Statistics show that as of 2017, more than one million Canadians have survived cancer for more than 10 years.[1] Yet, “the physical rehabilitation needs of cancer survivors in Canada have received little attention and few services.”[2] Only one large-scale study has been conducted in Canada that has identified gaps present in the provision of oncology rehabilitation programs. This study found that “Only 20 sites across the country were identified as offering some form of oncology rehabilitation program, which indicates that established programs are scarce despite growing evidence of the benefits of rehabilitation across the cancer survivorship continuum.”[3] The main barriers to development identified by respondents to the study were lack of funding and lack of resources, and the majority of rehabilitation programs which do exist were located in urban centres.
“The problem we have is that rehabilitation is not part of the normal cancer care continuum. If one were to have a stroke, one would automatically be triaged for the appropriate level of rehabilitation services. If it was a mild stroke, you would go home with community based services. If it was a moderate to severe stroke, you would go to inpatient rehabilitation and eventually progress to home community services. In a very severe stroke, you may go directly to a long-term care facility but you would still get some rehabilitation. That doesn’t happen in cancer.”
“Cancer rehabilitation is hit and miss. Depending on where you live and what type of cancer you have, there may be services available. If you have lymphedema following breast cancer and you live in Oshawa, you might be able to get to a lymphedema clinic. If you’ve had throat cancer and you need swallowing exercises and you need a speech therapist and you live in Elliot Lake, you probably won’t get it. Even if there are services, oncologists don’t often refer because they don’t know about the services. And when they do know about the services, sometimes they still don’t refer because we don’t have enough trained rehabilitation professionals in the community. So, some of the oncologists who are familiar with the benefits of rehab still don’t refer just because they know it’s very frustrating for the patients to be referred to a service that can’t help them.”
(Dr. Sara McEwen, Assistant Professor, Department of Physical Therapy, St. John’s Rehab Research Program, Sunnybrook Research Institute, Assistant Professor, Rehabilitation Sciences Institute, University of Toronto)[4]
[1] http://www.ccra-acrc.ca/index.php/publications-en/strategy-related-publications/item/pan-canadian-framework-for-cancer-survivorship-research
[2] https://physiotherapy.ca/blog/rep-24-we-know-it-works-so-where-are-cancer-rehabilitation-services-canada
[3] Ibid.
[4] All Party Cancer Caucus Ontario, Ontario Legislature 41st Parliament 2nd Session, November 22nd, 2017