Breast cancer: Rehabilitation promotes self-esteem and well-being

Breast cancer is the tumor that kills most women worldwide, including in Brazil. In the country, with the exception of non-melanoma skin cancer, this is the most common type of cancer in women. For the year 2022, 66,280 new cases were estimated, according to a survey by the National Cancer Institute (INCA).

There is a high probability of curing breast cancer when the diagnosis is made early. A tumor diagnosed at an early stage has more than a 90% chance of cure. However, treatment, which may include partial or total mastectomy, can bring physical and emotional sequelae.

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“The view that a woman has about herself is altered after the mastectomy and when there is no immediate breast reconstruction”, points out Vanessa Tiscoski, an oncological physiotherapist at the Brazilian Society of Mastology (SBM). “In addition, after the surgery, she suffers from limited movement of the shoulders and scapulae, postural changes, pain and change in sensitivity, difficulty in socializing and creating insecurity”, says the specialist.

Therefore, rehabilitation is a fundamental step during and after breast cancer treatment. It is a set of care to ensure the resumption of post-cancer life, improving women’s self-esteem and physical, emotional, social and sexual well-being.

Stages of post-breast cancer rehabilitation

Rehabilitation of the breast cancer patient should not only occur after treatment, but throughout the entire process, from diagnosis. The stages of rehabilitation are:

1. Physiotherapy before treatment

The physiotherapist and professor of the Physiotherapy course at Faculdade Santa Marcelina, Aline Machado, explains that the treatment physiotherapy is recommended throughout the patient’s follow-upfrom diagnosis to discharge.

Vanessa agrees and points out that it is now possible to make indications of appropriate physical exercises for each case during the patient’s evaluation. “We know that physical activity prevents the emergence of other diseases and alleviates the side effects of cancer treatment”, explains the oncology physiotherapist.

2. Physical rehabilitation after surgery

It is at this stage that physiotherapy will play its greatest role. Physiotherapeutic treatment is essential to help women overcome their physical limitations and promote functional independence, allowing them to perform daily activities alone and in greater comfort.

“The role of physiotherapy in breast cancer rehabilitation is to improve the quality of life of women in the postoperative period of breast cancer, in order to reduce pain and discomfort in the immediate postoperative period, improve range of motion and strength muscle of the upper limb involved in the surgery and minimize possible swelling that can occur both in the immediate and late postoperative period”, explains Aline.

This importance is mainly due to the injury caused by the surgical procedure itself, but also because there is a possibility that the doctor will have to remove muscles, which interferes with the movement of the upper limb on the operated side, and lymph nodes, which drain the arm. , which may cause post-mastectomy lymphedema.

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According to Vanessa, the benefits of physical therapy also include the prevention of respiratory, skeletal and circulatory complications and adequate and safe rehabilitation, with exercises and guidelines that must be followed after returning home.

Among the activities that are part of physiotherapy are muscle stretching, joint mobilizations, in addition to electrophysical resources and the use of manual therapy, as explained by Aline.

3. Emotional rehabilitation

During breast cancer treatment, a woman’s self-esteem can be impacted due to hair loss, a common side effect of chemotherapy, and due to mastectomy. In addition, it is common for patients to feel a decrease in libido and suffer from hormonal changes that can impact their sex life.

Therefore, it is also part of rehabilitation to restore the confidence and self-esteem of women. In these cases, breast reconstructive surgery may be essential for some patients. In addition, it is important to maintain psychological or psychiatric monitoring for the process of regaining self-confidence.

4. Social rehabilitation

Social rehabilitation encompasses the emotional and physical phases. After all, through physical therapy, the patient will be able to recover her physical functions and have more independence to perform her tasks, feeling less pain.

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Psychological follow-up will also promote mental and emotional well-being, motivating the patient to perform tasks that give her pleasure. All this is essential for her to feel free to resume social and leisure activities that were part of her routine before breast cancer treatment.