A Multidisciplinary Approach to Physical Therapy for Patients with Sarcomas
In the United States, 900 new cases of bone tumors are diagnosed each year, with approximately 400 of these cases occurring in patients less than 20 years of age. Osteosarcoma accounts for 3.4% of all childhood cancers and 56% of malignant bone tumors in
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Kelly O’Mara
16.1 Introduction In the United States, 900 new cases of bone tumors are diagnosed each year, with approximately 400 of these cases occurring in patients less than 20 years of age. Osteosarcoma accounts for 3.4% of all childhood cancers and 56% of malignant bone tumors in children. Soft-tissue tumors account for 7% of all childhood cancers. Seventy percent of patients diagnosed with osteosarcoma survive greater than five years. Medical and surgical management has progressed to improve these statistics over the past decades. Survivorship is a continuum (acute, transitional, extended, and permanent) (Fig. 16.1). Quality of life and function are crucial to meaningful survivorship. Physical therapists (PT) and occupational therapists (OT) are vital team members for improving quality of life and function in patients diagnosed with sarcomas across the survivorship continuum [1, 2].
16.2 Indications for Rehabilitation The International Classification of Functioning, Disability and Health (ICF; Fig. 16.2) is the standard language of rehabilitation sciences used to describe health and health-related states. This model demonstrates the interactions between health conditions, body functions and structures, activity, participation, and contextual factors (environment and personal). Alteration of health condition is disorder or disease; problems within body functions and structures are impairments; difficulties performing daily tasks are activity (or performance) limitations; and the inabilities to fulfill societal roles are participation restrictions. Environmental factors include
K. O’Mara, PT, DPT, PCS Children’s National Health System, Washington, DC, USA e-mail: [email protected] © Springer International Publishing Switzerland 2017 R.M. Henshaw (ed.), Sarcoma, DOI 10.1007/978-3-319-43121-5_16
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Long-Term Effects
Extended Survivorship Remained Remission
Diagnosis/Initial Treatment
Acute Survivorship
Extended Survivorship Cancer-free
Transitional Survivorship
Extended Survivorship Living with Cancer
Permanent Survivorship Cancer-free Free of Cancer Permanent Survivorship Long-term/ Late Problems Permanent Survivorship Second Cancers Permanent Survivorship Secondary Cancers
Fig. 16.1 Acute survivorship is the time when a person is being diagnosed and/or in treatment for cancer. Extended survivorship is the time immediately after treatment is completed, usually measured in months. Permanent survivorship is a longer period, often meaning that the passage of time since treatment is measured in years
Health Condition (Disorder or disease)
Body Functions & Structures (Impairments)
Activity
Participation
(Limitations)
(Restrictions)
Contextual factors
Environmental factors
Personal factors
Fig. 16.2 Adapted from The International Classification of Functioning, Disability and Health [3]
16 A Multidisciplinary Approach to Physical Therapy for Patients with Sarcomas
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the physical, social, and attitudinal environments within a person’s life; personal factors
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