Cancer Rehab for Young Adults and Adolescents
Introduction
If you’re seeking a cancer rehab therapist (especially an occupational therapy professional), we want you to be as informed as possible so we can truly partner to create the best course of treatment for YOU.
In occupational therapy, we tend to work from “menus” of evidence-based assessments and treatments. This gives us the flexibility to meet the specific needs of each patient. Below, you’ll see the assessment and treatment options your therapist may use, along with the evidence that supports them.
Please note that this page is for educational purposes and should not substitute advice from your medical provider. At the bottom of this page, you’ll find therapists near you who can support you in your cancer rehab.
A quick note on why to pursue cancer rehab
Cancer rehabilitation—including occupational therapy—can help improve your quality of life as you undergo cancer treatment. Cancer rehabilitation professionals can support everything from cancer prevention and health promotion following diagnosis to management of independence during and after cancer treatment. For example, cancer rehabilitation professionals are skilled in addressing many of the 10 recommendations for cancer prevention from the American Institute for Cancer Research.
Cancer rehab professionals can help with areas such as: quality of life, activities of daily living, fatigue, functional mobility, exercise, cognition, communication, sexual function, caregiving, and return to work. In addition to improving your overall quality of life, cancer rehabilitation services aim to:
decrease your risk of needing more intensive services, and
help you overcome severe side effects later in the cancer journey.
To date, outpatient oncology rehabilitation services have been linked to significantly lower costs associated with emergency department visits, home health services, skilled nursing facility stays, and hospice care.
Related Assessments
Assessments are powerful tools to help us partner in your care. They establish a clear baseline, direct our treatment efforts, and give us a reliable way to track your progress over time. Your team may select some specific measures that fit your unique situation. Here are some examples:
Occupation-Based & Role Resumption
Cognitive Functioning
Emotional / Psychosocial
Sexuality / Body Image
Symptoms
ADLs / IADLs
Return to Work / School / Role Resumption
Possible Goal Areas
Therapy only works best when there is buy-in from the patient. It is important that you work with your therapist to set treatment goals that truly reflect what’s important to you.
Goal Bank for Clinicians
Each goal is intended as a starting point. The functional motivation behind each goal should be identified collaboratively with the client.
COAST Format Client (Client, Occupation, Assist level, Specific conditions, Timeline)
Sexuality
To improve vaginal dryness and sexual functioning, client will be able to consistently apply vaginal moisturizer (recommended twice a week) with reminders as needed after showering within 1 month.
Body Image
To support body image and self-esteem post-chemotherapy, client will identify and implement 1-2 cosmetic strategies with positive affirmations when using the mirror, 3-5x/week, for 4 weeks.
Fertility and Health Management
To promote advocacy, client will create a health management folder with fertility-related information, resources, questions, and contacts with MIN support within 2 weeks.
Return to School (high school)
To improve the return to school transition, client will be able to implement at least two environmental strategies (reduce noise and improve lighting) to complete daily homework at home within 1 month.
Return to School (college)
To improve the return to school transition, client will keep track of deadlines using a visual planner (e.g., Google Calendar) and phone alarms as needed within 4 weeks.
Peer Connection
To facilitate peer connection, client will independently connect with one local AYA organization (e.g., Stupid Cancer) to request resources within 2 weeks.
Return to Work (RTW)
To facilitate RTW, client will verbalize understanding of 1-2 communication strategies and role-play RTW meeting with manager within 2 weeks.
Return to Work and Advocacy
To facilitate RTW, client will connect with one community resource (e.g., Cancer and Careers) to understand ADA rights and identify 2-3 potential accommodations to support documentation/request to employer within 4 weeks.
Occupational Identity
To facilitate a positive occupational identity, client will utilize a value-based decision-making worksheet to identify two to three new or previously meaningful occupations (e.g., photography, art, music) and incorporate them into their monthly schedule within 3 months.
Coping
To facilitate adaptive coping, client will identify and implement 2 coping strategies/techniques (e.g., breathing exercise, journaling, grounding techniques) during emotionally triggering activities or occupations (e.g., clinic visits, using a mirror during self-care) with verbal prompting within 2 weeks.
Financial Management
To facilitate financial management and minimize financial toxicity, client will identify and organize 3 key financial responsibilities (e.g., insurance, daycare costs, textbooks) using a budgeting worksheet with adaptations as needed within 4 weeks.
