Are you aware of any evidence supporting or negating the use of modalities such as a TENS unit to assist with pain during or after exercise for breast cancer particularly with patients with metastases?
Answer
Let me first say that, in general, we want to minimize the use of modalities in patients who have had a cancer diagnosis. We are not going to be putting heat on any patient who has had a cancer diagnosis. We are typically not going to be using ultrasound. We are not going to be doing E-stim. However, patients that are having pain and already have known metastases, if they are cleared by their doctor, they could go through a trial of TENS. Typically metastatic pain is a bone pain and TENS is not going to affect that. TENS is going to give them more superficial pain control, and it works well with musculature pain. This is not something that you are going to have a lot of opportunity to use, but if you, the patient, and the physician want to trial that, I think it is possible.
Andrea Branas, PT, MSE, MPT, CLT
Andrea Branas is a lead physical therapist at Good Shepherd Penn Partners in Philadelphia, PA. Andrea works in the Abramson Cancer Center at the University of Pennsylvania Health System providing patient care, education, leadership and training in the area of cancer rehabilitation. Andrea’s areas of clinical expertise include lymphedema, pelvic floor rehabilitation, breast cancer rehabilitation and exercise for cancer related fatigue. In her current role, Andrea uses her expertise to help cancer survivors reach their physical potential by promoting rehabilitation starting at the time of cancer diagnosis. She is currently a collaborator on an NIH Funded Dissemination grant to look at strength training for survivors of breast cancer. Andrea has served as a guest lecturer for women’s health and cancer content at Arcadia and Widener Universities and the University of Medicine and Dentistry in New Jersey DPT programs. Andrea received her Masters degree in Physical Therapy from the University of the Sciences in Philadelphia in 1998 and her Master’s of Science in Engineering degree from the University of Pennsylvania in 1991. She is currently working towards her transition DPT at Arcadia University.
Related Courses
1https://www.physicaltherapy.com/pt-ceus/course/mindfulness-beyond-guided-meditation-3902Mindfulness: Beyond Guided MeditationMindfulness can be a really powerful cognitive-behavioral tool and has many relevant applications when treating patients with pain, especially chronic pain. Many courses for rehabilitation professionals teach guided meditation, which is an amazing tool. However, mindfulness has many other applications and opportunities for use in the treatment of patients with pain. This session discusses the history and science behind mindfulness, as well as provides a variety of practical mindfulness tools for the everyday practitioner. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyPhysicalTherapy.comwww.physicaltherapy.comMindfulness: Beyond Guided MeditationMindfulness can be a really powerful cognitive-behavioral tool and has many relevant applications when treating patients with pain, especially chronic pain. Many courses for rehabilitation professionals teach guided meditation, which is an amazing tool. However, mindfulness has many other applications and opportunities for use in the treatment of patients with pain. This session discusses the history and science behind mindfulness, as well as provides a variety of practical mindfulness tools for the everyday practitioner. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.3902OnlinePT120M
Mindfulness can be a really powerful cognitive-behavioral tool and has many relevant applications when treating patients with pain, especially chronic pain. Many courses for rehabilitation professionals teach guided meditation, which is an amazing tool. However, mindfulness has many other applications and opportunities for use in the treatment of patients with pain. This session discusses the history and science behind mindfulness, as well as provides a variety of practical mindfulness tools for the everyday practitioner. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.
2https://www.physicaltherapy.com/pt-ceus/course/physical-therapist-management-pelvic-floor-4358Physical Therapist Management of Pelvic Floor Tension Myalgia: When Your Patient Has Pain Down TherePelvic floor tension myalgia can cause a range of symptoms including pain in the vagina and rectum, feeling of sitting on a ball or stick, and pain during intercourse. This course will explore why and how pelvic physical therapy is first line treatment for pelvic floor tension myalgia. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA. Editor's Note: Regarding Pennsylvania credits, this course is approved by the PA State Board of Physical Therapy for 1 hour of general and 1 hour of Direct Access CE credit.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyPhysicalTherapy.comwww.physicaltherapy.comPhysical Therapist Management of Pelvic Floor Tension Myalgia: When Your Patient Has Pain Down TherePelvic floor tension myalgia can cause a range of symptoms including pain in the vagina and rectum, feeling of sitting on a ball or stick, and pain during intercourse. This course will explore why and how pelvic physical therapy is first line treatment for pelvic floor tension myalgia. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA. Editor's Note: Regarding Pennsylvania credits, this course is approved by the PA State Board of Physical Therapy for 1 hour of general and 1 hour of Direct Access CE credit.4358OnlinePT120M
Pelvic floor tension myalgia can cause a range of symptoms including pain in the vagina and rectum, feeling of sitting on a ball or stick, and pain during intercourse. This course will explore why and how pelvic physical therapy is first line treatment for pelvic floor tension myalgia. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.
