Exercises Program in Breast Cancer Patient with Chemotherapy Induced Peripheral Neuropathy: A Case Study

Background: Breast cancer is one of the most common cancers in women worldwide, accounting for approximately 570,000 deaths in 2015. Over 1.5 million women (25% of all women with cancer) are diagnosed with breast cancer every year throughout the world. One of the most common complications after breast cancer surgery is functional limitation of the upper body. Up to 67% of breast cancer patients experience arm or shoulder impairment, including pain, numbness, loss of strength, and reduced ROM, after surgery. Breast cancer patients are presenting with chemo-induced peripheral neuropathy (CIPN) that is impacting their balance, quality of life, and overall participation, as a side effect of chemotherapy treatment. Study Design: This case study was used to highlight the role of physical therapy interventions in the management of Breast cancer patient after surgery with chemo-induced peripheral neuropathy. Case Description: A 55-years-old Saudi female, known case of diabetes mellitus on insulin, hypertension and history of DVT 27 years back on anticoagulant. She came to the combined clinic breast clinic and all workup and investigations were done and showed invasive ductal carcinoma. Referred to physical therapy department by breast and endocrine clinic for left shoulder limited range of motion, impaired mobility and managing the symptoms. PT Management and Outcome: The patient received 2 phases of rehabilitations, phase 1 the patient was seen once a week for 4 weeks, phase 2 the patient was seen 3 times per week for 6 weeks. Exercise program of patient education, therapeutic exercise of low- to - moderate intensity resistance exercise for UE and LE. Aerobic Exercise; Cardio bike progressive training for UE and LE and balance exercise. By the end of phase 1 patient’s ROM and pain improved significantly, and by the end of phase 2 of the rehabilitation program, patient’s balance (using BBS), functional ability and QOL using (FACT-B) improved. Discussion: This case study showed that physical therapy exercise program including therapeutic exercises, low- to moderate- intensity resistance exercise, aerobic exercise, balance exercise is an effective program for breast cancer patients as it improves CIPN, minimize dependency and improved QOL.