Rehabilitation of Breast Cancer Patients [Internet]

Excerpt

Breast cancer is the leading cause of cancer in women world wide. Although recent advances in therapy have improved survival rates, they are associated with significant side effects. The Central Norway Regional Health Authority requested that the Norwegian Knowledge Centre for the Health Services (NOKC) perform a systematic review (SR) on rehabilitation of breast cancer patients.

The aim of this overview is to explore literature to assess the efficacy of single treatments and combination of treatments (e.g. rehabilitation programs) with respect to improvements in physical functionality and psychological well-being.

Results We included 46 randomized controlled trials of moderate or high quality. Seven studies addressed physiotherapy, 11 studies investigated different types of physical activity, 18 studies examined different psychosocial interventions. Two studies addressed nutrition, and five studies address complementary interventions as rehabilitation. Three studies evaluated a complex rehabilitation program. Due to variation in interventions and outcomes it was not possible to perform meta-analyses. The studies on physical activity after primary cancer treatment showed effect on improving quality of life (QoL) and reducing fatigue. It was difficult to conclude about the studies on physical activity during primary treatment due to inconsistency. Three studies showed that early physical activity was not associated with aggravated lymphedema. Four studies showed that cognitive behaviour therapy (CBT) intervention after primary cancer treatment will increase overall QoL. More documentation is needed for the interventions of physiotherapy, psychoeducation, social and emotional support, nutrition, complementary interventions and complex interventions.

Conclusions There is limited documentation for the efficacy of different rehabilitation interventions for breast cancer patients. The documentation from this review indicates that physical activity after primary cancer treatment may increase QoL and reduce fatigue. Patients might also have some benefits on QoL from CBT interventions. More documentation is needed for the effect of interventions of physiotherapy, psycho-education, and social and emotional support. There is still a critical need for further research focusing on rehabilitation interventions throughout and after treatment among breast cancer patients.