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Introduction

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Rehabilitation examination and intervention at the initiation of cancer treatment planning are becoming standards of cancer care. Specific education and attention by the rehabilitation therapist throughout the continuum of cancer prevention, treatment, survivorship, and palliative care are essential to effectively address the multitude of complex rehabilitative needs. An understanding of cancer epidemiology and co-morbid conditions leads to better comprehension of the prognosis for long-term survival, thus providing a framework to develop local and regional oncology-specific exercise promotion programs including the areas of cancer prevention, rehabilitation, palliative care, and hospice.

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Epidemiology

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Incidence

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  • As of 2012, slightly more than one out of three women and slightly less than one out of two men in the United States will develop cancer.

  • According to the American Cancer Society, there are currently almost 12 million cancer survivors.

  • Rapidly evolving diagnostic and treatment methods change the trend of cancer incidence, prevalence, and mortality.

  • The online resources of the American Cancer Society provide a key source of up-to-date information on new cancer diagnosis, survival and mortality rates, as well as data ranked by state and global cancer trends.

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Modifiable Risk Factors for Cancer Prevention

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  • Tobacco

  • Obesity, lack of exercise, poor nutrition

  • Ultraviolet radiation

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Ten leading cancer types for estimated new cancer cases by sex, United States, 2009. Data from: Siegel, R, et al: Cancer statistics. CA: A Cancer Journal for Clinicians, 62:10–29. 2012.

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Mortality

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Ten leading cancer types for estimated cancer deaths by sex, United States, 2009. Data from: Siegel, R, et al: Cancer statistics. CA: A Cancer Journal for Clinicians, 62:10–29. 2012.

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Survivorship

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  • Generally defined from the moment of cancer diagnosis.

  • Many survivors have complex medical needs secondary to multiple comorbidities in combination from the primary cancer, prior cancer treatments, and resultant sequelae after those treatments.

    • Often results in multisystem impairments with activity limitations.

    • Early and late side effects such as cancer-related fatigue and lymphedema may cause significant morbidity and should be promptly addressed in a holistic manner.

  • Five-year survival rates for men and women of all ages are 67%.

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Estimated number of cancer survivors in the United States from 1971 to 2006. Based on data from: Horner, MJ, et al (eds): SEER Cancer Statistics Review, 1975–2006, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2006/, based on November 2008 SEER data submission, posted to the SEER website, 2009. Accessed May 1, 2010.

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Screening

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American Cancer Society Screening Guidelines for the Early Detection of Cancer in Average-Risk Asymptomatic People

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