Cancer Rehabilitation

Accredited Cancer Rehab in Southwest Florida

At our accredited Lee Health Cancer Institute, patients treated for cancer are living longer, well beyond their cancer diagnosis due to advances in early cancer detection and screening, and improvements in treatment protocols. However, many of the cancer treatments involve toxic agents or extensive surgeries that can leave side effects that limit physical functioning and quality of life.

It has been identified that 65-90% of cancer patients will have at least one rehabilitative need as a result of their cancer treatment. While some people experience minimal limitations, others may suffer several debilitating effects on their physical, functional, and emotional well-being or overall quality of life.

These side effects can limit one’s ability to stay active, work, and carry out other life roles. It is important to know that some side effects are experienced during treatment and others can evolve or linger for an extended period after treatment.

What cancer symptoms can rehabilitation help with?

Comprehensive individual therapies address a wide variety of cancer related conditions and symptoms including but not limited to:

Aerobic deconditioning
Bladder and bowel dysfunction
Increased tiredness, fatigue (CRF)
Joint stiffness, range of motion limitations
Lymphedema (swelling)
Memory and concentration (Chemo-fog)
Numbness, tingling, neuropathy (CIPN)
Pain
Postural instability
Scar tissue, radiation fibrosis
Swallowing and speech challenges
Weakness
Walking / balance problems

As pioneers in this region for cancer specific rehabilitation, we offer a unique service to all cancer patients and survivors known as Cancer Rehab Navigation.

Navigators for Rehabilitation

This is a licensed physical or occupational therapist, who specializes in cancer rehab and provides a free appointment in person or by phone to educate, identify and monitor your rehabilitative needs. Your navigator for rehab collaborates with your medical team and providers to identify and triage you to the appropriate rehab service.

Navigators for rehab also connect you to all the services and resources available in the Lee Health Cancer Institute including nurse navigation, oncology dietitian, licensed clinical social worker, support groups, integrative services, wellness programs and Palliative care. Every patient is offered this free navigation appointment which provides a “contact person” for any needs identified throughout treatment and after treatment.

Rehab for Cancer Patients

Cancer rehab Physical Therapist Megan Lord said 65 to 90% of cancer patients have at least one rehab need, “Our goal with the rehab navigation is to work with all the other disciplines like your nurse navigation, the dietitian, the counseling, your wellness program support groups, because we want to make sure that they have all the resources throughout the process.”

The way she helps depends on the stage the patient is in. Sometimes they do prehab, “Which is they have the cancer diagnosis, but they plan on having surgery and their physicians feel they need to build up their stamina or strength to prepare for surgery.”

They can also help with post-surgery impairments, “Whether it be limited range of motion of lifting their arm over head after breast cancer surgery, core or back weakness after gastrointestinal cancer.”

Lord said radiation brings its own set of challenges. “Our clinicians will do hands-on techniques, along with stretches and exercises to help remove that scar tissue. You also have speech therapy, that radiation affects their swallowing sometimes.”

Lord said she adjusts her therapy program to her patients’ needs, while always keeping their goals in mind, “You want to improve the quality of life as much as you can. Keep them at the prior functional level as much as you can, doing activities they want to do.” A helping hand during a difficult time.

Our Cancer Rehabilitation Team:

Physical therapists: evaluate, educate and implement individualized treatment programs to increase physical functioning and reduce intensity of cancer related side effects that decrease overall function and quality of life. Common challenges include pain, fatigue, neuropathy, stiffness, weakness, balance, work reintegration, low endurance and deconditioning. We also have specialists in pelvic floor dysfunction, vestibular therapy and Pilates based programs.

Occupational therapists: evaluate, educate and implement individualized treatment programs to improve one’s ability to perform activities of daily living such as dressing, bathing, energy conservation, upper extremity function, fine motor coordination and work reintegration.

Speech/swallow therapists: evaluate, educate and implement individualized treatment programs to address swallowing therapy, communication enhancement strategies and vocal strengthening, along with cognitive training and memory enhancement techniques to optimize quality of life.

