanced outcomes: Even brief prehab (<2 weeks) improves surgical tolerance and long-term function.

Yes, MDTs are critical for holistic care. Core members include:

• Physiatrists (Rehab specialists): Lead functional assessments and prescribe tailored exercise/mobility plans.

• Oncologists: Guide treatment integration and symptom management.

• Nurses: Coordinate care, monitor symptoms, and educate patients/families.

• Physical/Occupational therapists: Implement strength training and daily activity adaptations.

• Dietitians: Optimize nutrition to counter cachexia and support recovery.

• Psychologists: Address anxiety, depression, and cognitive changes.

Synergy: MDTs prevent gaps in care (e.g., untreated neuropathy) through coordinated plans, reducing hospital readmissions by 25%.

Physical rehab benefits most cancer types but requires caution in:

• Advanced metastatic disease: Focus shifts to palliative rehab; intense exercise may be inappropriate.

• Bone metastases/unstable fractures: Weight-bearing activities risk injury; hydrotherapy or seated exercises are safer.

• Severe thrombocytopenia: Low platelet counts contraindicate strenuous activity due to bleeding risk

Note: Rehab is adaptable – even bedbound patients benefit from breathing exercises or passive stretching.

Lymphedema (swelling due to lymphatic damage) is managed through:

• Complete Decongestive Therapy (CDT): Combines manual lymphatic drainage, compression bandages, exercises, and skincare. This gold standard reduces swelling by 40-60%.

• Compression garments: Worn daily to maintain fluid reduction after CDT.

• Exercise: Graduated strength training improves lymphatic flow without exacerbating swelling.

• Surgical options: Lymphaticovenular anastomosis (LVA) may be considered but shows limited efficacy in advanced cancer.

Key: Early intervention prevents progression. In palliative stages, focus shifts to comfort (e.g., gentle massage, soft bandages).