Recently, the open-access journal, Cancer, included a special issue: Supplement: A Prospective Surveillance Model for Rehabilitation for Women With Breast Cancer. This model has been described by researcher, Nicole Stout, as a “proactive approach to periodically examining patients and providing ongoing assessment during and after disease treatment, often in the absence of impairment, in an effort to enable early detection of and intervention for physical impairments known to be associated with cancer treatment(1).” In other words, checking early and often so that issues can be dealt with at a mangeable stage and not in a catastrophic end-stage presentation. Theoretically, this model of approach can mitigate many of the known poor related outcomes for patients following cancer treatment.
The model of prospective surveillance has been developed over the last decade at the National Naval Medical Center in Bethesda-now part of the Walter Reed National Military Medical Center. It’s the standard of care for all patients there and serves as a great base for research into the clinical effectiveness of this approach. While bottom-line cost savings numbers aren’t apparent yet, this seems a likely outcome, as overall, patients consume less care when issues are dealt with in early stages when their prognosis is still strong. Regardless, it’s a cool phrase!
The prospective surveillance model attempts to cover many aspects of cancer treatment, including awareness of known side-effects to the sometimes persistent upper extremity pain and dysfunction that so many women share following treatment for breast cancer. Describing and quantifying the séquelle of post-treatment effects that are common following treatment that can be ameliorated through rehabilitation are part in parcel in studying this model, and are dealt with as well in the supplemental Cancer issue. Check it out and get smart!
This issue hits close to home for me. My mother is a breast cancer survivor. As she recovered, I was well aware of the musculoskeletal dysfunction in her upper extremity, yet was confounded at the lack of attention that received from her care providers. Research into this area is a critical, emerging field of physical therapy and one that makes me proud.
As an aside, Nicole Stout is a member of the APTA Board of Directors (Scroll to Bottom). She is in candidate status this year and I’m sure would appreciate any support one could be in the position to be in as elections approach in June. She does important work.1. Stout NL. Cancer prevention in physical therapist practice. Phys Ther. 2009; 89( 11): 1119-1122.