Treatment Interventions
After a thorough evaluation and goal-setting process, it is time to start making progress. Below are treatment interventions that can be implemented as part of a holistic therapy program.
General
Lymphedema and conservative edema reduction techniques
Physical
Conditioning programs
Range of motion programs
Home exercise/activity programs
Balance and vestibular training
Early mobility
Chemotherapy-induced peripheral neuropathy
Mind-body practices, such as Yoga
Facilitating age and developmentally appropriate milestones
Interventions for scleroderma
Peri/Menopause symptoms
Hot flashes, joint pain,
osteopenia/osteoporosis; bone health interventions
Emotional Distress Management
Psycho-education
Pediatric to adult transitions
Return to work/school programs
Mindfulness-based interventions
Coping skills training
Social skills training and/or self-advocacy strategies
Sexuality, body image, and fertility
Relaxation training
Life review/narrative
Social connections
Symptom tracking
Creative arts
Meditation/yoga
Dignity therapy
Behavioral Activation
Cognitive behavioral therapy (CBT)
Dialectical Behavioral Therapy (DBT)
Acceptance and Commitment Therapy (ACT)
Sexuality & Fertility
Education on the impact of treatment on gonadal function, fertility, and sexual functioning
Sexual positions for symptom management
Fertility preservation
Education on peri-menopause and treatment-induced menopause
Cosmetic strategies for altered appearance
Ostomy care/management for sexual activity
Communication techniques to discuss sexual concerns with a partner
Education on potential precautions with sexual activity (e.g., use of physical protection after chemotherapy)
Social Connections, Relationships, & Caregiver
AYA peer connections/mentorship; refer to in-person or virtual organizations
Dating after a cancer diagnosis
Social skills training
Caregiver/Parent/Spousal support
SpiritualitySupport for existential distress
Lifestyle Medicine
SMART goal setting
Sleep
Sleep hygiene
Routine building
CBT-Insomnia
Diet/Nutrition
Weight management
Education on medications that can cause weight fluctuations (e.g., steroids).
Cancer-Related Fatigue
Activity planning
Pacing activity
Prioritizing activities and appointments
Planning a schedule (daily, weekly, monthly)
Positioning
Mindfulness-based interventions/relaxation training
Mind-body practices: Yoga, QiGong
Pain Management
Symptom tracking to identify patterns, triggers, and alleviators
Medication management
Phantom limb pain
Cognition
Education on potential cognitive changes, e.g., neurotoxicity, altered mental status, “chemo brain”, and chemotherapy-related cognitive dysfunction
Cognitive rehabilitation
Learning strategies for school
Remedial and compensatory cognitive strategies
Environmental adaptations to promote learning and improve attention/retention
Work and school accommodations
Career coaching and exploration to match cognitive skills
Sensory interventions
Additional
Health management
Coping and managing late effects and chronic conditions (e.g., diabetes)
Addressing financial toxicity by teaching financial management, and providing appropriate referrals (e.g., social work) and resources to financial support
Long-term survivorship
Metastatic cancer survivorship (emerging field)
ICU delirium
Notes for Clinicians on Cancer-Related Fatigue
NCCN:
Physical activity, physically based therapies, and psychosocial interventions have the strongest evidence base for treating fatigue; however, nutritional consultation and cognitive behavioral therapy (CBT) for sleep have some supporting evidence.
ASCO:
The evidence base consisted of 113 RCTs. Exercise, cognitive behavioral therapy (CBT), and mindfulness-based programs led to improvements in CRF both during and after the completion of cancer treatment. Tai chi, qigong, and American ginseng showed benefits during treatment, whereas yoga, acupressure, and moxibustion helped to manage CRF after completion of treatment. Use of other dietary supplements did not improve CRF during or after cancer treatment. In patients at the end of life, CBT and corticosteroids showed benefits.
Discharge Suggestions
Teach clients to monitor for signs of infections, an increase in symptoms (or new symptoms), and any signs of long-term effects/chronic issues.
Collaborate with the client to identify meaningful activities to incorporate into their lifestyle, activity, and self-management program;
Clear referrals and plan to follow up with community health services (e.g., psychotherapist, financial counselor, fertility specialist)
Recommend and refer to community AYA programs/peer connections (in-person or virtual)
Discuss the importance of long-term medical care and follow-up. Develop a plan to maintain communication with the medical team.
