Rehabilitation after bone cancer treatment

Rehabilitation is an important part of returning to the activities of daily living after bone cancer treatment. Recovery is different for each person and will depend on the type of treatment you had, your age, your overall health and many other factors. The most important part of rehabilitation is to help a person learn to walk or move again. Everyone needs physical rehabilitation after bone cancer treatment.

Several different healthcare professionals may be on your rehabilitation team. These may include the following.

Physiotherapists, or physical therapists, help you keep or return to a level of fitness by using strength and endurance exercises. They teach exercises and physical activities to help keep muscles strong and flexible or restore strength and movement.

Occupational therapists will look at your home and work or school environments. They will recommend changes or tools that can help you in your daily life.

Prosthetists are specially trained to design, make and fit people with artificial limbs called prostheses.

Members of your rehabilitation team will usually meet with you before your surgery to explain:

• what to expect after surgery
• the type of rehabilitation you will need
• where you will go for your rehabilitation
• the type of prosthesis that will be made for you

If you’ve had bone cancer treatment, you may have the following concerns about rehabilitation.

Limb-sparing surgery is more complicated than amputation, so it takes longer to recover from it. It can take about a year to learn to walk again after limb-sparing surgery. During that time, rehabilitation is very important for your recovery. After surgery, your rehabilitation team will teach you exercises to build up the strength and flexibility in your muscles and to keep your joints bending and moving. Without rehabilitation, the spared limb may become useless.

To help support the reconstructed limb, you may need to wear a sling, brace or splint. You may also have to use crutches for a while, because you can’t put your full weight on your leg until the bone graft has completely healed with the remaining bone. After using crutches, you may still need to use a cane or walker for a time until your leg fully heals.

A bone graft can be easily broken, so you may not be able to do activities that put stress or heavy weight on your leg for the rest of your life.

If you have an endoprosthesis to replace a joint in your hip or knees, your rehabilitation team will teach you how to move properly so that you don’t damage the endoprosthesis. You will also be given exercises to make your legs and hips stronger.

Rehabilitation is faster after an amputation than limb-sparing surgery, because the amputation surgery is not as complicated.

After surgery, your rehabilitation team will help you recover from your amputation. They will teach you how to care for the end of the limb left after amputation (called the stump). Caring for your stump includes learning the following:

• how to keep the skin on the stump clean and healthy, as well as how to look for any skin problems
• exercises that help strengthen and tone the muscles and keep the joints moving well
• how to bandage the stump after surgery to shape it to fit into your prosthesis and decrease swelling

Your rehabilitation team can also help you to find ways to change your home and workplace to help you move around and cope in your daily life. Most people will use a prosthesis after amputation.

A prosthesis is an artificial limb that is used to replace an arm or leg after it has been amputated. A prosthesis is designed and made for each person. It is fitted to the stump.

Before and after your surgery, a prosthetist will measure you to make sure that the prosthesis will fit you properly. You may have some options for the type of prosthesis that you can use, such as special types for sports or swimming. The prosthetist will design and make a prosthesis that will fit your activities and lifestyle.

You may be given a temporary prosthesis to use until your stump has healed. When the stump has completely healed, the prosthetist will fit your new prosthesis and make any changes to make sure it works properly.

The prosthetist will teach you the right way to put your prosthesis on and take it off. They will also teach you how to put on an elastic wrap or stump sock to protect the stump before putting on your prosthesis.

You will slowly increase the amount of time you wear the prosthesis until you are wearing it all day. During this time, you will have to learn how to walk, move and use the prosthesis. This can take a few months of rehabilitation and physical therapy. You may have to use a cane, wheelchair, walker or crutches until you have learned to walk with a new leg prosthesis. Many people with a prosthesis can return to the same level of activity that they had before surgery.

Some people may not be able to use a prosthesis because of their age, ability or health. They may have to use a wheelchair or crutches to move around.

Radiation therapy for bone cancer can cause stiffness and less ability to move joints, as well as loss of muscle strength. A physical therapist can teach you exercises to help keep your joints and muscles healthy and working properly. These are started before radiation therapy and may have to be done for a long time after treatment has finished.