If you or someone you care for has been told they have cancer, the first names on the care team are usually the Oncologist, the surgical team, and the nurses on the ward. Physiotherapy may not be on that list early on. It is, however, often part of the picture during treatment, after surgery, and through the months and years of recovery that follow.
01 . Scope
What Physiotherapy does in cancer care
Physiotherapy in cancer care is rehabilitation of physical function. It sits alongside the medical care plan that the Oncologist, surgeons, and other cancer-care professionals coordinate. Physiotherapists do not diagnose or treat cancer. They work on the physical effects of the cancer and its treatment. That means the things you feel day to day: what hurts, what swells, what feels stiff or weak, and what gets in the way of ordinary life.
The aim is to keep people moving, comfortable, and functional through treatment, and to support physical recovery in the months and years afterwards. The Australian Physiotherapy Association recognises cancer, lymphoedema, and palliative care as a clinical interest area within Physiotherapy practice. In day-to-day terms, this often means working through cycles of treatment with a moving target: what helps in cycle one may be different in cycle four, and different again after surgery or radiotherapy.
02 . Timeline
When Physiotherapy fits in cancer rehabilitation
Cancer rehabilitation is usually thought of in three phases: before treatment (often called prehabilitation), during treatment, and after treatment through survivorship. Each phase asks something different of the body, and each has its own Physiotherapy work.
Before treatment (prehabilitation). When time allows before surgery or other major treatment, Physiotherapy can help with baseline strength, breathing patterns, and education about which range-of-movement and mobility issues to watch for. A well-known prospective surveillance model makes the case for screening early rather than waiting until problems appear, which is particularly relevant for upper-limb function and lymphoedema risk in breast cancer.
During treatment. Many people experience reduced energy, deconditioning, and treatment-specific physical effects through chemotherapy, radiotherapy, hormone therapy, or surgery. Physiotherapy work in this phase is usually gentle, often short sessions, focused on keeping movement comfortable and the body working in the ways that matter for daily life. The Clinical Oncology Society of Australia position statement on exercise in cancer care recommends that movement-based care be part of standard cancer care rather than left until treatment is over.
After treatment (survivorship). This is often where Physiotherapy work intensifies: rebuilding range of movement after surgery, managing scar tissue and adhesions, addressing lymphoedema if it has appeared, working through chemotherapy-induced peripheral neuropathy, and getting back to the everyday activities and roles that matter.
Cancer rehabilitation runs in three phases, before treatment, during treatment, and through survivorship, and each one asks something different of the body.
03 . What we address
What Physiotherapy addresses in cancer rehabilitation
The physical effects of cancer and its treatment are wide-ranging. Physiotherapy work in cancer care commonly addresses:
- Lymphoedema. Swelling from disruption to the lymphatic system, often after surgical removal of lymph nodes or after radiotherapy. It is most commonly seen in the arm after breast cancer surgery, but it is also possible in the leg, trunk, head, or neck, depending on the cancer and treatment. Physiotherapy work includes manual lymphatic drainage, compression garments, exercise, and skin care. Lymphoedema can also be primary (genetic or developmental) or secondary to non-cancer causes, so cancer is one cause among several.
- Range of movement and scar-tissue mobility. Surgery, radiotherapy, and long periods of reduced activity can leave joints stiff and scar tissue tight. Physiotherapy work includes mobility exercises, manual therapy, and graded loading appropriate to the stage of healing.
- Chemotherapy-induced peripheral neuropathy (CIPN). Numbness, tingling, or weakness in the hands and feet from certain chemotherapy agents. Physiotherapy work commonly focuses on balance training, sensorimotor exercises, and safe movement strategies, alongside the medical team’s management of the neuropathy itself.
- Deconditioning. Loss of strength, fitness, and bone density across long stretches of being unwell and less active. Physiotherapy often pairs with Exercise Physiology here, with Physiotherapy addressing musculoskeletal restrictions and Exercise Physiology prescribing the broader aerobic and resistance program.
- Pain. Treatment-related pain (post-surgical, post-radiotherapy, neuropathic) is common and often layered. Physiotherapy work uses graded movement, manual therapy where appropriate, and pain-education strategies, in coordination with the medical team.
- Vestibular and balance changes. Some treatments cause dizziness or balance changes. Physiotherapists with vestibular rehabilitation training can address these.
- Bone health. Some cancer treatments affect bone density. Physiotherapy and Exercise Physiology share this work, with bone-loading exercise prescribed cautiously and tailored to the person, especially when bone metastases are present.
