Cancer rehabilitation is increasingly recognized as essential for restoring physical function, managing symptoms, and enhancing quality of life (QoL) both during and after treatment. Physiotherapy stands at the heart of this multidisciplinary effort, delivering targeted interventions—from prehabilitation to palliative care—that significantly benefit patients at every stage.
1. Prehabilitation: Building Resilience Before Treatment
Research supports prehabilitation—starting physiotherapy before surgery or chemotherapy—to boost cardiorespiratory fitness, muscle strength, and psychological adaptability. For instance, pulmonary and strength training before gastrointestinal or lung cancer surgery has been shown to reduce postoperative complications and hospital stay by 1–2 days
2. Restorative Rehabilitation During and After Treatment
Physiotherapy that targets early mobilization, breathing exercises, and pelvic floor or lymphedema care supports post-treatment recovery. A Cochrane review highlights increased exercise capacity, muscle strength, and improved QoL in lung cancer patients post-resection .
3. Managing Pain, Lymphedema & Mobility
Physiotherapists effectively address treatment-related side effects using manual therapy, stretching, and functional strengthening. In breast cancer postoperative care, these methods restore shoulder range of motion, reduce swelling, and help resume daily activities .
4. Fighting Fatigue & Neuropathy
Cancer-related fatigue (CRF), reported by nearly all patients, is more intense than usual tiredness ([en.wikipedia.org][3]). Meta-analyses confirm that tailored exercise—such as aerobic, resistance training, yoga, or Qigong—reduces CRF and improves QoL .
Physiotherapy interventions also help manage chemotherapy-induced peripheral neuropathy, improving strength and well-being .
5. Safe, Tailored Exercise Across Cancer Types
A systematic review of head/neck, lung, and breast cancer survivors found that combined aerobic and resistance training—with stretching, relaxation, or manual therapy—significantly improves strength, coordination, balance, pain relief, and QoL.
Similarly, guided exercise is safe even in patients with bone metastases or during chemotherapy, provided it's supervised and adjusted.
6. Palliative Physiotherapy: Enhancing Comfort & Function
Even in advanced cancer, physiotherapy improves symptom control—reducing pain, fatigue, breathlessness—and maintains independence. It plays a critical role in holistic palliative care by promoting functional mobility and psychological well-being.
7. Barriers & Facilitators to Engagement
Common barriers include fatigue, depression, low motivation, and logistical challenges. Studies show that personalized programs, social support, familiar activities, and early education enhance adherence and outcomes .
8. What the Evidence Says
A major review of 80 studies (2012–2024) in the British Journal of Sports Medicine confirms that exercise reduces side effects like chemotherapy damage and “brain fog,” improving physical function, mental health, and survival outcomes.
Meta-analyses link physical activity with reduced all-cause and cancer-specific mortality in breast and colon cancer survivors.
Conclusion:
Why Physiotherapy Matters in Cancer Care
Physiotherapy plays a crucial role at every phase of the cancer journey—before, during, and after treatment, as well as in palliative settings. By delivering personalized, safe, and evidence-based interventions, physiotherapists:
- Aquatic Therapy: Gentle, Effective & Stimulating
Water-based exercise offers a low-impact, supportive environment that enhances strength and mobility with less joint stress. A 2023 study showed aquatic therapy was even more effective than yoga or Pilates for breast cancer survivors, reducing fatigue, tension, depression, and anger.
- Exercise for Metastatic and Stage IV Patients
Structured aerobic and strength training programs, supervised by physiotherapists, have been found safe and beneficial even for stage IV breast cancer patients—significantly reducing fatigue, pain, and improving quality of life and physical fitness.
- Older Adults on Chemotherapy: Preventing Functional Decline
One study showed that 35% of women over 65 on chemotherapy experienced significant decline in daily activities compared to just 8% not on chemo—highlighting the need for tailored physiotherapy that integrates geriatric assessment and targeted physical interventions.
- Pelvic Floor Rehabilitation in Bladder & Gynecological Cancers
Pelvic floor physical therapy greatly improves post-surgical continence and bladder function in bladder cancer survivors. For gynecological cancers, a systematic review of 5 studies showed combined exercise, photobiomodulation, and pelvic floor rehab improved outcomes substantial.
