Rehabilitation of Cancer Patients
Rehabilitation of the cancer patients is a complex of public, medical, pedagogic, social and economic measures that aim to repair or compensate for the damaged functions of the body, to adapt the patients to new conditions induced by the disease and therapy and to restore their social functions and working capacity.
The scientific and medical advances allowed for significant improvement of the cancer outcomes. Meanwhile, along with the increased survival rates the number of disabled patients with disordered function of some of the organs after the surgical interventions has greatly increased as well. Consequently, medical rehabilitation in oncology gives its priority to the improvement of the life quality of cancer patients. Contemporary oncology should evaluate the results of the combined and complex treatment not only by survival rates but also by the specific rates of life quality that reflect the general tendency of return to the humane traditions of medicine.
The oncologic patients receive medical rehabilitation in the medical institutions. It aims to restore the damaged functional and psychological abilities of the patient, to develop the compensatory mechanisms by surgical, pharmaceutical and sanatorium-resort treatment.
Rehabilitation of cancer patients includes multiple stages. Various methods of rehabilitation that permit patient’s return to work, to family, to the previous level of social communication are used at every stage of the therapy and follow up; if the restoration to the pre-surgical level is not possible they should provide for the acceptable life quality.
If the rehabilitation is started early and remains regular, the disability reduces as well as the expenses for financial support of the disabled. According to the data of German researchers, the costs of the first six years of rehabilitation return tenfold and even twentyfold.
Medical rehabilitation of the patients in the Russian Federation is regulated according to the Order of the Ministry of Healthcare №1705n “On the Order of Organization of Medical Rehabilitation” dated December 29, 2012. The Order of the Ministry of Healthcare of the Russian Federation №915n regulates the medical assistance in the field of oncology.
According to the Order the medical assistance to the oncologic patients is subdivided into:
- primary medical and sanitary assistance,
- specialized medical assistance along with highly technological, including:
- prevention and diagnostics of cancer;
- treatment and rehabilitation of cancer patients using contemporary special methods and complex, including unique medical technologies.
Medical assistance to rehabilitate the patients with oncologic diseases is provided according to №№ 25–27 to the Order that regulate:
- Activity of Rehabilitation Departments of Oncology Centers and medical organizations that provide medical assistance to cancer patients;
- Recommended staff norms for Rehabilitation Departments of Oncology Centers and medical organizations that provide medical assistance to cancer patients;
- Standards of equipment of Rehabilitation Departments of Oncology Centers.
The rehabilitation measures to the people who recover after cancer is in extremely high demand.
Twenty five per cent of the in-patients need all types of rehabilitation. For example, in the case of the Blokhin Cancer Research Center it totals two and a half thousand in-patients per year. No less than fifty per cent of out-patients from the general number of cancer patients need rehabilitation. It would be practical to have in-patient rehabilitation departments for 50 beds or to study the opportunities to organize a rehabilitation center in the structure of the municipal cancer center or a separate medical organization on the principles of the public and private partnership for 150 or 200 beds with the in-patient department of 50 beds. The first rehabilitation department for cancer patients for 40 beds was open in 1965 in Moscow State Cancer Hospital № 62.
However, rehabilitation of the cancer patients should include not only the physical methods of treatment and physical training. After the standard course of chemo- or radiotherapy, these patients have more or less pronounced disorders of hematopoiesis and immunopoiesis, metabolic and endocrine disorders. So, administration of the hematopoietic stem cells (HSCs) and hematopoietic precursor cells (HPCs) has direct indication, as for these patients restoration of the disordered hematopoiesis and immunopoiesis should be a necessary component in the rehabilitation.