Hope in Motion

Expert offers insight into the role of physical therapy in cancer patients’ mental and physical recovery

By Anna Schmidt

February 15, 2024 •

Fresh out of her physical therapy undergraduate degree, Margaret McNeely, ’86 BSc(PT), ’02 MSc, ’07 PhD, accepted a job in an area of treatment she’d never heard of — cancer recovery.

“I really enjoyed it right from Day 1, going into it not even realizing there was a role for physical therapists in cancer,” says McNeely, recalling her position at Edmonton’s Cross Cancer Institute.

Over the next decade, she witnessed patients weakened by chemotherapy rebuild strength, women with breast cancer regain the use of their shoulders, and those with throat cancer learn to speak after surgery. “We were doing this really good work and helping a lot of people with our rehab services,” says McNeely. “But there wasn’t research evidence to support that.”

She set out to fill that gap, returning to the U of A for a master’s in rehabilitation sciences and a PhD in exercise oncology. That was nearly three decades ago, and today McNeely is the director of the university’s Cancer Rehabilitation Clinic — a working physical therapy centre that doubles as her research lab. There, McNeely conducts research on new treatments and technologies to support cancer patients.

At first, there is a strong focus on the disease itself, on treating the cancer, curing or controlling the cancer. My focus is on the person and how they live their life.
Margaret McNeely, ’86 BSc(PT), ’02 MSc, ’07 PhD

Approximately 16,000 Albertans face a cancer diagnosis each year. McNeely offers expert insight to some of them into the crucial role physical therapy plays in helping patients reclaim movement — and imagine life beyond the disease.

Tailored treatment

Unlike therapy for many other diseases, which help patients to feel better, cancer treatments like radiation and chemotherapy initially make the patient feel worse, taking an immense physical and mental toll, explains McNeely.

This means physical therapists have a major role to play in supporting patients to feel empowered in their bodies again. “At first, there is a strong focus on the disease itself, on treating the cancer, curing or controlling the cancer. My focus is on the person and how they live their life.”

At the Cancer Rehabilitation Clinic, McNeely and her team work with each patient to understand the specific activities that person plans to get back to, whether it be working in the trades, playing a specific sport or walking the dog. Then the team crafts a program tailored to help that patient build the strength, mobility and confidence needed for their lifestyle.

An integrated approach

While therapy is individualized to a patient’s specific struggles and goals, McNeely always anchors recovery in general fitness. This method is driven by her research, where she discovered that cancer patients recover best when therapy addresses both the compromised parts of the body and overall strength.

“If you put physical therapy and exercise together, it’s powerful. We take this interdisciplinary approach and tailor the exercise so it addresses the impairments at the same time we’re dealing with general fitness.”

Purposeful progression

For many patients, the early days of physical therapy can be frustrating as they come face-to-face with their body’s limitations. That’s why McNeely and her team typically engage patients in a 12-week program, ensuring each person starts at a realistic point and feels they can stick with therapy.

She shares the story of a head-and-neck cancer patient who had lost a lot of weight and came into the clinic very lean. “He was surprised that we actually put him on a strength training program, and we just kept gently pushing him so that every time it was a bit harder.”

He later contacted McNeely about his experience, writing that at the seventh week of the program, he felt a sudden shift. “I was like a flower growing, and I started to blossom. Everything started to come together,” he wrote. This is a common refrain among her patients, says McNeely, so she encourages them to push through what can feel like a long stagnation phase.

Meaningful community

Beyond the physical role of therapy, one of the surprising keys to recovery is the opportunity to connect with other patients. That’s why McNeely set up the U of A’s rehabilitation clinic as an open space where patients can exercise, chat and heal alongside others with similar experiences.

“A patient will see somebody else who’s further along and say, ‘Wow, if only I could do what they’re doing.’ Then that person says back, ‘I was where you are,’” says McNeely. “It’s that hope that comes through.”

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