Screen for any needs to transition AYAs back to work and/or school.
AYA is in treatment: CANCER SURVIVORSHIP CHECKLIST from the National Coalition for Cancer Survivorship
Educate and address concerns/questions about sexual functioning and fertility preservation. Refer to a fertility specialist (ideally completed before induction chemotherapy)
Red Flags
Osteopenia, Osteoporosis, Bone Mets (Increases fracture risk, especially in spine, pelvis, and long bones)
Development of a personalized activity program
Activity and environmental adaptations
Body mechanics education/training
Health management (e.g., scheduling/maintaining appointments for DEXA scans)
Neutropenia, Immunosuppression, Anemia, Thrombocytopenia
Check with your institution for any rehab parameters
ANC < 500 cells/µL (high risk for bacterial or fungal infection)
Monitor for adverse reactions reported or observed (e.g., SOB, mucosal bleeding) with low hemoglobin and thrombocytopenia.
Graded exercise/physical activity as tolerated
Ostomies (Colostomy, Ileostomy, Urostomy) * Discuss with medical oncologist clearance for sexual activityEducate on cosmetic/concealing options if preferred
Educate and train on ostomy care; embedding into daily routine
Central Lines, Ports, PICCs (Peripherally Inserted Central Catheters) * Educate patients and caregivers re: infection prevention and signs of infection.Activity/Environmental adaptations (e.g., showering with
Other rehab considerations:
CNS involvement; Brain Mets
Steroid Use (e.g., Dexamethasone)
Estrogen/Vaginal Creams
BMT/GVHD
Lymphedema Risk
Radiation Fibrosis / Contractures
Autonomic Dysregulation / Orthostatic Hypotension
Education Resources for Clients
Choosing a Therapist
When searching for an occupational therapy professional to provide treatment for cancer, you may want to look for someone with multiple focus areas relevant to your condition (e.g., “lymphedema,” “cancer rehab,” or “insomnia.” )
Below, you can find OT professionals who have tagged cancer rehab as a focus area.
Jamie Boldig
MOT, OTR/L
Appleton, Wisconsin
Aging in Place, ADHD, Amyotrophic Lateral Sclerosis (ALS), Anxiety, Aphasia & Communication Disorders, Assistive Technology, Autism, Burns, Cancer, Cerebral Palsy, Chronic Conditions, Chronic Pain, Coaching, Cognitive Rehabilitation, Dementia, Depression & Mood Disorders, Dystonia, Ergonomics, Fitness, Feeding and Eating, Functional Neurological Disorder (FND), Grant Writing, Hand Therapy, Health Data, Health Policy, Health Promotion, Hippotherapy, Home Modifications, Insomnia & Sleep, Intellectual and Developmental Disabilities (IDD), Knowledge Translation, Lifestyle Medicine, Leadership, Medication Management, Multiple Sclerosis, Nature-based, Neurodiversity, Obsessive-Compulsive Disorder (OCD), Orthopedics & Musculoskeletal, Osteogenesis Imperfecta, Parkinson’s, Pelvic Health, Prevention, Population Health, Postural Orthostatic Tachycardia Syndrome (POTS), Rare Diseases, Rheumatic Diseases, Seating and Mobility, Spinal Cord Injury, Stroke, TBI, Trauma & PTSD, Tourette syndrome, Voice & Fluency
Nancy Broadway
