Lymphoedema and Oncology

Understanding Oncology Rehabilitation and Lymphoedema Therapy

Oncology rehabilitation in physiotherapy is a highly specialized program designed to help individuals diagnosed with cancer maintain, restore, or improve physical function, strength, endurance, and overall quality of life. This evidence-based care is tailored to support patients at every stage of their cancer journey: before, during, and after treatment, as well as during survivorship and palliative care.

The core principle is to actively address the physical limitations caused by the cancer itself or related treatments, such as surgery, chemotherapy, radiation, hormone therapy, or immunotherapy.

Does Any of This Sound Familiar?

Physical challenges arising from cancer treatment can significantly impact daily life, mirroring the way chronic pain limits function:

Persistent fatigue or profound lack of energy that is not alleviated by rest.

Pain that restricts movement or lingers after treatment.

Weakness or reduced mobility affecting simple daily tasks like walking or reaching.

Swelling (Lymphoedema) in a limb or body part, especially after lymph node removal or radiation.

Stiffness or reduced range of motion following surgery (e.g., breast, chest, or abdominal surgery).

Numbness or tingling (Peripheral Neuropathy) in the hands or feet, often a side effect of chemotherapy.

If these challenges sound like something you are experiencing, a focused physiotherapy assessment and targeted rehabilitation plan can significantly improve function, emotional well-being, and independence.

What Causes Functional Decline in Cancer?

Systemic Impairment

Fatigue and reduced endurance are common, driven by the cancer itself, chemotherapy, radiation effects, and overall deconditioning.

Surgical Deficits

Weakness, post-surgical stiffness, and scar tissue restriction following procedures like mastectomy, lymph node dissection, or tumour removal.

Lymphatic System Failure

Lymphoedema—abnormal, chronic swelling—caused by damage or removal of lymph nodes or fibrosis from radiation, leading to fluid accumulation.

Neurological Side Effects

Peripheral neuropathy, balance issues, and reduced fine motor control resulting from neurotoxic treatments.

Musculoskeletal Issues

Pain and reduced mobility often caused by changes in joint health, muscle atrophy (weakness), or chemotherapy-induced joint pain.

Cardiopulmonary Function

Breathing limitations or reduced aerobic capacity, especially after thoracic surgery or cardiotoxic therapies.

Why Recovery Might Not Be Getting Better

Recovery from cancer and its treatments requires specialised, active care. Progress can be stalled if the following factors are not addressed:

Insufficient Progressive Loading

Excessive rest or a fear of activity leads to deconditioning and muscle atrophy. Tissues and systems need graded activity to adapt and rebuild tolerance.

Unrecognized Lymphatic Impairment

Swelling is dismissed as temporary, leading to untreated lymphoedema, which becomes harder to manage the longer it persists.

Over-reliance on Pacing Without Rebuilding

While energy conservation is crucial, relying solely on pacing strategies without including active, graded strength and aerobic training prevents the long-term rebuilding of physical capacity.

Ignoring Neuromuscular Control

Failure to address balance problems or weakness that increases the risk of falls and limits independence.

Lack of Prehabilitation

Not engaging in strengthening and functional preparation before surgery or treatment, which has been shown to improve post-treatment outcomes.

How Evidence-Based Physiotherapy Helps

Oncology rehabilitation is fundamentally an active recovery model focused on measurable functional goals.

Comprehensive Assessment and Individualised Diagnosis

Functional Baseline

We assess key metrics including strength, endurance, range of motion, balance, and fatigue (using validated scales) to establish a precise starting point and identify modifiable impairments.

Identifying Drivers

We determine if the primary limitations are due to cardiovascular deconditioning, muscular weakness, pain, joint stiffness, or lymphatic dysfunction.

Progressive Exercise Therapy

(The Cornerstone of Care)

Reversing Deconditioning

Graded strength training and aerobic training are proven to safely and effectively combat cancer-related fatigue, improve muscle strength, and enhance cardiovascular function.

Restoring Mobility

Targeted flexibility and range-of-motion exercises address post-surgical stiffness and radiation-induced fibrosis.

Safety and Prescription

Exercise prescription is adjusted based on blood counts, fatigue levels, and treatment cycles, ensuring safety and optimal progress.

Lymphoedema Management

(Complete Decongestive Therapy - CDT)

CDT Approachs

This is the gold standard for managing or reducing chronic swelling.

Compression

Application of short-stretch bandaging or custom-fitted compression garments to reduce fluid accumulation.

Therapeutic Exercise

Limb movements performed while wearing compression to maximize fluid return.

Skin Care

Education on meticulous care to reduce the risk of infection (), a serious complication of lymphoedema.

Neuromuscular and Motor Control Retraining

Balance Training

Specific exercises and drills to improve stability and reduce fall risk, especially important for individuals with peripheral neuropathy.

Functional Retraining

Guidance on safe body mechanics for lifting, reaching, and other activities of daily living.

Education and Self-Management

Energy Conservation

Teaching pacing strategies and activity modification to manage fatigue without promoting excessive rest.

Prevention

Providing education on recognizing early signs of lymphoedema, managing scars, and adhering to lifelong protective measures.

Next Steps

If cancer treatment has limited your activity, mobility, or energy, booking a thorough oncology rehabilitation assessment is the starting point for active recovery. Expect a clear roadmap with targeted exercise programming, symptom management (e.g., fatigue, pain, lymphoedema), functional restoration, and self-management strategies to maintain independence and improve your overall well-being.

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