Rehabilitation is paramount for cancer patients, as cancer treatments usually come with temporary, but inevitable, physical, psychological and cognitive problems. These problems often make it harder for the patients to return to their normal lives. If left unaddressed, there are high chances of these problems having a lasting negative impact on their health.

Rehabilitation is a highly person-centric health strategy, where issues like impairments, activity limitations and participation restrictions are effectively addressed and the overall well-being of the patients is improved.

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At HCG, we have a multidisciplinary rehabilitation team that comprises physiotherapists, speech and swallow therapists, onco-dieticians, psycho-oncologists, yoga therapists and onco-dermatologists to holistically support recovery among our patients. Specialists from various disciplines come together to work towards the common goal, which is to positively impact the patient’s response towards the treatment and support his/her recovery.

HCG’s Multidisciplinary Rehabilitation Programme

PHYSIOTHERAPY

Physiotherapy is an important aspect of cancer care. Physiotherapy is known to be beneficial in overcoming physical deficits, building strength, reducing pain and combating fatigue following cancer treatment and surgery. Exercise has also been shown to reduce nausea, pain, stress and help maintain a good weight.

Physiotherapy plays a significant role in restoring and maintaining the highest possible level of function, independence and quality of life among cancer patients and survivors.

At HCG, the department of physiotherapy functions synergistically, wherein our physiotherapists, clinicians and patients work as a team. This leads to the best physical rehabilitative care practices and, in turn, improves patients’ quality of life and functional status.

The department houses fully-equipped electrotherapy and exercise therapy units to provide inpatient, outpatient and home care services.

The core focus of this department lies in providing preventive, promotive and curative rehabilitation services in areas of (but not limited to):

• 1. Lymphedema management
• 2. Post-surgical oncology rehab
• 3. Post chemo / radiation-associated musculoskeletal complications
• 4. Gynaec onco rehab
• 5. Haematological onco rehab
• 6. Management of swallowing disorders
• 7. Cardiac and pulmonary rehab, including pulmonary function assessment
• 8. Inspiratory muscle training
• 9. Exercise capacity training and fitness programs
• 10. Pain management
• 11. Biofeedback training
• 12. Orthopaedic rehab
• 13. Neurological rehab
• 14. Paediatric and neuro-developmental rehab
• 15. Women’s health
• 16. Geriatric and fall prevention programs
• 17. Group and circuit training programs

All our physiotherapists are specifically trained in the field of cancer rehabilitation. The department manages to provide close to 700 physiotherapy sessions every month.

SPEECH AND SWALLOW THERAPY

Head and neck malignancies and the diversified treatments administered to manage them can often lead to challenges associated with speech and swallowing. At HCG, our specialists strive to preserve these functions; however, a few patients may still end up requiring speech and swallow rehabilitation after their treatment.

Speech, language and swallowing rehabilitation therapy is a service provided by highly qualified speech-language pathologists during the evaluation and treatment of articulation, language, stuttering, voice, cognition and swallowing disorders.

Our specialists evaluate the specific needs of the patient and select a technique or a combination of techniques to serve the patient’s needs and improve the condition.

This department aims at reducing the barriers of communication for patients and helping them gradually return to their normal lives. The speech and swallow therapists often collaborate with nutritionists, physiotherapists and home care specialists in order to address all possible challenges related to swallowing and improve the overall quality of life for patients.

Our speech and swallow therapy department provides services in areas of (but not limited to):

• 1. Language therapy / Aphasia
• 2. Articulation therapy
• 3. Computer-aided speech or alternative non-vocal communication
• 4. Swallowing therapy / Barium Swallowing Exam
• 5. Stuttering/ fluency
• 6. Cognitive retraining to improve memory, attention and organisational skills
• 7. Voice improvement

PSYCHO-ONCOLOGY

Scientific evidence suggests that one-third of the individuals experience severe psychological distress upon being diagnosed with cancer. Not acknowledging and addressing these stress symptoms will only worsen the condition of cancer patients.

Psycho-oncology is a sub-discipline of oncology that focuses on the psychological, behavioural, social and ethical aspects of cancer management.

With the help of adaptations, such as Cognitive Behavioural Therapy (CBT), psycho-oncology effectively deals with various non-physical aspects of cancer, such as the patient’s reaction to the cancer diagnosis, coping mechanisms of the patient and social factors associated with cancer care, along with the communication with the caregivers and the loved ones and social support.