OTRL, MBA. CLT
Occupational Therapist
Michigan Medicine
Ann Arbor, Michigan
Aging in Place, Amyotrophic Lateral Sclerosis (ALS), Burns, Cancer, Chronic Conditions, Chronic Pain, Cognitive Rehabilitation, Dementia, Low Vision Rehabilitation, Lymphedema, Neurodiversity, Orthopedics & Musculoskeletal, Parkinson’s, Prevention, Population Health, Spinal Cord Injury, Stroke, TBI, Trauma & PTSD, Vestibular & Balance Rehab
Paul Pettyjohn
OTR/L, CPAMS, MLD/CDT, CAPS
Monterey Park, California
Aging in Place, Burns, Cancer, Cerebral Palsy, Chronic Conditions, Chronic Pain, Ergonomics, Fitness, Functional Neurological Disorder (FND), Hand Therapy, Health Promotion, Home Modifications, Lymphedema, NICU, Orthopedics & Musculoskeletal, Prevention, Stroke, TBI
Harmony Direct Therapy
Occupational Therapist
Harmony Direct Therapy
Forest lodge, New South Wales
Aging in Place, ADHD, Anxiety, Assistive Technology, Autism, Cancer, Cerebral Palsy, Cognitive Rehabilitation, Dementia, Intellectual and Developmental Disabilities (IDD), Lifestyle Medicine, Neurodiversity, Neurorehabilitation, Obsessive-Compulsive Disorder (OCD), Parkinson’s, Rheumatic Diseases, Seating and Mobility, Stroke, TBI, Trauma & PTSD
Bethany Vitko
OTR/L, CLT, Women's health
Bethany Vitko Wellness; B | Well OT
Lincoln
Anxiety, Cancer, Chronic Conditions, Chronic Pain, Coaching, Fitness, Health Promotion, Home Modifications, Lifestyle Medicine, Leadership, Lymphedema, Maternal Health, Pelvic Health, Prevention, Population Health
Briana Bonner
OTD, OTR/L
Dr. Bri The OT
Saint Johns, Arizona
ADHD, Aquatic Therapy, Assistive Technology, Autism, Cancer, Cerebral Palsy, Chronic Conditions, Coaching, Fitness, Grant Writing, Health Policy, Health Promotion, Hippotherapy, Home Modifications, Intellectual and Developmental Disabilities (IDD), Lifestyle Medicine, Leadership, Maternal Health, Nature-based, Neurodiversity, NICU, Population Health, Rare Diseases, Seating and Mobility, Sexuality/Intimacy, Spinal Cord Injury, Stroke, TBI, Trauma & PTSD
Emily Rich
PhD., OTR/L
Occupational Therapist
Tucson Medical Center
Tucson, Arizona
ADHD, Cancer, Chronic Conditions, Chronic Pain, Cognitive Rehabilitation, Ehlers-Danlos Syndrome, Functional Neurological Disorder (FND), Lifestyle Medicine, Neurodiversity, Parkinson’s, Postural Orthostatic Tachycardia Syndrome (POTS)
Lori Volin
OTR/L,CLT-LANA
Lymphatic Rehab, LLC
Lincoln, Nebraska
Aging in Place, Cancer, Chronic Conditions, Chronic Pain, Dementia, Lifestyle Medicine, Lymphedema, Prevention, Rare Diseases
Matthew Dodson
OTD, OTR/L, CBIST, FAOTA
Braintrust Services
Ft. Collins, Colorado
ADHD, Cancer, Cognitive Rehabilitation, Leadership, Neurorehabilitation, TBI
Marissa Ruhl
MOTR/L, CLT-LANA, CPAM
Thrive Occupational Therapy Health and Wellness PLCC
Omaha, Nebraska
Cancer, Chronic Pain, Fitness, Health Promotion, Lifestyle Medicine, Lymphedema, Maternal Health, Pelvic Health, Prevention, Sexuality/Intimacy, Trauma & PTSD
Vanessa Yanez
PhD, MSOT, OTR/L
Los Angeles, California
Anxiety, Cancer, Chronic Conditions, Chronic Pain, Cognitive Rehabilitation, Health Promotion, Lifestyle Medicine, Sexuality/Intimacy
