Journal: South African family practice : official journal of the South African Academy of Family Practice/Primary Care
This publication is a narrative overview highlighting the role of physiotherapy in managing common, function-limiting side effects of cancer and its treatment—specifically cancer-related fatigue (CRF), chemotherapy-induced peripheral neuropathy (CIPN) and lymphoedema.
Key points:
- As cancer survival improves, persistent treatment-related side effects significantly impair quality of life and daily function.
- Basic undergraduate physiotherapy training provides a foundation for oncology rehabilitation, but optimal management of CRF, CIPN and lymphoedema requires additional oncology-specific training.
Cancer-related fatigue (CRF):
- CRF is described as one of the most common and distressing symptoms during and after treatment.
- Evidence strongly supports non-pharmacologic interventions, particularly structured exercise, as the mainstay of management; pharmacologic options remain limited.
- Physiotherapists should be considered as primary providers for CRF management, with early referral encouraged.
Chemotherapy-induced peripheral neuropathy (CIPN):
- Physiotherapeutic interventions, including exercise and sensorimotor integration approaches, are supported by research for improving symptoms and function in CIPN.
- Rehabilitation aims at reducing sensory deficits, improving balance and gait, and preventing falls.
Lymphoedema:
- Physiotherapists with additional certification in lymphoedema therapy can provide Complex Decongestive Therapy (CDT), identified as the gold standard for lymphoedema management.
- In South Africa, the Lymphoedema Association (LAOSA) supports standardised care through a 135-hour certification process.
Practical implications for primary care:
- All members of the multidisciplinary team should actively promote exercise in patients with cancer.
- Early identification of CRF, CIPN and lymphoedema in primary care and prompt referral to appropriately trained physiotherapists are emphasised as integral to comprehensive cancer care and survivorship.