Rehabilitation of complications after oncological treatment up to 50 minutes – 40 € Rehabilitation of complications after oncological treatment includes assessment of the patient’s condition and functional capacity and counseling of the patient and their relatives. It is important to build cooperation and trust, and to plan short- and long-term treatment in cooperation. As rehabilitation treatment has to start very early, it is divided into different stages: 1. Pre-operative counseling and necessary assessment: e.g. Measurement of arm circumferences by the Truncated Cone method (allows to adequately assess the occurrence / absence of later edema and respond accordingly), measurement of joint mobility (eg measurement of shoulder mobility before surgery to adequately restore hand mobility, eg in breast cancer patients), clarification of limitations and mandatory , measurement of chest and chest circumference to choose the right bra and prosthesis, etc. 2. Postoperative appointment 7 days after surgery to assess for scars, fasciasis, edema, pain and emotional disturbances – if necessary, start manual lymphatic massage. 3. Physiotherapy period during chemotherapy, which is between 3 weeks after the operation and radiation therapy: arm therapy, treatment of fascias, treatment of axillary web syndrome (AWS), manual lymphatic massage, exercise (assessment of the condition and starting new exercises) , fascia and muscle condition). 4. Rehabilitation during radiation therapy. 5. Rehabilitation after radiation therapy. 6. Rehabilitation after oncology treatment and patient counseling, motivation, lymphatic therapy. Physiotherapy related to oncology treatment as a process changes over time with the patient’s progress and achievement of goals. It is important to do the right things at the right time, and rehabilitation treatment involves the recovery of tissues (especially scars) and changes in collagen. Of course, the planning of rehabilitation treatment and the actions to be taken depend on the location of the disease. In patients with prostate cancer, pre- and post-operative pelvic floor muscle training is also important (studies have shown that strengthened pelvic floor muscles 4 weeks before surgery or radiation treatment provide less urinary incontinence) and treatment of erectile dysfunction. 

To:

breast cancer patients before and after starting treatment (including years)
Prostate cancer patients before and after starting treatment (including years)
patients with gynecological cancers before and after starting treatment (including years)
patients with melanoma removal before and after starting treatment (including years)
The service is chargeable and no prescription is applicable. Before therapy:

bring (epicrisis or print digilugu.ee) description of the operation, pathology response and other documents related to the disease
bring comfortable clothing
what medicines you have taken

Pelvic floor physiotherapy is necessary for both men and women after various pelvic surgeries. Patients with important counseling and pelvic floor muscle training prior to surgery or radiation therapy (prostate cancer patients, oncologic patients), patients with pelvic and urinary tract trauma, patients with group disorders and women with postpartum recovery (urinary incontinence, pelvic floor) Pelvic floor disorders are quite common and can affect up to a third of adult women, but also men. The pelvic floor muscles belong to the deep muscles of the trunk muscles, together with the deep abdominal and back muscles and the diaphragm. These muscles all work together to ensure a good posture and lower back-pelvic position. Pelvic floor muscle weakness may be reflected in changes in body position and may be associated with lower back pain. Physiotherapy involves training and working together the pelvic floor and trunk deep muscles to ensure the stability of the back and pelvis in different positions. The client receives instructions for identifying the pelvic floor muscles and instructions and exercises to develop the strength and endurance of the pelvic floor muscles and muscle sensation. Pelvic floor muscle dysfunction can be caused by:

  • pregnancy and childbirth
    aging and associated estrogen depletion
    factors that increase pressure on the abdomen, such as obesity, lifting heavy objects, constipation and chronic cough
    pelvic and trunk invasive procedures
  • Pelvic floor muscle dysfunction may be accompanied by:
  • urinary and defecation disorders
    problems during sexual intercourse in both men and women
    pain in the pelvic area
    pelvic depression
    back pain
    group disorders

AWS or Axillary Web Syndrome is a condition where are stiffened lymphatic vessels form after surgery when lymph nodes are removed or after chemotherapy treatment. The term AWS was first reported in the literature in 2001, where it was described as a palpable rope-like formation in subcutaneous tissue layer that begins in the axillary region, or under the armpit, and can extend down the shoulder and arm, in some cases to the thumb. This description has been confirmed by later authors. The formation of AWS is associated with the removal of axillary lymph nodes, whether there has been removal of all lymph nodes or only the sentinel lymph node. It has also been found that AWS is more common in younger patients with a lower body mass index. Rope-like formations are thought to be either lymphatic vessels whose function is disrupted or interrupted by the removal of lymph nodes and in which the lymph fluid is coagulated or high-protein longitudinal lymph fluid assemblages located outside the lymphatic zone and containing fibrin or other proteins. Usually after removal of the lymph nodes in the armpits, which are associated with mastectomy or partial lumpectomy in breast cancer patients, or removal of melanoma in the chest, upper limb and back, rigid lymph zones under the armpit, and forearm, on top of the groin and pelvis. For other surgeries, such as oncologic surgeries, or, for example, removal of melanoma of the abdomen, lower back, buttocks, or lower limb, in addition to the removal of lymph nodes behind the knee, groin, or pelvis, rigid lymph zones may also form in certain areas from scars. In therapy, the surface of the skin and the rigid veins are treated by stretching the scars or joints in the right directions to break these rigid adhesions. Typically, when this is done, an audible SOUND or click is heard, after which the patient feels relief, pain resolves, and joint mobility improves. Improvements in the range of mobility with a manual treatment during one therapy session have been achieved by as much as 20-40º. After treating the rigid lymphatic vessels, it is good to do an additional manual lymphatic massage and thereby improve the normal angiomotor or pumping of the lymphatic vessels themselves.