Editor's Note: Regarding Pennsylvania credits, this course is approved by the PA State Board of Physical Therapy for 1 hour of general and 1 hour of Direct Access CE credit.
3https://www.physicaltherapy.com/pt-ceus/course/cancer-related-comorbidities-and-adverse-3592Cancer Related Comorbidities and Adverse Treatment EffectsCancer and its treatment are known to cause survivors to experience a number of comorbidities and adverse effects. Because physical therapy management of the cancer survivor must either focus on these comorbidities/adverse effects or treat them, physical therapists must have a fundamental understanding of the most common of conditions. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyPhysicalTherapy.comwww.physicaltherapy.comCancer Related Comorbidities and Adverse Treatment EffectsCancer and its treatment are known to cause survivors to experience a number of comorbidities and adverse effects. Because physical therapy management of the cancer survivor must either focus on these comorbidities/adverse effects or treat them, physical therapists must have a fundamental understanding of the most common of conditions. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.3592OnlinePT120M
Cancer and its treatment are known to cause survivors to experience a number of comorbidities and adverse effects. Because physical therapy management of the cancer survivor must either focus on these comorbidities/adverse effects or treat them, physical therapists must have a fundamental understanding of the most common of conditions. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.
4https://www.physicaltherapy.com/pt-ceus/course/upper-extremity-neuropathies-in-oncology-5137Upper Extremity Neuropathies in OncologyThis course aims to explore upper extremity neuropathies within the oncology setting, including chemotherapy-induced peripheral neuropathy, cervical radiculopathy, thoracic outlet syndrome, and peripheral median and ulnar nerve neuropathies. Included case studies provide real examples of peripheral neuropathies in the oncology setting.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyPhysicalTherapy.comwww.physicaltherapy.comUpper Extremity Neuropathies in OncologyThis course aims to explore upper extremity neuropathies within the oncology setting, including chemotherapy-induced peripheral neuropathy, cervical radiculopathy, thoracic outlet syndrome, and peripheral median and ulnar nerve neuropathies. Included case studies provide real examples of peripheral neuropathies in the oncology setting.5137OnlinePT120M
This course aims to explore upper extremity neuropathies within the oncology setting, including chemotherapy-induced peripheral neuropathy, cervical radiculopathy, thoracic outlet syndrome, and peripheral median and ulnar nerve neuropathies. Included case studies provide real examples of peripheral neuropathies in the oncology setting.
5https://www.physicaltherapy.com/pt-ceus/course/pelvic-organ-prolapse-and-you-3877Pelvic Organ Prolapse and YouThis course provides an overview of types of pelvic organ prolapse, discusses causes of pelvic organ prolapse, and discusses rehabilitative management of both post-operative and non-operative patients with pelvic organ prolapse. This course is best suited for physical therapists who already have some underlying pelvic floor/pelvic health knowledge, but may also be taken by those who do not with the understanding that some additional outside study of anatomy may be needed. This course is directly related to the practice of physical therapy and athletic training and is therefore appropriate for the PT/PTA and AT. Editor's Note: Regarding Pennsylvania credits, this course is approved by the PA State Board of Physical Therapy for 1 hour of general and 1 hour of Direct Access CE credit.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyPhysicalTherapy.comwww.physicaltherapy.comPelvic Organ Prolapse and YouThis course provides an overview of types of pelvic organ prolapse, discusses causes of pelvic organ prolapse, and discusses rehabilitative management of both post-operative and non-operative patients with pelvic organ prolapse. This course is best suited for physical therapists who already have some underlying pelvic floor/pelvic health knowledge, but may also be taken by those who do not with the understanding that some additional outside study of anatomy may be needed. This course is directly related to the practice of physical therapy and athletic training and is therefore appropriate for the PT/PTA and AT. Editor's Note: Regarding Pennsylvania credits, this course is approved by the PA State Board of Physical Therapy for 1 hour of general and 1 hour of Direct Access CE credit.3877OnlinePT120M
This course provides an overview of types of pelvic organ prolapse, discusses causes of pelvic organ prolapse, and discusses rehabilitative management of both post-operative and non-operative patients with pelvic organ prolapse. This course is best suited for physical therapists who already have some underlying pelvic floor/pelvic health knowledge, but may also be taken by those who do not with the understanding that some additional outside study of anatomy may be needed. This course is directly related to the practice of physical therapy and athletic training and is therefore appropriate for the PT/PTA and AT.
Editor's Note: Regarding Pennsylvania credits, this course is approved by the PA State Board of Physical Therapy for 1 hour of general and 1 hour of Direct Access CE credit.