Amanda M Fonner
OTR/L
Educator
Mercy Hospital Jefferson
Festus, Missouri
Anxiety, Burns, Cancer, Chronic Conditions, Chronic Pain, Cognitive Rehabilitation, Dementia, Depression & Mood Disorders, Ehlers-Danlos Syndrome, Functional Neurological Disorder (FND), Hand Therapy, Health Promotion, Low Vision Rehabilitation, Lymphedema, Multiple Sclerosis, Neurodiversity, Neurorehabilitation, Orthopedics & Musculoskeletal, Parkinson’s, Social Determinants of Health, Stroke, TBI, Trauma & PTSD, Vestibular & Balance Rehab
Miriam Clapp
OTA/L
Administrator
Sacramento, California
Anxiety, Autism, Cancer, Chronic Conditions, Dementia, Fitness, Neurodiversity, Neurorehabilitation, Stroke
Madison Lund
OTS
Student
Queen Creek, Arizona
Anxiety, Assistive Technology, Burns, Cancer, Cerebral Palsy, Chronic Conditions, Cognitive Rehabilitation, Ehlers-Danlos Syndrome, Ergonomics, Grant Writing, Health Data, Insomnia & Sleep, Intellectual and Developmental Disabilities (IDD), Leadership, Maternal Health, Multiple Sclerosis, Neurodiversity, Neurorehabilitation, NICU, Obsessive-Compulsive Disorder (OCD), Orthopedics & Musculoskeletal, Postural Orthostatic Tachycardia Syndrome (POTS), Rheumatic Diseases, Spinal Cord Injury, TBI, Trauma & PTSD
Cynthia Kisik
COTA/L
Patriot at Home
Louisville, Ohio
Aging in Place, Amyotrophic Lateral Sclerosis (ALS), Aphasia & Communication Disorders, Assistive Technology, Burns, Cancer, Cerebral Palsy, Chronic Conditions, Chronic Pain, Dementia, Fitness, Grant Writing, Home Modifications, Insomnia & Sleep, Lifestyle Medicine, Medication Management, Multiple Sclerosis, Nature-based, Neurodiversity, Neurorehabilitation, Orthopedics & Musculoskeletal, Parkinson’s, Pelvic Health, Rare Diseases, Rheumatic Diseases, Seating and Mobility, Sexuality/Intimacy, Spinal Cord Injury, Stroke, TBI, Trauma & PTSD, Vestibular & Balance Rehab
Lindsay Voorhees
OTR/L, CYT200
Lindsay Voorhees Wellness
Durham, North Carolina
Cancer, Chronic Conditions, Chronic Pain, Coaching, Health Promotion, Lifestyle Medicine, Multiple Sclerosis, Neurorehabilitation, Parkinson’s, Postural Orthostatic Tachycardia Syndrome (POTS), Spinal Cord Injury, Trauma & PTSD
Rachel Egan
OTR/L, MS, CHT, COMT-UE
NovaCare Rehabilitation
Blaine, Minnesota
Aquatic Therapy, Cancer, Chronic Pain, Coaching, Cognitive Rehabilitation, Dementia, Fitness, Hand Therapy, Industrial Rehabilitation, Leadership, Orthopedics & Musculoskeletal, Prevention, Postural Orthostatic Tachycardia Syndrome (POTS), Rheumatic Diseases, Stroke
Greta Rompel
OTR/L
Saint Charles, Missouri
Aging in Place, Amyotrophic Lateral Sclerosis (ALS), Burns, Cancer, Cerebral Palsy, Chronic Conditions, Chronic Pain, Cognitive Rehabilitation, Dementia, Functional Neurological Disorder (FND), Health Policy, Home Modifications, Low Vision Rehabilitation, Lymphedema, Multiple Sclerosis, Neurorehabilitation, Orthopedics & Musculoskeletal, Parkinson’s, Seating and Mobility, Spinal Cord Injury, Stroke, TBI
Shaunna Kotka
OTD, OTR/L, CLT-LANA, CMT
Administrator
Open Grounds Inc.