Psycho-oncology counselling benefits the patients in the following ways:

• Helps patients learn healthy ways to cope with the cancer diagnosis and feel more in control.
• Assists in the effective management of key symptoms of stress: anxiety and depression
• Helps patients learn how to communicate with health professionals and caregivers
• Promotes discussion on issues at the workplace and helps plan strategies to address them.
• Allows patients to discuss life after finishing the cancer treatment
• Helps patients explore ways to make their family understand their condition and adjust to the new routine.

The key services offered by the psycho-oncology department are as follows:

• 1. Distress assessment and evaluation
• 2. Individual therapy
• 3. Marital therapy
• 4. Family therapy
• 5. Stress management techniques (relaxation therapy, guided imagery etc.)
• 6. De-addiction (tobacco cessation, alcohol & other substance abuse)
• 7. End-of-life care
• 8. Grief and bereavement counselling
• 9. Rehabilitation counselling: breast prosthesis (artificial breast), wigs to deal with hair loss, stoma care etc.
• 10. Brain lab: neurocognitive assessment and remediation

YOGA

Practising yoga is known to have a positive impact on physical health by supporting the enhanced circulation of oxygenated blood in the body, retraining the sense organs and thereby inducing tranquillity and serenity of mind. It also helps in preventing psychosomatic disorders and improving an individual’s resistance and ability to endure stressful situations.

Our own research studies at HCG have reported that yoga reduces stress; treatment-related symptoms and improves the overall quality of life. Yoga helps cancer patients to recognise their stress and helps them to calm down their reaction to stressors that significantly reduces their distress. This results in improved quality of life and better treatment outcomes.

At HCG, our yoga therapists help cancer patients learn yoga techniques, such as breathing exercises, breath training, modified postures (asana), regulation of breath (pranayama) and meditation techniques, which can help them cope with their distress. The yoga sessions at HCG are individualised and specific to the patient’s condition.

ONCO-DIETETICS

The body that has been fighting cancer works a lot differently. Similarly, its nutritional demands may also be different. Onco-dieticians are specially trained to understand these differences, learn every cancer patient’s needs, issues, how cancer is affecting them, etc., and plan nutritional interventions accordingly.

Personalised nutritional support provided by onco-dieticians could positively impact the treatment response shown by patients, their recovery rate, quality of life after the treatment, etc.

There are multiple ways to treat the nutritional demands of the patients, and they largely include, diet modification, counselling and education, intake of dietary supplements and lastly, tube feeding or IV feeding.

ONCO-DERMATOLOGY

Cutaneous (skin-related) reaction is a typical side effect of cancer treatments, such as chemotherapy and radiation therapy. Itching and rashes, dry and rough skin, mouth sores, pigmentation, sensitivity to light, and hair loss are the most frequent skin disorders reported in cancer patients. Swelling and blisters, skin burning and peeling, painful fingertips and weak nails are some of the other skin symptoms.

Oncodermatology is one of HCG’s special supportive departments, and it focuses on controlling the side effects of cancer treatments on the skin, hair and nails.

This division works in tandem with other disciplines to ensure that skin-related disorders that cancer patients encounter are accurately diagnosed and treated, allowing them to recover faster and have better treatment outcomes.

Our oncodermatologists at HCG help you in the management of the following conditions:

• 1. Allergies and toxicity in the skin, hair and nails caused by chemotherapy
• 2. Skin reactions caused due to radiation therapy
• 3. Skin infections that are triggered due to immunosuppression
• 4. Graft-versus-host-disease in the skin caused due to bone marrow transplants

In addition to these supportive services, the department also offers screening services for cancerous and precancerous conditions of the skin.

DENTISTRY

Head and neck cancer patients experience specific dental problems during and after the treatment. Some of the common dental problems caused due to cancer treatments include tooth decay, oral mucositis, bleeding gums and mouth infections. At HCG, our dentists carefully go through the patient’s information, talk to the patients to understand the challenges that they have and plan dental interventions accordingly.

Advantages

Our comprehensive, multidisciplinary rehabilitation programme helps cancer patients in numerous ways. Following are some of the main advantages of rehabilitating after cancer treatment:

• Rehabilitating helps patients stay as active as possible and enables them to participate in work, domestic activities and fulfil other life roles.
• Rehabilitation under the supervision of professionals will reduce the severity of the ill impact caused by side effects and symptoms that come along with the cancer treatment.
• Multidisciplinary after-care plays a critical role in ensuring that patients gradually become independent after the treatment.
• A well-planned rehabilitation programme will also have a positive impact on the quality of life in patients.