Rehabilitation of Breast Cancer Patients
Aim: To evaluate different rehabilitation interventions for breast cancer patients.
Conclusions and results: Limited documentation addresses the efficacy of rehabilitation interventions for breast cancer patients. The documentation from this review indicates that physical activity after primary cancer treatment may increase quality of life (QoL) and reduce fatigue. Patients might also have some benefits in QoL from cognitive behavior therapy (CBT) interventions. More documentation is needed on the effects of physiotherapy, psycho-education, and social and emotional support.
We identified 9617 references and assessed 191 full-text articles. We included 46 randomized controlled trials (RCTs) of moderate or high quality. Seven studies addressed physiotherapy, 11 studies investigated different types of physical activity, and 18 studies examined different psychosocial interventions. Two studies addressed nutrition, 5 studies addressed complementary interventions as rehabilitation, and 3 studies evaluated a complex rehabilitation program. Meta-analyses were not possible due to variations in interventions and outcomes. The studies on physical activity after primary cancer treatment showed effects on improving QoL and reducing fatigue. Inconsistencies made it difficult to draw conclusions from the studies on physical activity during primary treatment. Three studies showed that early physical activity was not associated with aggravated lymphedema. Four studies showed that CBT intervention after primary cancer treatment will increase overall QoL.
Methods: A group of experts in areas related to generic medical rehabilitation and more specific breast cancer treatment was organized to evaluate the literature. Systematic searches were carried out in relevant databases, eg, Cochrane Library, Centre for Reviews and Dissemination, MEDLINE, EMBASE, CINAHL, PsycINFO, AMED, and PEDro until September 2008. Two separate reviewers selected relevant studies. One person retrieved and another person checked the data from included studies.
Further research/reviews required: Further research should examine the effect of rehabilitation interventions in breast cancer patients. Few studies in the present review include patients undergoing new, long-term medical treatment regiments for breast cancer; new studies should address this. Additional research might profitably assess whether some interventions are more effective in certain subgroups of breast cancer patients.
Written by: Lene Kristine Juvet, NOKC, Norway