After surgery to remove her cancerous lung, then chemo and radiation, my friend’s mother was still alive—but her quality of life was poor. Too exhausted, breathless and dizzy to do even simple daily tasks, she asked her oncologist when she’d feel normal again. He shrugged and said, “You’ve been through a war. Maybe you’ll feel better eventually, but you need to accept a new definition of ‘normal.’” That was scant comfort to a woman accustomed to working full time and bowling every week…and despite her attentive daughter’s devotion, she felt helpless and hopeless.

If my friend’s mom had had a post-treatment therapy called cancer rehab, her recovery experience might have been much better, but few such programs existed when she was battling cancer in the 1990s. Today, cancer rehab is increasingly available. Yet even now, many patients—and doctors—are unaware of this vital resource for people struggling with the debilitating aftermath of toxic cancer treatments.

Julie Silver, MD, a breast cancer survivor herself, is determined to change that. An assistant professor in the department of physical medicine and rehabilitation at Harvard Medical School and author of After Cancer Treatment: Heal Faster, Better, Stronger, Dr. Silver told me, “For a stroke patient or an orthopedic patient, it would be far below the usual standard of care to recommend a yoga class or massage instead of evidence-based rehabilitation services. But many people think this is reasonable advice for cancer patients. It’s not! Yoga and massage are excellent, but they are not substitutes for cancer rehab provided by board-certified physicians and licensed health-care professionals.”

Whether cancer patients are cured or are living with cancer as a chronic disease, rehab can help them function better, with less pain and more energy. Rehab also is a source of information and emotional support, so patients feel less confused and afraid. That’s why Dr. Silver developed the STAR Program® (Survivorship Training and Rehabilitation) Certification for hospitals and cancer centers, which involves a protocol for best practices in cancer rehab.

Progress: This year, Rhode Island will become the first state to make cancer rehab services available to every cancer survivor in the state through the adoption of the STAR Program…Massachusetts is not far behind. And the American College of Surgeons’ Commission on Cancer recently recommended that, by 2015, every patient treated at an accredited cancer center receive a post-treatment “survivorship care plan.” For information and/or a referral to a STAR Program in your area, visit the Web site of Oncology Rehab Partners (, an organization founded by Dr. Silver and dedicated to advancing survivorship care.

What to expect from cancer rehab. The exact treatment depends on a particular patient’s needs. Typically, cancer rehab includes…

  • Individualized therapies specific to the type of cancer. For instance, a lung cancer patient can benefit from improving upper-body strength to help with breathing, plus overall conditioning to assist with walking and other activities that require endurance. For a breast cancer survivor, hands-on therapies can ease pain and minimize scarring and fluid buildup that limit arm movement. A person recovering from head or neck cancer may need speech-language pathology services to help with talking or swallowing.
  • Physical therapy that addresses pain, balance, gait, dizziness and/or exhaustion…plus a therapeutic exercise plan that accommodates current limitations while encouraging improvement. “Exercise may reduce cancer recurrence risk, so a rehab program that gets a patient to be more active may increase the length of her life,” Dr. Silver noted.
  • Occupational therapy to help with tasks of daily living, such as bathing, dressing or driving…plus cognitive strategies to ease “chemo brain” and improve concentration, memory and/or organizational skills.
  • Psychological counseling to ease fear, anxiety and a sense of isolation or loss.

Helpful: Set specific rehab goals for yourself—such as being able to sit comfortably long enough to resume your weekly bridge games—and share them with rehab personnel. Dr. Silver said that she wants to help people return to what they value. For example, one patient longed to return to door-to-door proselytizing with other members of her church, which required stamina to walk long distances, climb stairs and be out in all weather. With help from cancer rehab, Dr. Silver’s patient achieved her goal…and with the right support, chances are good that you can, too.