Spinal cord cancer and brain cancer are very serious and can be terminal, even with aggressive treatment. If you have these types of cancer, you will likely undergo surgery, hospitalization, chemotherapy, or a stay at a rehabilitation facility. Understanding the importance of the purpose of physical therapy for these conditions will guide you in your treatment time, recovery period and end-of-life considerations.
Associated Symptoms of Brain Cancer
Because your brain tumor places pressure on an area of your brain, your symptoms are similar to other brain injuries such as a severe trauma to your brain or a stroke. Numbness, difficulty speaking, confusion and poor coordination are among the most common functional symptoms. Physical, occupational and speech therapy are usually indicated to address the plethora of functional deficits that you may face. However, localized tumors that do not metastasize will likely affect only one aspect of your body. Surgery to remove them can be problematic, creating new deficits from areas damaged as the surgeon retrieves the tumor.
Challenges of Spinal Cord Cancer
Spinal cord cancer can cause extreme pain, numbness and paralysis as the spinal cord is compressed and potentially damaged at the site of the tumor. Furthermore, removal of the tumor can cause additional damage and may not reverse the symptoms, but will decrease the risk of metastases. The extent of symptoms range from numbness in a small area from the neck down to total quadriplegia, or paralysis from the neck down. The extent of your symptoms depends upon the location and size of the tumor. All of the nerves located below the tumor on your spine can be affected; thus, a tumor that is located closer to the neck poses the greatest risk for symptoms.
Physical Therapy
Physical therapy (PT) can vary greatly throughout your treatment and recovery process and will often be accompanied by occupational and speech therapy. The focus of your PT will be ambulation and your therapist will work with you to strengthen your muscles and improve your balance, which may be further affected by chemotherapy or surgical side effects. You may require the use of an ambulation device such as a cane or walker, and your therapist will teach you how to use them safely. As you prepare to return home, your PT will additionally focus on stair negotiation so that you can climb stairs to enter your home.
Terminal Considerations
If your cancer progresses, you will notice a decline in your functional independence and an increase in your symptoms related to your cancer site. Additionally, bone metastases are a significant risk and can result in bone fractures from mild activity. Your therapist will educate you on these limitations and continue to facilitate your independence with ambulation. You may require a walker or wheelchair for mobility if your symptoms worsen. If you require hospice, therapy will center around your comfort and may include adaptations to your bed or wheelchair for positioning and comfort or range of motion to ease your pain.
