STAR Program® - Helping Cancer Survivors Overcome the Effects of Treatment
HealthReach, Fall 2013 | Page 10
The STAR program is only available in the Washington Metro Area at Virginia Hospital Center.
Before Annalisa Parks was treated for breast cancer, she ran four miles a day, three times a week, went to yoga weekly and did cross training. Chemotherapy and radiation, however, took a heavy toll. Annalisa became increasingly fatigued and had trouble with her memory—the notorious “chemo brain” that often plagues patients who undergo chemotherapy. She also suffered from radiation changes to her skin and lymphedema, which caused fluid build-up in her limbs.
Annalisa Parks with her physical therapist Michelle Kondracki, MPT, CLT-LANA
“I was so weak and debilitated, it was hard to tie my shoes,” Annalisa said. “I was walking with a cane, I couldn’t walk my dogs and I had a hard time dressing myself.”
Annalisa is far from alone. Between 65 percent and 90 percent of cancer survivors develop debilitating physical impairments caused by cancer treatments, says Julie Silver, MD, associate professor at Harvard Medical School, who developed the STAR Program® (Survivorship Training and Rehabilitation).
“Cancer rehabilitation is an important part of highquality oncology care,” Dr. Silver says. “Yet, fewer than 10 percent of cancer survivors receive the services they need. Most survivors could benefit from some type of rehab. Cancer rehab can help with physical problems and emotional outlook, whether the cancer is chronic, in remission or cured.”
The STAR Program has been adopted by hospitals and cancer centers in nearly every state in the U.S. and now is only available in the Washington Metro Area at Virginia Hospital Center. To become STAR Program certified, the Hospital’s physical, occupational and speech therapists, and nurse navigator received in-depth, evidence-based training in oncology rehabilitation based on the protocols of the STAR Program.
Rehab can be just as beneficial for cancer patients as it is for patients recovering from heart attack and stroke, says Sandy Austin, Assistant Director, Rehabilitation, and Coordinator of Virginia Hospital Center’s STAR Program. “We want cancer survivors to achieve the highest ‘new normal’ they possibly can.”
For breast cancer survivors like Annalisa, the effects of treatments can cause pain in the chest, difficulty carrying and lifting things, and sleep issues. Some survivors may stop driving because they have trouble turning their head. Physical therapy can help restore cervical range of motion.
Peripheral neuropathy (loss of sensation in the fingers and toes), as well as fatigue and chemo brain are other common side effects. Physical and occupational therapy can help patients improve their balance and fine motor movements, and speech and occupational therapists can help with strategies for short-term memory, focus and attention.
“Even survivors who have not had treatment for five or six years can still suffer from fatigue,” Austin explains. “By tailoring a therapeutic exercise program to meet individual needs, we can help abate it.”
It’s important to point out that cancer rehab is very different from general wellness and exercise at the gym, Dr. Silver notes. “Cancer rehabilitation involves medical interventions that are covered by healthcare insurance and are designed to treat physical impairments, as opposed to general exercise and wellness that are designed to improve endurance.”
“When patients go through medically-supervised rehab in our STAR Program, we know what cancer treatments and medications they have had,” adds Austin. “We look at the whole patient and provide a specialized exercise program.”
When Annalisa first began her cancer rehab program at Virginia Hospital Center, her therapists asked about her prior activities and what was important to her to be able to do again. Those were the things they helped her work toward.
“Now, I can do modified yoga, walk without a cane, and walk my dogs three times a day,” Annalisa says. “I have better range of motion, I can lift my arm above my head and I’m more flexible. This has been a miraculous change for me. My quality of life is dramatically improved.”
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