![]()
Cancer Rehabilitation: Adding Quality to the Years
June is National Cancer Survivor Month, a time to celebrate the extraordinary advances in cancer treatment that have extended lives—and to highlight, as well, how those additional years can be lived. That is the promise of cancer rehabilitation, a fast-growing field that convenes integrated care focusing on quality of life before, during and after treatment, on how people function and how they can return to the full life they want to live.
Dr. Sammy Wu, a physiatrist who directs the Cancer Rehabilitation Program at Burke Rehabilitation® in collaboration with White Plains Hospital’s Center for Cancer Care, defines his specialty broadly: a comprehensive approach to maintaining or restoring physical, psychological, social, cognitive, and vocational function. “The rehabilitation, the focus on function and quality of life, should not be an afterthought,” he says. “It should be thought of at the very beginning.” The goal, as Dr. Wu frames it, is adding quality to the years, not just years to the life.
The need is significant and growing. Advances in treatment -more targeted therapies, less invasive procedures, precision medicine—mean that people are living longer after a cancer diagnosis than ever before. By 2040, an estimated 26 million cancer survivors are projected in the United States alone. Many will be contending with the lingering effects of their treatments: fatigue, pain, weakness, neuropathy, cognitive changes, and other impairments that can quietly erode independence and daily function. “Patients are living longer, with better treatments,” says Dr. Wu. “But if they’re living with significant functional impairments, have we done enough for them?”
Dr. Wu describes his role as that of a holistic guide. “Things we take for granted—showering, dressing, preparing a meal—can be profoundly challenging for cancer patients,” he observes. In a busy healthcare system where clinical attention is focused on treatment plans, functional and quality-of-life dimensions can go under-addressed. That is where physiatry, rehabilitation medicine with specialized oncology training,serves as an essential advocate. The approach is distinctly multidisciplinary. With a central focus on each patient’s individual experiences and goals, Dr. Wu works with a comprehensive team, in an outpatient setting, that includes physical, occupational and lymphedema therapists; speech, language and swallowing pathologists; neuropsychologists; orthotists for bracing; and pain specialists. Many have pursued advanced oncology education and certification.
What makes cancer rehabilitation complex—and Dr. Wu’s role particularly demanding—is the variability of the patient population. Every cancer and its treatment regimen is different, and every person brings their own baseline of health, age, and goals. There will be one course of rehabilitation for a patient with prostate cancer on anti-androgen therapy who may find it difficult to rise from a chair and another for a breast cancer patient who has undergone mastectomy and radiation, now dealing with restricted shoulder range of motion, lymphedema, and cording. Someone recovering from a brain tumor may be navigating deficits in memory, attention, and executive function, requiring work with speech-language pathologists and occupational therapists who specialize in cognitive rehabilitation, reinforcing that work at home through targeted computer-based programs. A patient with chemotherapy-induced neuropathy might face balance issues that raise fall risk alongside difficulty with fine motor tasks—opening jars, buttoning a shirt—that make ordinary life a challenge.
From Prehabilitation to Survivorship: Meeting Patients Where They Are
A distinctive aspect of cancer rehabilitation is how early it can—and, in many cases, should—begin. Called “prehabilitation,” this early rehab involves intervening at diagnosis, before treatment even starts. When a patient has weeks before major surgery, that window is an opportunity to prepare body and mind for the intervention and recovery to come. Prehab focuses on building aerobic capacity and strength, improving nutrition, social connection, stress/mental health management, substance avoidance, and optimizing sleep, all pillars of the holistic approach to health known as lifestyle medicine. “The idea of seeing someone upfront, at the time of diagnosis, is to really set them up for success,” says Dr. Wu.
Rehabilitation continues through treatment—managing side effects of chemotherapy, radiation, and surgery—and into survivorship, which can extend for decades. It is in survivorship that patients can find themselves without enough guidance: surveillance scans monitor for recurrence, but who is helping them stay active, maintain strength, and address the ongoing functional changes that come with aging after a cancer history?
“If you’re not doing anything proactively to mitigate the natural decline that happens with time, you’re going to run into more trouble,” Dr. Wu says. His guidance is consistent across patients, regardless of age or cancer type: stay active, engage in aerobic and resistance training, tend to the full picture of wellness. Survivorship is a long road, and the goal is to travel it well.
One patient, Elaine, has been living with the effects of surgeries, radiation, and chemotherapy for years, and nerve pain and shortness of breath limited her active life. At Burke, she has found the guidance she needs to continue the all-important journey of survivorship. “Once the cancer’s under control you’re dismissed by the oncologist,” she says. “But we need someone for survivorship also. Dr. Wu knows what cancer treatments can do to the body and what you need to heal from there. We need a guide—we need someone like Dr. Wu.”
The field is relatively new and evolving fast, with research pushing the horizons of what we know. Dr. Wu’s research includes investigating how resistance training can help patients living with breast cancer and how prehabilitation can help frail cancer patients. He also tracks clinical outcomes, including objective measures such as how far a patient can walk in six minutes, how many times they can rise from a chair in thirty seconds, and grip strength, as well as assessments of anxiety, depression, and quality of life.
Getting Back to Life
Cancer rehabilitation is as individual as a life, and what each patient hopes to return to during their journey. Dr. Wu invokes the construction worker returning to the physical demands of the job, the musician recovering the fine motor control to play their instrument, older patients eager to play with their grandchildren. “Everybody has some different skill set or vocation that requires different uses of their bodies—which is what rehab is about,” he says. The aspiration, in every case, is the same: helping people do what they love, what sustains them, what makes life feel like theirs.
Dr. Wu came to this specialty through training rotations at Memorial Sloan Kettering Cancer Center, where he found both purpose and direction in caring for people at one of the most vulnerable moments of their lives. What drives him now is a vision of the field’s future—one in which cancer rehabilitation is built into every care plan from diagnosis onward.
Says Dr. Wu, “I’m excited for the prospect of it being a no-brainer—that if you think about cancer, you’re going to think you need someone to treat the tumor, and you need someone to help you with your function and quality of life.” At Burke, that vision is already a reality.
