Article

The relevance of cancer rehabilitation as a public health issue grows steadily as
cancer incidence, survival, and mean patient age increase. Reported rates of
physical impairment and disability are already high, prior to the anticipated
influx of aged cancer survivors. Despite the high prevalence of cancer-related
disablement, treatment rates, even for readily remediable physical impairments,
are as low as 1-2%. In addition to low referral rates, a challenge to
patient-centric cancer rehabilitation is a fractured system that requires
multiple visits to a range of specialists to address even a single issue, and
cancer survivors generally have several. Effective solutions must acknowledge the
limited cancer rehabilitation clinical work force and its clustering in tertiary
centers, as well as the lack of consensus regarding the essential and effective
components of a cancer rehabilitation program. A number of models of cancer
rehabilitation service delivery have been developed, but, as yet, none have been
empirically validated. This paper describes these models and proposes a taxonomy
for stratifying the needs of cancer survivors. Modalities used to preserve or
restore function among survivors range from simple, relatively intuitive
activities to complex, integrated programs that include diagnostic and
multi-modal pharmacological, manual, and even procedural interventions. Criteria
for determining a survivor's needs across this spectrum are proposed, and the
role of the physiatrist as a vital advocate and champion discussed.
CI - Copyright A(c) 2016 Elsevier Inc. All rights reserved.

Langue : ANGLAIS