New Zealand Rehabilitation Association, Inc.

One of the interesting topics at the recent Australian Faculty of Rehabilitation Medicine annual meeting in Adelaide (May 2008) was a whole stream of papers about cancer survivorship and rehabilitation (and there is another one in the AFRM/NZRA conference in Queenstown in 2009). Given that more and more people are surviving their initial cancer diagnosis, we are increasingly seeing people having to manage ongoing difficulties with fatigue and physical deconditioning and other changes in functional abilities such as activities of daily living. But there is increasing evidence that many people experience broader ‘disabling’ consequences of the condition and its treatment where rehabilitation could and arguably should, make a difference. This includes changed relationships, disconnection of social networks, financial difficulties and return to work issues, where there is less attention in terms of service development, delivery and indeed research.

It seems to me that this changing demographic of disability is something we need to be aware of, plan for and respond to, and not just in cancer survivorship. After all – its not a new scenario. A few years back, many people with severe brain injury did not survive the initial insult. But new initiatives in medicine, surgery and rehabilitation have changed that and rehabilitation services have been increasingly recognised as important and as a result, increasingly funded and provided.

What should we do? I guess the first thing is not to give up just because its not going to be funded by ACC! There are other options - internationally and indeed in New Zealand, services are confronting the issue. No doubt, more dialogue between rehabilitation and cancer services would be a good step. For instance at AUT we’ve been linking with other academic colleagues and talking with the Cancer Society here in Auckland and about responding to survivor issues and improving knowledge about the most important issues and the best ways of promoting adaptation and recovery. Who knows where it will lead but meantime, the discussions have also prompted me to reconsider where we currently focus our efforts and to question if there are missed opportunities for rehabilitation to make a difference that we should become interested in - sooner rather than later.