- Head, Neck, Lung & Breast Cancer Survivors
A 2024 systematic review (19 RCTs) demonstrated physiotherapy greatly improves pain, strength, fatigue, coordination, balance, ADLs, psychosocial and cognitive function, and QoL across head-and-neck, lung, and breast cancer populations.
- Managing Chemotherapy-Induced Peripheral Neuropathy
An RCT review (10 trials) found physiotherapy enhances QoL and reduces neuropathy severity in patients with chemotherapy-induced peripheral neuropathy through sensory reeducation, strength training, and balance exercises.
- Tech-Driven, Personalized Rehab
Innovations like wearables, telerehab, VR/AR, AI, and 3D-printed aids allow real-time data monitoring, personalized planning, and remote delivery. These advances optimize safety, motivation, and therapy adherence across outpatient and home-based settings
Call to Action
☑️ Cancer care teams: integrate physiotherapy early and systematically.
☑️ Physiotherapists: champion exercise even in complex cases.
☑️ Patients and carers: seek guidance on safe, adapted physiotherapy programs.
References
1. Systematic review: physiotherapy in head/neck, lung, breast cancer ([pubmed.ncbi.nlm.nih.gov][5], [link.springer.com][2], [pubmed.ncbi.nlm.nih.gov][9], [pubmed.ncbi.nlm.nih.gov][4])
2. Prehabilitation evidence in surgical cancer care ([pmc.ncbi.nlm.nih.gov][1])
3. Pulmonary rehab and restorative rehab improvements ([pmc.ncbi.nlm.nih.gov][1])
4. Pain, ROM, lymphedema in breast cancer rehabilitation ([australian.physio][6])
5. Exercise safety, fatigue reduction, bone metastases benefits ([australian.physio][10])
6. Neuropathy and QoL benefits from physiotherapy 
7. Large review on exercise benefits clinical and survival outcomes ([theguardian.com][7])
8. Barriers and motivational strategies for exercise adherence ([pmc.ncbi.nlm.nih.gov][11])
9. Palliative rehab and patient-reported outcomes 
10.https://pmc.ncbi.nlm.nih.gov/articles/PMC7406418/?utm_source=chatgpt.com "Cancer Rehabilitation and Palliative Care—Exploring the Synergies - PMC"
11: https://link.springer.com/article/10.1007/s40141-025-00489-3?utm_source=chatgpt.com "The Importance of Rehab in Treating Cancer and Palliative Care Patients | Current Physical Medicine and Rehabilitation Reports"
12.https://en.wikipedia.org/wiki/Cancer-related_fatigue?utm_source=chatgpt.com "Cancer-related fatigue"
13. https://pubmed.ncbi.nlm.nih.gov/37522184/?utm_source=chatgpt.com "Effectiveness of physiotherapy interventions on improving quality of life, total neuropathy score, strength and reducing pain in cancer survivors suffering from chemotherapy-induced peripheral neuropathy - a systematic review - PubMed"
14.https://pubmed.ncbi.nlm.nih.gov/38205574/?utm_source=chatgpt.com "Physiotherapy in Head, Neck, Lung and Breast Cancer Survivors: A Systematic Review - PubMed"
15. https://australian.physio/inmotion/five-facts-about-physiotherapy-cancer-care?utm_source=chatgpt.com "APA | Five facts about … physiotherapy cancer care"
16:https://www.theguardian.com/society/2025/apr/29/exercise-can-counter-side-effects-of-cancer-treatment-biggest-review-of-its-kind-shows?utm_source=chatgpt.com "Exercise can counter side-effects of cancer treatment, biggest review of its kind shows"
17: https://en.wikipedia.org/wiki/Exercise?utm_source=chatgpt.com "Exercise"
18: https://pubmed.ncbi.nlm.nih.gov/39409991/?utm_source=chatgpt.com "Recommended Physiotherapy Modalities for Oncology Patients with Palliative Needs and Its Influence on Patient-Reported Outcome Measures: A Systematic Review - PubMed"
19: https://australian.physio/inmotion/physiotherapy-and-exercise-rehabilitation-cancer-care?utm_source=chatgpt.com "APA | Physiotherapy and exercise rehabilitation in cancer care"
20:https://pmc.ncbi.nlm.nih.gov/articles/PMC8645643/?utm_source=chatgpt.com "Physiotherapy and Physical Activity as Factors Improving the Psychological State of Patients With Cancer - PMC"
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