Rehabilitation of cancer patients
Oncology / / May 11, 2016
few people thought about the rehabilitative treatment of cancer patients Until recent years;Doctors treated him with great skepticism and fatalism.However, this type of treatment is becoming increasingly important due to the increasing number of cancer patients who received radical treatment.For example, in Russia registered in cancer institutions is about 2 million. Patients with malignant tumors with a follow-up of more than 5 years.
well known that malignant tumors are most common in the elderly, but among the cases is relatively large and also the proportion of young people in the prime of creative and work.For example, lung cancer often suffer from the husband's 41 year to 55 years, uterine horionkartsinoma most common in women between 20-40 years, bone tumor lower extremities usually strike persons between the ages of 10-30 years, and so on. D. Thus,rehabilitation treatment of these patients, the return of disability they become important.
should be noted that the concept of survival of cancer p
program of rehabilitation treatment should be planned individually for each patient, depending on the general condition, sex, age, stage of tumor development, its localization, histological structure, the alleged treatment, prognosis, state of neuro-psychiatric patient, his labor orientation, careerand working conditions.Despite the fact that it is impossible to accurately determine the prognosis of the disease at the beginning of the treatment, it is necessary to set goals remedial actions to be able to draw up their plan.The physician must be provided to all possible causes of disability, which may arise as a result of the disease or the treatment to be able to reduce or prevent them.
presence of cancer or even suspected it is in itself a powerful stress factor.Changes occur in the psyche of patients regardless of the type, shape and location of cancer, the patient's condition, sex, age, intellectual level and education.In this case the patient psychologically easier removal of the internal transfers invisible body than, for example, amputation, breast removal or operation of the head and neck.
One of the major activities of the program of rehabilitation treatment without exception cancer patients, is psychological work with the patient.Getting it should fall at the time of examination of the patient, and the dynamic observation of the psychologist and psychiatrist continue not only for clinical, but also distant rehabilitation treatment period.
Repeated, everyday conversation, doctor, psychotherapeutic behavior of all staff branches, differentiated application of individual and collective group activities negate confusion, anxiety patients, neurasthenic syndrome.Effective use of combined techniques with elements of anger management.In the following good results with rational psychotherapy autogenous training.
powerful psychotherapeutic influence has physiotherapy, are also included in the program of rehabilitation treatment of cancer patients.In the preoperative period, the purpose of employment, along with the psychological impact of a patient education proper, full breathing, coughing techniques, turning and landing in bed, t. E. The skills that should find its application in the postoperative period.When diagnosed terminally ill similar classes continue in a minimum volume, pursuing a goal of psychotherapy.Upon successful surgical treatment of the intensity of physical activity in the postoperative period is greatly increased.At this time, in addition to the general objectives for all the patients (prevention of pneumonia and atelectasis, fighting hypostatic phenomena), and solve the specific problems for certain species and location of the lesion.Patients who have had a radical mastectomy, offers a complex of gymnastic exercises to facilitate full restoration of function of the shoulder girdle and the shoulder joint on the side of the operation.In patients after lobectomy take persistent attempts to compensate for respiratory function due to the remaining lung tissue.Patients who have undergone amputation of the lower limbs, are trained to prosthetics, including not only exercise for the muscles of the truncated limbs, but also exercise the shoulder and pelvic girdle.Patients with laryngeal cancer who have undergone laryngectomy, ready for further training sonorous speech by certain breathing exercises.
In the late postoperative period, goals and methods of rehabilitation treatment is even more diverse and unique.For example, in malignant tumors maxillofacial main treatment is surgery, in particular, electrosurgical.Radical removal of the tumor followed by disfigurement of the face, impaired speech, chewing, swallowing, salivation.As a restorative treatment gives good results with pillowtop way of closing the vast damage to the face.Eliminating cosmetic defects thus possible in a shorter time than by means of multi-stage plastic surgery.Purchasing patients temporary and permanent maxillofacial prostheses with regard to their functionality reduces postoperative disfigurement of the patient and allows the restoration of oral function.
For patients operated on for gastric cancer to the forefront among the rehabilitation act rational diet therapy and diet.
patients operated on for cancer of the rectum and colon;Postoperative gives an idea about how to care for an artificial anus, intestinal motility control methods, means of combating the uncontrolled discharge of gases and unpleasant odor.Through individual selection of reliable sealing is achieved stoma bags.The ability to use them in a complex overall remediation usually calms patients, inspires confidence in myself, the desire to return to the family and socially useful work.
Rehabilitation of patients after lower limb amputation for malignant tumors is one of the most difficult problems.Despite the timely radical surgery, a large number of patients die in the early stages of metastasis.However, this does not provide sufficient evidence to deny the patient's active life, even with an unfavorable prognosis.
basis of rehabilitation treatment with amputation of the lower limb prosthesis is directly on the operating table.It allows you to restore the lost function of limbs, as well as labor and professional activity of the patient.Early use of medical prostheses significantly reduces the terms of the final prosthesis.
Upon receipt of the training of the prosthesis on the operating table, patients are up and about 2-3 days after the amputation of the lower leg or thigh.After 2-3 weeks, almost all patients are able to walk with the aid of one or two sticks, and after 30-35 days - without them.Most patients are well master walking on primary permanent prosthesis.
main methods of treatment of malignant tumors of female reproductive organs that make up 1/3 of all women's cancers are surgery, radiation and chemotherapy, as well as combinations thereof.Rehabilitation treatment of such patients should be carried out on ways to address the functional consequences associated with the loss of organs (uterus, ovary) in the surgical treatment;eliminate changes in neighboring tissues and organs in the application of radiotherapy and chemotherapy effects;save for the possibility of a normal functional capacity of organs and, in particular, fertility, as well as the elimination of neuropsychiatric disorders associated with the disease and treatment.Most women operated after 2-4 weeks after surgery revealed violations specific to postcastration syndrome.Vegetative-vascular disorders in the form of feelings of heat, hot flashes, sweating, pain in the heart and headaches, dizziness, numbness of extremities significantly reduce the ability to work, and when severe (hot flushes up to 30 times per day) completely violate it.Integrated sedation (medication, psychotherapeutic) with elements of physical therapy (indifferent baths and showers, electrosleep) bring significant relief to patients, reduced working capacity.
Thus, the restorative treatment of cancer patients has the following objectives:
1) reducing - expected to recover without significant disability;example is the patient after a radical mastectomy, which has a stiffness of the shoulder joint on the side of the operation;
2) supportive - the disease results in a loss of ability to work, but it can be reduced by adequate treatment and proper training.An example would be a patient with amputee;
3) palliative - in the progression of the disease can prevent the development of certain complications (pressure sores, contractures, excruciating pain, mental disorders).