Onco-physiotherapy: embedding exercise into cancer care
Srinivasan Vijay
M.S. Satish 06.06.2025
“Movement is Medicine” is the mantra of physiotherapy. Physiotherapy is the field where a trained professional is dedicated to evaluating, assisting, and strengthening physical function and movement. It is grounded in the science of structured physical activity to enhance health and quality of life. “Onco-physiotherapy” is a dedicated branch of physiotherapy, with focussed programmes to assist cancer patients during all the stages of cancer care.
Cancer (diagnosis and treatment) can have a global impact on the patient and the family. The treatment comprises a combination of surgery, chemotherapy and radiation. This multi-modality treatment approach is the key to potential cure and better outcomes. However, the disease and the treatment can be debilitating. The journey to recovery post-treatment is not always smooth; it may be pervaded with pain, weakness, stiffness, fatigue, muscle wasting and reduced mobility. “We need more than just treatment to combat cancer; a dedicated field such as “onco-physiotherapy” works as a vital counter balance and perfect partner to negate some treatment side-effects and strengthen the body and mind of our patients,” stated V. Sridevi, senior surgical oncologist. At Cancer Institute hospital, we administer one-on-one physiotherapy sessions to our in-patients.
A vital aspect
Physiotherapy plays a vital role across the entire spectrum of cancer care, supporting patients through each phase of their journey. Before treatment (Prehabilitation), it enhances physical resilience, preparing patients to better tolerate cancer treatment and assist recovery. During and after treatment (Rehabilitation & Survivorship), targeted exercises help manage symptoms, reduce side effects, increase stamina and energy levels, restoring physical function, and enable a return to everyday life. After care (Palliative support) where physiotherapy supports comfort, mobility, and dignity, even within palliative care settings.
Prehabilitation is an essential phase before surgery and cancer treatment, helps strengthen patients both physically and mentally. Physiotherapy is a key component, offering customised exercises to boost fitness, strength, and flexibility, thereby minimising complications.
“A physiotherapy-driven approach reduces the length of hospital stay and readmissions, and improves surgical outcomes; all of which emphasises a proactive, patient-centered approach,” mentioned C. Punitha, anaesthesiologist.
“Physiotherapy not only focusses on cardiac fitness and mobility exercises, but also on breathing exercises. This is crucial in reducing post-treatment respiratory related complications such as pneumonia,” added S. Keerthika, physiotherapist.
Post-treatment, when patients return for their follow-up care to meet their doctors, they also come back to see their physiotherapists to work on improving their fitness and attend to any physical challenge.
“Cancer survivors are almost three times more likely to report fair or poor overall health, twice as likely to experience psychosocial disabilities and functional limitations compared to those without cancer or chronic illness. We have adopted globally established framework, such as The International Classification of Functioning, Disability, and Health. This helps our physiotherapists to assess and address the multifaceted impacts of cancer. Such objective tools for assessment ensure a holistic rehabilitation approach,” remarked Anitha D., senior physiotherapist.
Patient’s mental health
For a majority of cancer patients, healing is not merely a physical process, it is also a deep wound at the psychological level. “Research has proven that exercise has a profound impact on mental well-being of cancer patients; from alleviation of depressive and anxiety symptoms to enhanced self-esteem and improved sleep,” remarks Surendran Veeriah, head of psycho-oncology department. Physical activity triggers the release of endorphins, natural chemicals in the body that make you feel well and help reduce pain and boost mood/energy. Regular moderate exercise can increase motivation and provide a natural, non-pharmacological way to cope with stress during and after cancer treatment.
Cancer-related fatigue
Cancer-related fatigue is frequently reported as the most debilitating and persistent symptom of cancer treatment. Guidelines recommend regular fatigue screening during all phases of treatment and survivorship.
Fatigue is not just a side effect, it is often the most distressing symptom reported by cancer patients. It can persist for months or even years post-treatment, hence regular exercise is crucial in the long-term.
Advances in cancer care have resulted in improved survival rates and an increase in survivors. A significant percentage of these survivors are young and in the working age group. Thus, it is imperative to focus on optimising their new normal via physiotherapy so we preserve their quality of life and their ability to resume work.
The benefits of regular physical exercise are overarching on global health (such as: improved cardiovascular parameters, respiratory function and mental health, reduction in obesity, diabetes and cancer, improved sleep and psychosocial well-being). Logically, “movement” should be the health mantra, not just for cancer patients, but for the general public as well. Sadly, we live in an era where there is a reduction in overall physical activity especially with the advent of smart devices.
Embedding exercise and gyms into our daily routines, workspaces should perhaps be the universal prescription for lasting health and well-being!
(Dr. Srinivasan Vijay is chief physiotherapist, and head, department of physiotherapy, Cancer Institute (WIA), Adyar. Dr. M.S. Satish is chief physiotherapist and Scientist D at the institute)