How can the therapist modify the CDT approach for patients with end stage cancer?
While it is certainly appropriate to continue with CDT in the advanced stages of cancer, it is most essential to recognize the need for a modified CDT program. Considering the prognosis of the patient, the goal of CDT changes from one of maximal decongestion, to that of comfort, alleviation of pain, and promotion of optimal function for the patient. Often, patients are faced with significant fatigue-related limitations that greatly impair function. Consideration should be given as to the frequency of therapy sessions as well as the time of day the patient is most likely to be suited for therapy. Attendance in therapy involves tremendous preparation on the part of the patient and caregiver, including dressing and grooming, driving to and from the clinic site and the overall energy demands of mobility. Modifying the traditional recommendation of CDT, 4-5 days weekly may greatly improve the ability of the patient to attend clinic sessions. Scheduling frequency may be more reasonable at 2-