Certified Lymphedema therapists: evaluate, educate and treat swelling, known as lymphedema in the extremities, trunk and neck that often follows cancer treatment. This can be a result of lymph node removal and radiation. Initiation of therapy as early as possible can decrease extensive, irreversible changes that can lead to life-long management,

Specialty Programs

Lymphedema Surveillance Program:

Early detection of Lymphedema is key to reversing or minimizing the long-term challenges and management of this condition often seen in cancer related surgeries and treatments that involve lymph node biopsy and radiation treatment. Monitoring for lymphedema is frequently used for cancer diagnoses involving breast, melanoma, prostate, gynecological, bladder, and lymphoma.

At the Lee Health Cancer Institute, we use a non-invasive, state of the art bio-impedance device called the SOZO. SOZO® uses technology, which sends a low-level electrical signal through the body. This can deliver a precise snapshot of fluid status and tissue composition in less than 30 seconds for swelling in the arms and legs. (SOZO not used to detect head and neck cancer related lymphedema).

This measure aids in monitoring fluid and tissue status in patients, which can enable earlier intervention and improved outcomes for Lymphedema management. Click on this link to learn about Lymphedema and your risks.

All newly diagnosed Breast cancer patients who are involved in the Multidisciplinary Breast Clinic are measured on the SOZO as part of our Breast Cancer Related Lymphedema Surveillance Program.

To inquire about our SOZO, contact Denise.Pfeiffer@Leehealth.org or call (239) 343-9586

Detecting and Reversing Lymphedema

Using your hands and feet—this high-tech machine is able to determine your risk for lymphedema in just a few seconds. “The SOZO machine is a bioimpedance device that utilizes a low energy current that can detect fluid and tissue volumes in the body,” explained Denise Pfeiffer, a physical therapist with Lee Health.

The SOZO is used in the Regional Cancer Center’s rehabilitation program as a way for therapists to check patients for lymphedema. “Lymphedema is a condition that occurs for some patients when they have a removal of lymph nodes or have radiation treatment near a specific area of the body that can interrupt the flow of the lymphatic fluid,” she said.

Lymphedema is a backup of lymphatic fluid that commonly occurs in patients with head and neck cancer, breast cancer, prostate cancer, gynecological cancers, and melanoma. “Lymphedema if it is not caught in its earliest phase, which the SOZO device allows us to do, it can become a chronic long-term condition that reduces the quality of life as well as creates many functional and physical impairments for patients,” said Pfeiffer.

The SOZO can detect the signs of lymphedema as early as four to ten months before a patient develops symptoms. “The most common symptom that we see is swelling,” she said.

The sooner lymphedema is detected and addressed, the better the outcome.

Prehabilitation (PRE-HAB):

Prehabilitation is a program designed to help you physically prepare for cancer related surgery or treatment through participation in physical and/or occupational therapy. This occurs between the time of a cancer diagnosis and the beginning of surgery or treatment to establish a baseline functional level, identify impairments, and provide interventions that promote and optimize your physical and functional status. Prehab improves recovery time and coping ability, as well as decreasing hospitalization length of stay and complications. After your surgery or treatment, cancer rehabilitation can be continued once cleared by your referring surgeon or physician.

Prehab is referred routinely by some providers based on your cancer diagnosis and pre-treatment physical condition. If you feel you could benefit from Prehab, contact a Navigator for rehab directly at (239) 343-9586 and we will assist you.

Head and Neck Cancer Rehab Pathway

At the time of diagnosis, head/neck cancer patients are referred to the Speech Language Pathologist as a standard of care. This is an opportunity to complete baseline measures of swallow function, make diet recommendations for the safest diet, and reduce aspiration risks. Many diagnosed with head/neck cancer will develop swallowing deficits during treatment and some have swallowing difficulty at the time of diagnosis.

The patient is also provided with education and a home exercise program to help maintain swallowing muscle function throughout treatment. If a patient will be undergoing surgery, then pre-op education is provided regarding the impacts on speech and swallowing.

