Leah Dalby MCSP Physiotherapist 
Knowledge & experience with kindness & respect 
Leah Dalby MCSP Physiotherapist 

Physiotherapy and Cancer. Rehabilitation, Recovery and Palliative Care. 

In The Association of Chartered Physiotherapists in Oncology and Palliative Care we have extensive experience working with people who have or have had cancer. I may be able to help you
We can help with effects of cancer and its treatments, especially, but not exclusively with: 
advice and/or treatment before surgery 
maintaining fitness during chemotherapy and after surgery 
breathlessness, fatigue (exhausted feeling) and pacing yourself to get things done 
relaxation and stretching 
treating scarring from surgery, radiotherapy, cording (axillary web syndrome AWS) and venous cording 
answering questions such as, “is this normal?” 
effects eg GVHD graft versus host disease 
encouraging you 

Just diagnosed with cancer? 

If you are waiting for surgery, please feel free to contact me to see if a session before you go to theatre may be useful to optimise your recovery period. 
If you are expecting to have treatment to address your symptoms, rather than aiming for a cure, I may be able to help you with managing fatigue, breathlessness, a new relaxation technique, exercises and an opportunity to discuss your symptoms and concerns.  

Cancer Surgery? 

Some people want a “one off” session to check that they are doing the right exercises. Others need several sessions of “hands on” treatment if they have tightness or restriction from scarring after surgery and/or radiotherapy 
Fascia is just under the skin. Around the muscles, in between the muscles and amongst our organs – almost everywhere in the body! It embraces the muscles so they can work efficiently and when we move, structures can slip over one another smoothly. 
When we have surgery, an injury or radiotherapy, the fascia can be scarred and get stuck – you may be someone who has had painful adhesions after abdominal surgery. 
The myofascial techniques I use are very effective on recent scars – perhaps after breast, gynaecology or other trunk surgery and also work well on old scars. It has been moving to use them for women have described themselves as, “disfigured” after Caesarean Section or other abdominal surgery, sometimes many decades earlier. 
You may need support regarding movement, posture, continence, sexual and physical intimacy – your specialist nurse may be able to help, but please feel free to ask if you hope that physio may also be useful. And please do ask. Many people have change around intimacy and/or sex. If I haven't already been asked, I will learn something new. 

Having chemotherapy? 

As with the whole of life, we are all different. At any stage, some people may feel weary with their chemo and loose some of their previous fitness. Exercises and stretches can be very useful at this time. Simple things like keeping your “pushing up” muscles working well can help with getting in and out of the car/bed or on and off the toilet. 
You may be very fit and need support to feel confident for when you go back to work. 
If you have changes in sensation after chemo, some physio may help with balance and function. 
If you have venous cording (this can look similar to cording or axillary web syndrome (AWS)) myofascial work may help to relieve this. 


Physiotherapy may be essential before radiotherapy after breast surgery if your arm movement is very restricted, If you have had good advice about how to move your arm after surgery you will probably be moving well though. 
If you have stiffness in the tissues after radiotherapy (weeks, months or decades later) some myofascial work may be very helpful for you. 
Looking after your skin is important, so please check with the hospital team to make sure that your skin feels and is as comfortable as possible. 
crps and cancer late effects is a specialist service to assess and support people severely adversely affected by their radiotherapy. 
I offer advice regarding care of your limb after removal of or damage to, lymph nodes, including simple lymphatic drainage and occasionally manual lymphatic drainage.(MLD) I do not carry a stock of hosiery (special sleeves/stockings). 
I have worked with people with GVHD (graft versus host disease). "Hands on," work may help to relieve some of your tightness. We can also look at exercises and stretches, together. 
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