Oncologists' Attitude and Knowledge about Cancer Rehabilitation

Introduction: Cancer survivors may experience multiple comorbidities related to the disease itself and adverse effects from treatment. Rehabilitation specialists could provide treatment options; however, oncologic rehabilitation services are underutilized. Objective: To assess oncologists' awareness of the benefits of rehabilitation for cancer care patients and to identify barriers to rehabilitation referrals in adult cancer patients in Puerto Rico. Design: Cross-sectional study. Setting: Regional Annual Meeting of the Association of Medical Hematology and Oncology of Puerto Rico, 4-7 September 2015. Participants: Forty-two oncologists. Interventions: Participants completed a 10-item questionnaire focused on demographics, knowledge, and clinical practices over the previous 12 months related to rehabilitation in cancer patients. Main Outcome Measures: Frequency, reasons, and timing for oncologist referral of cancer patients to rehabilitation. Perceived risks and benefits of rehabilitation in cancer patients and their correlation to patient referrals, prognosis, type of cancer, and type of symptoms. Results: Thirty-seven oncologists (88.1%) received minimal or no education about cancer rehabilitation, its benefits, and indications. This resulted in 31 oncologists (73.8%) referring less than 15% of their patients for rehabilitation, with almost a third of participants referring less than 5%. However, 39 (92.9%) agreed that rehabilitation is always or frequently beneficial for their patients. Fifteen (35.7%) said they did not refer patients if prognosis was less than 6 months, and 16 (38.0%) avoided referring patients with life expectancy of less than 3 months. Conclusions: Although medical oncologists have some knowledge that rehabilitation is beneficial for their patients, there is a low referral rate. This could be due to lack of information about cancer rehabilitation and limited access to cancer rehabilitation specialists. Further efforts should be made to improve access to rehabilitation care for cancer patients and survivors.