DivaCare speaks with Dr. Grigory Syrkin about breast cancer rehabilitation. Dr. Syrkin is a Physical Medicine and Rehabilitation specialist at Montefiore Medical Center Einstein Campus. www.montefiore.org/body.cfm?id=3596&action=detail&ref=5645

What is your current role in cancer rehabilitation?

I see patients before, during, and after cancer treatment, in and out of the hospital. My main job is to help them manage physical problems that take away from their quality of life.

What is your background?

As an undergraduate, I studied math and computer science, but was always drawn to the most perfect imperfect – the human body and mind. During medical school I became interested in the way we move (since motion is life!) and was fortunate enough to spend an entire year working on human motion analysis. During residency training, I was given the opportunity to study surgery, cancer, and eventually came to realize that the most advanced treatments and procedures mean nothing if a patient can not get back to living their life the way they want.

How did you become interested in cancer rehab?

As a part of my residency training, I worked at the Memorial Sloan Kettering Cancer Center and found it to be the most rewarding of my assignments. After completing my general rehabilitation medicine program, I was granted the opportunity to spend an additional year at MSKCC, learning the art and science of cancer rehabilitation.

 

How can rehabilitation help breast cancer patients recover after treatments? After surgery?

Rehabilitation can help breast cancer patients BEFORE, DURING, and AFTER any treatment that they undergo. There is not a system in the human body that remains untouched by a cancer diagnosis, especially if systemic treatments are needed. The combination of surgery, chemotherapy, radiation, and the sheer stress of the “Big C” is the greatest physical, mental, and emotional challenge that most people will face in their lifetime. As with any difficult task, the stronger, fitter, and more determined you are, the better your result will be. In my opinion, rehabilitation should begin the same day that a cancer is suspected. There are numerous studies showing that all side effects of cancer and its treatment (pain, weakness, stiffness, chemo brain, fatigue, poor sleep, depression and many others) can be reduced with proper rehabilitation program.

Is it important to get in shape before starting treatments?

ABSOLUTELY! – simply put, fitter patients are more likely to survive!

What are the biggest obstacles patients face when getting referred to rehab?

The biggest obstacle is, probably, the fact that most people think that rehab is something that you do when you develop a physical problem.  That cannot be further from the truth –  after all, an ounce of prevention is worth a pound of cure. The second obstacle is that most people assume that all the troubles that come with chemo, radiation, surgery are their new normal and nothing can be done about it. While no cancer treatment can be made completely benign, a well-designed rehabilitation program can go a long way in making the journey more tolerable. There is at least one person (not Lance Armstrong!) who decided that she wanted to become a runner, trained and successfully completed an entire marathon between chemotherapy cycles! Lastly, during active treatment the patient and their doctors often feel that they have “bigger fish to fry” and delay rehabilitation until the completion of chemo, radiation and anything else that deals directly with the cancer. Unfortunately, that approach does not address all the additional needs of the patient.

What would you like women with breast cancer to know about rehab?

Rehab is more than just isolated physical or lymphedema therapy.

It is an overall strategy to help survive the treatment, reduce the chance of long-term complications, and most importantly, prevent cancer recurrence.