Advances in cancer diagnosis and treatment have led to increased patient survival rates and, consequently, have made it increasingly important to address the impact that both the disease itself and its treatments can have on physical capacity, functional ability and quality of life.

With this aim, Hospital Ruber Internacional has launched a new Oncology Physiotherapy Unit, led by Sara Catalá Rivero, a specialist in Physical Medicine and Rehabilitation, and Sara García Pavón, an expert in Oncology Physiotherapy and Sports Physiotherapy.

The Unit provides specialised, personalised care that can begin from the moment of diagnosis and continue throughout the different stages of the cancer journey. Its purpose is to anticipate potential complications, identify physical and functional changes at an early stage, and treat the effects associated with both cancer itself and surgery, chemotherapy, radiotherapy and other treatments.

"Oncology physiotherapy should not be understood solely as a tool for recovery once treatment has ended. We can intervene from the time of diagnosis, throughout treatment and afterwards, adapting our approach at every stage to the patient’s clinical and functional condition," explain Sara Catalá and Sara García.

Physiotherapy from Diagnosis: Anticipating the Effects of Cancer

One of the key aspects of the new Unit is early intervention. Although every patient has different needs, people with cancer can benefit from a specialised assessment to establish their functional status, identify risk factors and develop a plan tailored to the characteristics of their disease and treatment.

When appropriate, this intervention can begin even before treatment through prehabilitation programmes. The aim is to improve aspects such as strength, mobility, cardiorespiratory fitness and functional reserve so that patients are better prepared to undergo surgery or other cancer treatments.

"The earlier we assess the patient, the greater our ability to anticipate potential problems. Early referral allows us to identify deficits or risk factors and intervene before certain limitations become established or develop into more complex problems," the Unit’s specialists explain.

Physiotherapy can also support patients during hospitalisation, particularly in the immediate postoperative period, and continue throughout chemotherapy, radiotherapy or other treatments to help maintain physical activity and prevent functional decline. Subsequently, it can address effects that persist or emerge in the medium and long term.

Fatigue, Loss of Strength, Pain and Lymphoedema: Effects That Can Be Addressed

The physical consequences of cancer vary considerably depending on the type and location of the tumour, the treatment received and the individual characteristics of each patient.

"Among the problems that can be addressed through oncology physiotherapy are cancer-related fatigue, loss of muscle mass, reduced functional capacity, physical deconditioning, pain, scars and adhesions, peripheral neuropathies, pelvic floor dysfunction and lymphoedema," explains Sara Catalá.

Specific limitations may also arise in connection with particular tumours and treatments. "For example, following breast cancer surgery, shoulder mobility may be affected and there may be a risk of lymphoedema, particularly when lymph nodes have been removed and radiotherapy has been administered," says Sara García.

According to both specialists, patients with head and neck cancers may experience pain, trismus or reduced mobility of the mouth, head and neck. People who have undergone surgery for lung cancer may require respiratory physiotherapy and exercises designed to improve thoracic mobility and rib cage expansion.

Similarly, patients with colon cancer who require a stoma may benefit from abdominal strengthening and lumbopelvic control exercises, while some people with bladder cancer may experience pelvic floor dysfunction that can be addressed through specific physiotherapy.

"No two patients are the same. The type of tumour is important, but so are the treatment received, the effects experienced, the patient’s previous physical condition and the stage of the cancer journey they are currently going through. This is why an individualised assessment is always our starting point," the specialists emphasise.

Treatment Tailored to Each Patient

The work of the Oncology Physiotherapy Unit begins with a comprehensive assessment that takes into account the patient’s medical history, tumour type and stage, location, treatments already received or planned, potential side effects, symptoms and functional capacity.

Based on this information, a personalised treatment plan is established, with objectives tailored to each stage of the patient’s clinical journey.

Available interventions include therapeutic exercise and strength and endurance training, scar and adhesion treatment, techniques aimed at restoring mobility and function, pain and lymphoedema management, and therapeutic education to help patients maintain safe levels of physical activity.

Treatment is not static. It is regularly reviewed and adjusted according to the patient’s clinical progress, tolerance to cancer treatments and any new needs that may arise.

"Care can be provided both at the hospital and in the patient’s home when their clinical or functional condition requires it, helping to ensure continuity of care," says Sara Catalá.

Therapeutic Exercise: An Ally During Cancer Treatment

Exercise is one of the cornerstones of oncology physiotherapy. It should be prescribed on an individual basis, taking into account the patient’s diagnosis, the treatment they are receiving, its potential side effects and their functional capacity.

Before treatment, exercise can form part of a prehabilitation programme designed to increase functional reserves. During the cancer journey, it can help reduce fatigue, preserve muscle mass and bone mineral density, improve cardiorespiratory fitness and reduce certain types of joint pain, while also helping patients maintain their independence.

"Exercise cannot be prescribed in the same way for every patient. It must be based on an individual assessment and progress according to each person’s response and any changes that may occur during treatment," explain Catalá and García.

This personalised approach is particularly important because a patient’s condition may change throughout the different stages of their cancer treatment.

Coordinated Care with the Teams Supporting Each Patient

Oncology physiotherapy forms part of a multidisciplinary approach. For this reason, the new Unit works in close coordination with the different professionals involved in each patient’s care, including teams from Oncology, Surgery, Rehabilitation, Nursing and Psycho-oncology, as well as other specialties whenever required.

Sharing the same hospital environment facilitates direct communication between professionals, helps functional needs to be identified at an early stage and enables patients to be referred to physiotherapy at the most appropriate time.

The case manager also plays an important role in guiding patients, coordinating referrals and promoting continuity of care.

Maintaining Independence and Quality of Life Throughout the Cancer Journey

One of the ongoing challenges is to raise awareness of the role physiotherapy can play as part of cancer care. For the specialists leading the new Unit, the key message is that patients do not need to wait until a significant complication or functional limitation develops before seeking an assessment.

"Our aim is not simply to help patients recover a function they have lost. We want to support each person throughout the entire process, identify potential limitations at an early stage and provide them with the tools they need to remain active, maintain their independence and achieve the best possible quality of life," conclude Sara Catalá Rivero and Sara García Pavón.

Hospital Ruber Internacional is part of One Oncology Madrid–Quirónsalud Group, the comprehensive, patient-centred cancer care programme launched by Quirónsalud across its network of private hospitals in the Community of Madrid. The programme is based on a cross-disciplinary model structured around a single Oncology Department serving all the hospitals participating in the programme.

Within this framework, the launch of the Oncology Physiotherapy Unit at Hospital Ruber Internacional forms part of a multidisciplinary care model designed to support patients throughout the different stages of their disease and facilitate coordinated care among the various professionals involved in their treatment.