Marina del Rey, California
ADHD, Anxiety, Cancer, Chronic Conditions, Chronic Pain, Cognitive Rehabilitation, Dementia, Depression & Mood Disorders, Dystonia, Ehlers-Danlos Syndrome, Fitness, Health Promotion, Home Modifications, Insomnia & Sleep, Knowledge Translation, Lymphedema, Medication Management, Neurodiversity, Neurorehabilitation, Obsessive-Compulsive Disorder (OCD), Orthopedics & Musculoskeletal, Parkinson’s, Prevention, Population Health, Postural Orthostatic Tachycardia Syndrome (POTS), Rare Diseases, Rheumatic Diseases, Social Determinants of Health, Sports Medicine & Performance, Stroke, TBI, Trauma & PTSD
Karen Johnson
MOT, OTR/L, CBIS, CSRS
Innovative OT NC, LLC
Holly Springs, North Carolina
Cancer, Coaching, Cognitive Rehabilitation, Dementia, Functional Neurological Disorder (FND), Health Promotion, Home Modifications, Multiple Sclerosis, Neurorehabilitation, Prevention, Spinal Cord Injury, Stroke, TBI
Kaci Behrens
OTD/S
Student
Ankeny, Iowa
Aquatic Therapy, Autism, Cancer, Cognitive Rehabilitation, Home Modifications, Intellectual and Developmental Disabilities (IDD), Leadership, Multi-tiered System of Supports, Neurorehabilitation, NICU, Parkinson’s, Rare Diseases, Spinal Cord Injury, Stroke, TBI, Trauma & PTSD
Ashley Elma
OTS
Student
Xavier University
Cincinnati, Ohio
ADHD, Autism, Cancer, Ehlers-Danlos Syndrome, Hand Therapy, Home Modifications, Intellectual and Developmental Disabilities (IDD), Lifestyle Medicine, Lymphedema, Maternal Health, Neurodiversity, Neurorehabilitation, NICU, Obsessive-Compulsive Disorder (OCD), Prevention, Spinal Cord Injury, Stroke, TBI, Trauma & PTSD, Tourette syndrome
Anna Addison
MSOT, OTR
Industry Professional
Prompt Health
San Francisco, California
Aging in Place, Aphasia & Communication Disorders, Burns, Cancer, Chronic Conditions, Chronic Pain, Cognitive Rehabilitation, Ergonomics, Fitness, Feeding and Eating, Health Data, Home Modifications, Leadership, Medication Management, Multiple Sclerosis, Neurorehabilitation, Orthopedics & Musculoskeletal, Parkinson’s, Postural Orthostatic Tachycardia Syndrome (POTS), Rare Diseases, Sports Medicine & Performance, Spinal Cord Injury, Stroke, TBI, Trauma & PTSD, Vestibular & Balance Rehab, Wound Care
Destiney Carmichael
OTS
Student
Xavier University
Cincinnati, Ohio
Aging in Place, ADHD, Amyotrophic Lateral Sclerosis (ALS), Anxiety, Assistive Technology, Autism, Burns, Cancer, Cerebral Palsy, Chronic Conditions, Chronic Pain, CIMT, Cognitive Rehabilitation, Dementia, Dystonia, Ehlers-Danlos Syndrome, Fitness, Feeding and Eating, Functional Neurological Disorder (FND), Home Modifications, Insomnia & Sleep, Intellectual and Developmental Disabilities (IDD), Lymphedema, Maternal Health, Multiple Sclerosis, Nature-based, Neurodiversity, Neurorehabilitation, NICU, Obsessive-Compulsive Disorder (OCD), Orthopedics & Musculoskeletal, Osteogenesis Imperfecta, Parkinson’s, Pelvic Health, Prevention, Postural Orthostatic Tachycardia Syndrome (POTS), Rare Diseases, Rheumatic Diseases, Seating and Mobility, Sexuality/Intimacy, Social Determinants of Health, Spinal Cord Injury, Stroke, TBI, Trauma & PTSD, Vestibular & Balance Rehab
Conclusion
Hopefully, this article has helped you understand what therapy for cancer rehab entails, and whether you are a good candidate!
This article is updated regularly based on new research. If you have any research you would like us to consider for our next update, please drop it in the comments! Therapists who would like more fleshed-out information on cancer rehab treatment can join us as members of OT Potential.
OT Potential does not endorse any treatments, procedures, products, or therapists referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking medical advice should consult their medical provider.
Contributors
Sarah Lyon
OTR/L
Sarah Lyon, OTR/L, is the CEO of OT Potential. Sarah earned her BA from St. Olaf College and her master’s degree in occupational therapy from New York University. Her diverse clinical background spans multiple settings, including critical access, acute trauma, and state inpatient psychiatric hospitals. In 2011, she founded OT Potential to fulfill the industry's need for reliable, high-quality occupational therapy resources and continuing education.
As a recognized content creator, Sarah has collaborated with top healthcare brands like VeryWell Health, WebPT, and MedBridge. She blends her clinical expertise with a talent for creating clear, action-oriented content that empowers practitioners to excel. Passionate about elevating the OT profession, she has been featured on numerous industry podcasts. Sarah ultimately returned to her roots, running OT Potential and raising her family in her hometown of Aurora, Nebraska.
Vanessa Yanez
PhD, MSOT, OTR/L
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