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Correspondence to Author:  Shuhei Ohkura ^a, Satoru Sagae ^b,*, Nayu Someki ^c, Ayumi Tanimoto ^d, Arisa Konishi ^d, Ayako Iizuka ^e, Aiki Takedae,Mikiko Ogasawara ^f, Riyo Shinya ^g, Yoshihito Ohhara ^h., 

^aDepartment of Rehabilitation Oncology, Sapporo Kojinkai Memorial Hospital, Sapporo, Japan.
^bDepartment of Internal Medicine, Palliative Care, Sapporo Kojinkai Memorial Hospital, Sapporo, Japan.
^cDepartment of Nursing Section of Outpatient Chemotherapy, Sapporo Kojinkai Memorial Hospital, Sapporo, Japan.
^dDepartment of Pharmacy, Sapporo Kojinkai Memorial Hospital, Sapporo, Japan.
^eDepartment of Nursing 6 East Ward, Sapporo Kojinkai Memorial Hospital, Sapporo, Japan.
^fDepartment of Nutrition, Sapporo Kojinkai Memorial Hospital, Sapporo, Japan.
^gDepartment of Medical Coordination, Sapporo Kojinkai Memorial Hospital, Sapporo, Japan.
^hDepartment of Medical Oncology, Sapporo Kojinkai Memorial Hospital, Sapporo, Japan

DOI: 10.52338/apmr.2025.5180

Abstract:

Background: Advances in oncology have extended cancer patient survival, underscoring the importance of rehabilitation in maintaining quality of life (QOL). Rehabilitation spans physical, psychological, social, and spiritual domains, and is categorized as preventive, restorative, supportive, or palliative. In palliative care, rehabilitation helps alleviate symptoms and preserve dignity and autonomy, thereby supporting patients’ values and preferences.
Objective: This review used a systematic–narrative hybrid approach. We drew from a structured literature search and thematic synthesis. Literature from 2010 to 2025 was identified through PubMed, Web of Science, and CINAHL. The keywords used included “cancer rehabilitation,” “palliative care,” “advance care planning,” “multidisciplinary,” and “prehabilitation.” Representative studies, guidelines, and reviews were included in the analysis. Studies focused on pediatric oncology and non-cancer populations were excluded from the analysis. About 230 records were screened, and 96 studies and guidelines were included in the narrative synthesis. To ensure methodological rigor, the quality of the studies was assessed using a modified version of the Cochrane Risk of Bias tool, which examines factors such as sequence generation, allocation concealment, blinding, and incomplete outcome data. Standardized criteria were applied across all included studies, reinforcing the reliability of the synthesis.
Results: Five themes emerged: (1) evolving definitions of cancer rehabilitation; (2) the interface between rehabilitation and palliative care, especially in advance care planning (ACP); (3) disease-specific approaches for bone metastases, brain metastases, and lung cancer; (4) models of multidisciplinary collaboration; and (5) emerging innovations like prehabilitation, tele-rehabilitation, and AI-supported interventions. A Japanspecific perspective identifies barriers, including reimbursement limitations, resource allocation issues, and training gaps.
Conclusion: Cancer rehabilitation should be a core component of palliative care, not simply adjunct therapy. Rehabilitation professionals uniquely support patient goals and ACP. Key future steps include standardizing evidence, integrating technologies, and enacting reforms to ensure equitable access.

Keywords:Cancer Rehabilitation; Palliative Medicine; Advance Care Planning; Multidisciplinary Collaboration; Prehabilitation

Citation:

Satoru Sagae, MD, PhD,Current Status and Future Perspectives of Cancer Rehabilitation in Palliative Care: A Systematic– Narrative Hybrid Review. Annals of Physical Medicine & Rehabilitation 2025.