The Exercise and Sports Science Australia position statement on exercise medicine in cancer management sets the exercise-prescription framework that Exercise Physiologists use, and the Clinical Oncology Society of Australia position statement sets the broader cancer-care framework that includes referral to a Physiotherapist with experience in cancer care. A 2019 systematic review of systematic reviews of rehabilitation after breast cancer treatment found that individualised rehabilitation, including exercise and lymphoedema work, was linked with improvements in physical and psychosocial functioning.
04 . Collaborative care
Working alongside your oncology team
Physiotherapy is one part of the cancer-rehabilitation picture. A cancer-care team is usually large. On the medical side, that is the Oncologist, the surgical team, the nursing team, and your GP. On the allied-health side, it can include Physiotherapy, Exercise Physiology, Dietetics, Occupational Therapy, Speech Pathology (for head and neck cancers), and Psychology. At Optimum Health Solutions, we provide the Physiotherapy, Exercise Physiology, Dietetics, Occupational Therapy, and Speech Pathology parts of this team. If Psychology support fits your situation, your GP or hospital cancer-care coordinator can connect you with a Psychologist outside our team.
Different professionals address different things and often share the work. Physiotherapy works on range of movement, scar-tissue mobility, lymphoedema, CIPN, vestibular changes, and musculoskeletal pain. Exercise prescription during and after cancer treatment is the Exercise Physiology arm of cancer rehabilitation; our companion piece on the benefits of exercise during and after cancer treatment covers that. For men with a prostate cancer diagnosis, our exercise for prostate cancer post covers the Australian evidence on androgen deprivation therapy and resistance training. For women in or after breast cancer treatment, our exercise during and after breast cancer post covers the breast-specific evidence. For people whose main concern is fatigue, our cancer-related fatigue and exercise post covers what the research says.
Coordination matters. We share relevant findings and changes with the consultant or GP who is coordinating care, especially when something Physiotherapy notices may be clinically relevant to the medical plan. The flow goes both ways: referral letters from the oncology team shape the Physiotherapy plan, and Physiotherapy findings feed back into the medical record where useful.
05 . Getting started
How to access Physiotherapy for cancer recovery
You can refer yourself directly to a Physiotherapist; a GP referral is not required to book an appointment. A GP referral under a Medicare GP Chronic Condition Management Plan can provide rebated visits for people with a chronic condition who meet the plan criteria. The right pathway depends on the person and the funding situation.
A first appointment usually runs 45 to 60 minutes. The Physiotherapist reads any referral and recent correspondence, asks about the cancer type, treatment to date, and current treatment plan, and runs a baseline assessment that fits the day: range of movement, strength, scar-tissue mobility, swelling measurements where relevant, balance, and a conversation about what is hardest right now. The starting program is intentionally conservative.
If you are looking for a Physiotherapist with training in cancer rehabilitation, the Australian Physiotherapy Association Cancer, Lymphoedema and Palliative Care group is a useful starting point. You can also ask the cancer-care team for a referral to a Physiotherapist experienced in oncology rehabilitation. Funding pathways in Australia include a Medicare GP Chronic Condition Management Plan (a GP referral provides rebated visits where eligible), NDIS funding for eligible participants, Department of Veterans’ Affairs cover for veterans, private health extras, and private fees.
References
- Cormie and colleagues, 2018 (COSA position statement). Clinical Oncology Society of Australia position statement on exercise in cancer care. Medical Journal of Australia, 209(4), 184-187. DOI: 10.5694/mja18.00199. (According to PubMed.)
- Hayes and colleagues, 2019 (ESSA position statement). The Exercise and Sports Science Australia position statement: exercise medicine in cancer management. Journal of Science and Medicine in Sport, 22(11), 1175-1199. DOI: 10.1016/j.jsams.2019.05.003. (According to PubMed.)
- Stout and colleagues, 2012 (prospective surveillance model). A prospective surveillance model for rehabilitation for women with breast cancer. Cancer, 118(8 Suppl), 2191-2200. DOI: 10.1002/cncr.27476. (According to PubMed.)
- Olsson Möller and colleagues, 2019 (systematic review of systematic reviews). A comprehensive approach to rehabilitation interventions following breast cancer treatment. BMC Cancer, 19(1), 472. DOI: 10.1186/s12885-019-5648-7. (According to PubMed.)
- Cancer Council Australia. Managing side effects.
- Australian Physiotherapy Association. Cancer, Lymphoedema and Palliative Care group.
- Australian Institute of Health and Welfare. Cancer data in Australia.