Speech/swallowing therapy may be initiated post-surgery and before starting chemoradiation. Participation in the head/neck cancer pathway provides better functional outcomes and a faster return to tolerating an oral diet post-cancer treatment.

Head and Neck Cancer

Detecting head and neck throat cancer early is crucial. Learn about non-small cell cancer symptoms and treatment options available at Lee Health Cancer Institute.

Pathway to Cancer Therapy

Three times Phil McNulty battled throat cancer. He won each time, but in the process lost his voice.

"They were doing very massive radiation back then and it was so massive that I really couldn't swallow for like three years," says McNulty.

His story is painfully familiar. Speech therapist Stacey Brill works with people like McNulty- helping them eat, drink and speak. The sooner they start, the better their chances.

"We've had many patients referred to us 10 years post chemo and radiation. Many of them still have a feeding tube in. So imagine living your life with feeding tube for all of those years when potentially you may have not had to," says Stacey Brill, speech therapist with Lee Memorial Health System.

The road to swallow therapy wasn't well paved. Many patients never heard of it. Something Brill hopes to change.

"Listening to the cancer patient and family members as to what was missing and feeling out some input from some physicians we were able to put together and head and neck cancer pathway," says Brill.

Here's how the pathway works: when someone gets a diagnosis, they can work with a cancer navigator, a Lee Memorial Health System specialist, who will guide them to specialists and help set appointments, one of which will be with a speech therapist.

"As soon as we're able to identify they're having difficulty swallowing we go ahead and start them in swallow therapy so we can maintain a goal of oral intake throughout the course of their chemo and radiation," says Brill.

Some patients will have temporary swallowing issues, others permanent. Therapy can strengthen or retrain the throat muscles. Using exercises and electrical stimulation, it made a world of difference to McNulty.

"The more you know about your problem and how you can help yourself, that's really important to recover or just to start functioning again," says McNulty.

Pre-Surgery Educational Videos For Lumpectomy, Partial Mastectomy and Mastectomy Surgeries

The Breast Cancer Nurse Navigation team and Cancer Rehabilitation team partner to help you get ready for your Breast Cancer related surgery.

Education and instruction is presented to you in an informal setting that prepares you for your surgery, what to expect, care after surgery, activity guidelines, precautions, mobility and exercise guidance.

View our Cancer Patient Educational Videos to improve your knowledge and readiness for surgery

Pre-Operative and Post-Operative Education at Cancer Institute

Prepare for your journey with comprehensive pre-operative and post-operative education at the Lee Health Cancer Institute. Our informative videos covers essential insights, from understanding procedures to post-surgery care.

Contact The Cancer Rehabilitation Program

To access the Cancer Rehabilitation Program at Lee Health, you can call 239-343-9595 to make a free appointment with the Cancer Rehabilitation Navigator or ask your oncologist or physician for a referral to the Cancer Rehabilitation Program. All fax referrals must be sent to (239) 343-9598. Otherwise referrals may end up with general therapists and not cancer rehabilitation therapists.

With a signed order for a specific discipline evaluation for physical therapy, occupational therapy, speech therapy, and/or lymphedema therapy and fax to the number above.

Every referral to the Cancer Rehabilitation Program includes a free rehabilitation navigation interview either in person or by phone. This appointment identifies rehabilitation needs, referrals to other services including a dietitian, palliative care for pain and symptom management, the Healthy Life Center, and provision of resources for support groups, counseling, yoga, massage, acupuncture, and smoking cessation.

What is the cost of navigation services?

Navigation for rehab is of NO COST to you. It is an appointment by phone or in-person.

The cost of rehabilitation therapy services (PT, OT, SP and Lymphedema) varies based on your insurance coverage. This also depends on if you have met your overall insurance deductible. It is always best to check with your insurance provider to determine if you have an out-of-pocket cost or co-pay.

We understand that not all patients have insurance or the same financial circumstances. We have a variety of discount programs, payment options, and specialists who can work with you one-on-one to understand your bill, your insurance coverage, and the assistance you may qualify for.