Seen the social media account of cancer thrivers or survivors? Watched some videos of them heading into the surf, doing awesome yoga moves or finishing a marathon? Heard from your surgeon that you’ll be right in 3 months? Sure get inspired. Sure aim high. Sure feel pleased that timeframes are within sight. Aiming high is wonderful, inspiration is essential, looking into the future and getting specific healing timeframes can be hopeful. However, to keep aiming high, to keep being inspired and keep being hopeful it is vital that the aims are appropriate for you. You are unique, your recovery will be unique and getting individualised, careful planning of your physical management and recovery with your own cancer rehab physiotherapist is key to achieving your aims. The following article will outline some of the potential challenges related to cancer recovery that I come across in my practice as a cancer rehab physio. My hope is that if you are aware of these challenges, you alongside your physio will be better able to make decisions that suit you and this awareness will allow your rehab plan to be individualised so that you get to where you want to go.

Challenge one: Healing Timeframes don’t always correlate to function.

One of the issues I see is that medical healing timeframes does not mean the same to clients as they do in a medical sense. For the surgical team, they see a 3-month post op timeframe as when they expect the body’s healing to be sorted and this is often the case from a normal tissue healing perspective. It is their job to make sure the wound site is healed before they hand you over to other members of the medical team. However, clients often hear this timeframe or complete their 3-month surgical check and expect that they should be ‘back to normal’. Without taking this timeframe away from you, depending on the surgery, depending on any complications that arise, depending on your unique circumstances such as medical history, exercise history and lifestyle this may not be the case. Some of these factors are discussed in subsequent sections below. It is of course expected that you will feel much better at 3 months than you did day one post operatively, but I often find clients get very frustrated around the 3-month mark because they still notice some activities remain limited at this point. Just remember, in the same way that healing takes place over 3 months, strengthening too takes time. Therefore, when you’ve been in pain, when you haven’t moved the same way for weeks or months then it will take 2 – 3 months plus of consistent targeted exercise to improve strength and function. This timeframe is often on the longer end if you want to return to sports or activities that require a high level of function because the complexity and or repetition of movement needs a lot more time and training to allow tissues to adapt to the movements involved. With rehab, the expectation is that over time there are fewer and fewer activities of higher complexity that are limited. A cancer rehab physio can support you prior to surgery and post-surgery for as long as required to help restore ease of movement, function and strength to the operated areas as well as supporting you to access exercise options that you enjoy doing for the multitude of health benefits that this brings. So, keep the faith, keep working with your physio and the results will follow.

Challenge two: You are unique

The human body is incredibly adaptable and resilient, it can be supported to adapt and recover post-surgery. Something I enjoy about my work is that each client is unique both in a physical sense and in what you want to do with your lives. You have a medical history unique to you. For instance, you may already have had neck/shoulder/arm issues previously and if that is the case it is likely you will need targeted physio support to address this. You have your own aims, dreams and interests. For instance, if you have a practical job where you use your upper limbs regularly or if you are in an office on a computer these jobs all have their own set of physical requirements that you may require targeted therapy to return to. If you want to return to upper body dominant sports such as rock climbing or swimming, contact sports such as rugby or boxing these all have their own rehab requirements as well. Training plans and management plans can be put in place according to what you are able to do now, capable of doing in the future and weighing up pros and cons of activities so that you can make informed decisions. One thing I will also note is that interests can change over time so just let your physio know and adapt the plan to the new interest and away you go!

Challenge three: Things don’t always go according to plan

Unexpected things are somewhat expected in cancer treatments and recoveries. Complications such as seroma, infection, lymphoedema and cording can occur which can lengthen recovery timeframes. Furthermore, other cancer treatments including chemotherapy, radiotherapy, immunotherapy and hormone therapies have an impact on – your time, your energy levels, your sleep, healing and so much more. Talk with your medical team including your physio to help with planning. This could include putting some extra time in your goal timeframes to allow for the unexpected and having key check in points to help with adjusting targets. These actions help avoid disappointment and the sense of failure when a timeframe comes and goes. It also helps you to stay on track towards your goal and in a positive frame of mind. Finally, it helps put in place resources and support to optimise your recovery in a proactive manner which is incredibly empowering.

Challenge four: Being too competitive

Competitive clients are great – you are often motivated which leads to good adherence to physiotherapy advice and exercise regimes but it can also lead to a lot of frustration, overdoing things too early and unrealistic expectations. Don’t get me wrong, I want you to dream big, seek great things and go after challenges. I just find there is a sweet spot – where you have a big dream, and we work towards that together whilst avoiding comparing yourself to others or to your previous physical ability. It is this comparison that can lead to you overdoing activities when you aren’t ready and causing an injury or issue. This comparison can be emotionally painful and drain your energy.

One helpful solution is trying to accept yourself where you are now. That isn’t an easy task to accomplish by yourself, that’s why it is useful to have a physio to help with this. Importantly, acceptance does not mean that you must ‘like’ where you are at. Instead, acceptance is recognition of where you are now and adjusting to work with that. A physio assessment can be useful because I can show you clear measures of what you are able to do now as well as explain why this is the case. This recognition and knowledge can lead to acceptance which allows treatment plans to be made to help you improve these measures. Then overtime you can watch the measures improve and thus encourage you to keep up with your physio sessions and your home exercises as you know they are helping you achieve your goals.

Challenge five: Boring or unsustainable plans

Have you ever found yourself working towards a goal, not enjoying yourself and therefore stopping taking actions? Just like children in school, those who are interested in class are going to get the results, the kids that are bored won’t. So, if your recovery plan is boring, not tailored to your interests and does not fit into your schedule easily, it is unlikely to get results. I want to ensure that the pathway to getting to where you want to go is enjoyable, fulfilling and works with your lifestyle. This will ensure you are consistent with your actions. So, if you hate dancing then we won’t incorporate it in your exercise plan, however if you love a good boogie then for sure let’s add that into your weekly exercise plan! If you know it is unrealistic to do proposed exercises daily because of your family role, your work role or your other cancer treatments then let’s adjust to ensure it works for you in the long term.

Now that you are aware of some of the challenges, I hope you can recognise that your recovery requires the following; acknowledging where you are right now, knowing where you want to head to, making a plan (that is likely to require adapting at times) and taking targeted actions that are individualised, consistent, progressive and fun to help you get there. So, continue to be inspired, hopeful, aim high and lean on your cancer rehab physio.