Post-Cancer Treatment Care

Chemotherapy Side Effects and Physical Therapy Role

Chemotherapy is an important tool to fight cancer, but it doesn’t only target cancer cells. Healthy tissues are affected too, which can lead to unwanted side effects such as fatigue, weakness, numbness, or pain (Mustian et al., 2012). These changes can make everyday activities—like walking, cooking, or even sleeping—more difficult.

Physical therapy and other supportive treatments can make a big difference. By working with specialists, patients can stay active, reduce side effects, and recover more quickly after treatment (Courneya & Friedenreich, 2011).

Types of Chemotherapy and Common Side Effects:

Chemotherapy drugs are grouped by how they work. Each type has its own side effects:

1. Alkylating Agents

Examples: Cyclophosphamide, Ifosfamide, Melphalan
How they work: Damage DNA to stop cancer cells from dividing.
Common side effects: Low blood counts, nausea, hair loss, and bladder irritation (hemorrhagic cystitis) (Mustian et al., 2012).

2. Antimetabolites

Examples: 5-Fluorouracil (5-FU), Capecitabine, Methotrexate, Cytarabine
How they work: Mimic normal cell nutrients and interfere with DNA and RNA production.
Common side effects: Mouth sores, diarrhea, fatigue, and skin problems such as hand-foot syndrome (Mustian et al., 2012).

3. Anthracyclines (Anti-Tumor Antibiotics)

Examples: Doxorubicin, Epirubicin, Daunorubicin
How they work: Interfere with enzymes involved in DNA replication.
Common side effects: Heart problems, fatigue, hair loss, and mouth sores (Winters-Stone & Horak, 2019).

4. Plant Alkaloids (Mitotic Inhibitors)

Examples: Paclitaxel, Docetaxel (Taxanes); Vincristine, Vinblastine (Vinca alkaloids)
How they work: Stop cancer cells from dividing by disrupting cell structures.
Common side effects: Nerve damage (neuropathy), muscle/joint aches, swelling, nail changes, and fatigue (Stubblefield & Keole, 2014).

5. Platinum-Based Drugs

Examples: Cisplatin, Carboplatin, Oxaliplatin
How they work: Bind to DNA and prevent cancer cell growth.
Common side effects: Neuropathy, kidney damage, nausea, fatigue, and hearing loss (Stubblefield & Keole, 2014).

6. Targeted Therapies & Monoclonal Antibodies

Examples: Trastuzumab, Bevacizumab, Rituximab, Imatinib
How they work: Target specific molecules on cancer cells.
Common side effects: Heart problems (especially with trastuzumab), high blood pressure, infusion reactions, fatigue (Winters-Stone & Horak, 2019).

7. Hormonal Therapies

Examples: Tamoxifen, Letrozole, Anastrozole (Aromatase inhibitors)
How they work: Block hormones that certain cancers (like breast or prostate) need to grow.
Common side effects: Joint stiffness, bone thinning, hot flashes, and fatigue (Stubblefield & Keole, 2014).

How Physical Therapy Can Help:

Physical therapy is not just about exercise—it’s about helping you stay safe, independent, and active during and after cancer treatment. Research shows it improves function, reduces fatigue, and enhances quality of life for people undergoing chemotherapy (Courneya & Friedenreich, 2011; Mustian et al., 2012).

Managing Fatigue
- Gentle exercise (walking, cycling, or light resistance training) helps fight fatigue better than rest alone (Mustian et al., 2012).
- Therapists teach pacing strategies—how to save energy for the things you enjoy.

Improving Strength and Endurance
- Strengthening exercises help rebuild muscles weakened by chemotherapy (Winters-Stone & Horak, 2019).
- Aerobic training and breathing exercises support heart and lung health, especially important if drugs affect the heart (Courneya & Friedenreich, 2011).

Reducing Neuropathy (Numbness or Tingling in Hands/Feet)
- Balance and coordination training helps prevent falls (Winters-Stone & Horak, 2019).
- Sensory re-education and safety strategies may reduce discomfort (Stubblefield & Keole, 2014).

Lymphedema Care
- Specialized therapists use gentle massage (manual lymph drainage), compression bandages/garments, exercise, and skin care to control swelling (International Society of Lymphology, 2020).

Easing Pain and Stiffness
- Stretching, massage, and posture training reduce stiffness and joint pain, especially from taxanes or hormonal therapy (Stubblefield & Keole, 2014).

Maintaining Daily Function
- Therapy supports independence with daily activities—whether it’s climbing stairs, working, or playing with family (Winters-Stone & Horak, 2019).

Other Helpful Treatments:

Physical therapy works best when combined with other supportive care:

Nutrition counseling for energy and healing (Mustian et al., 2012).
Occupational therapy to make daily activities easier (Stubblefield & Keole, 2014).
Psychosocial support for stress and emotional health (Courneya & Friedenreich, 2011).
Speech therapy if treatment affects swallowing or communication (Stubblefield & Keole, 2014).

Summary:

Chemotherapy can be tough, but you don’t have to go through it alone. Side effects vary by drug type, but physical therapy helps you stay strong, manage fatigue, and reduce problems like numbness, swelling, or pain. Combined with nutrition, emotional support, and medical care, physical therapy is a vital step toward recovery and living well during and after cancer treatment (Courneya & Friedenreich, 2011; Winters-Stone & Horak, 2019).

Scientific References:

Courneya, K. S., & Friedenreich, C. M. (2011). Physical activity and cancer: An introduction. Recent Results in Cancer Research, 186, 1–10. https://doi.org/10.1007/978-3-642-04231-7_1
International Society of Lymphology. (2020). The diagnosis and treatment of peripheral lymphedema: 2020 Consensus Document of the ISL. Lymphology, 53(1), 3–19.
Mustian, K. M., Sprod, L. K., Janelsins, M., Peppone, L. J., & Palesh, O. G. (2012). Exercise recommendations for cancer-related fatigue, cognitive impairment, sleep problems, depression, pain, anxiety, and physical dysfunction: A review. Oncology & Hematology Review, 8(2), 81–88.
Stubblefield, M. D., & Keole, N. (2014). Upper body pain and functional disorders in patients with breast cancer. PM&R, 6(2), 170–183. https://doi.org/10.1016/j.pmrj.2013.08.605
Winters-Stone, K. M., & Horak, F. (2019). Rehabilitation approaches for cancer survivors: Falling into a new paradigm of cancer care. American Journal of Physical Medicine & Rehabilitation, 98(12), 1023–1028. https://doi.org/10.1097/PHM.0000000000001291