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Finding Balance

Sheridan, Laura PT, DPT, CLT

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doi: 10.1097/01.REO.0000000000000251
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2020 was a year full of different challenges that have left many of us feeling off-center. Although these challenges won't be behind us in 2021, we have all hopefully had time to flex our resilience and adapt. Not making it easy, but hopefully more manageable. This is somewhat analogous to the challenge all people affected with cancer face from the time of diagnosis. Their world is disrupted by the uncertainty that lies ahead and the sequelae of impairments that can come with treatment and survivorship. It is their medical teams, ancillary services, support of friends and family, and, mostly, their individual resilience and strength that help them move forward.

Impairments will vary for each individual depending on type of cancer, comorbidities, and treatment interventions administered. One exception is fall risk. It is a vulnerability for all people affected by cancer regardless of age, type of cancer, and whether at time of diagnosis or end of life. This should come as no surprise, given our knowledge of cancer-related sequelae and symptoms experienced including fatigue, cognitive, vision, and vestibular deficits, decreased strength, pain, and neuropathy.

One thing unchanged as we head into 2021 is the need for physical therapy to address the issues of balance and falls in people affected by cancer. Based on research available, it can, and should, be argued that screening for falls and balance deficits should be included in all physical therapy evaluations of patients affected by cancer. It is something I implement in my own practice with each referred evaluation and encourage my colleagues to do the same. As a result of screening during evaluation when impairment in balance is noted, I have the opportunity to discuss with the referring provider my findings and provide education on fall risk in this patient population. Hopefully, this leads to sooner screening and awareness for these patients before physical therapy intervention is necessary. As physical therapists (PTs) and physical therapist assistants (PTAs), it is part of our role to make sure this is addressed for all patients. I encourage everyone to find the opportunities that exist within your practice, no matter the setting, to reduce people affected with cancer vulnerability to falls.

APTA Oncology's Balance and Falls Special Interest Group provides such an opportunity for PTs, PTAs, and students with an interest in balance and falls in cancer survivors to share resources, explore research, collaborate, and network. The group puts a focus on the important work our profession does to screen and reduce fall risk in people affected by cancer. Their strong leadership and membership has led to the development of educational webinars and resources to assist us as professionals in advancing our abilities to improve our patients' balance and quality of life.

As we rally around one another to help us find our center in 2021, we should continue our vigilance in screening for and addressing fall risk among people affected by cancer to ensure safety and security for all.

Best regards,

Laura Sheridan, PT, DPT, CLT

© 2021 Academy of Oncologic Physical Therapy, APTA.