[Cancer Rehabilitation: integrated in the care pathways of modern oncology].

Cancer Rehabilitation: integrated in the care pathways of modern oncology People suffering from cancer are affected both by the cancer disease and from side-effects of multimodal anticancer interventions such as surgical, radiooncological and drug therapies. These effects can lead to physical, emotional, social, intellectual or existential functional deficits, which presence and impact are often underrecgonized by oncology professionals. Oncological rehabilitation targets such deficits by multimodal, transprofessionally delivered, goal steered and human centered coordinated interventions. Indications for oncological rehabilitation exist in situations before, during, between and after cancer therapies in both curative and non-curative intention. This includes for example prehabilitation, rehabilitation of myeloma patients between transplantions, of patients suffering from cancer-treatment related fatigue or from advanced cancer undergoing anticancer treatment: basically, every patient in modern oncology who suffers from substantial functional deficits. Oncological rehabilitation defines concrete goals in order to achieve the functions in comparison to before the deficits occurred, the overlaying aims to achieve an optimal self-determination and independence. A profound understanding of the oncological situation by both the patient and professionals is necessary to define realistic goals. Based on - and steered by - these goals, oncological rehabilitation employs specific rehabilitation interventions, supported by a transprofessionally coordinated team of exercise specialists, physiotherapy, ergotherapy, speech, art and music therapists, nutritional, socialwork and psycho-oncological counsellors, as well as activating and therapy-accompanying nurses and physicians. Competence in both cancer disease and anticancer treatment side effects as well as rehabilitation procedures is relevant in goal setting and rehabilitative treatment guidance as well as administration of systemic cancer therapies during oncological rehabilitation. It is a reality in modern oncology that many cancer patients require both oncological rehabilitation and ongoing anticancer treatments. The integration of oncological rehabilitation in the treatment pathways of modern oncology demands new models - including new forms of reimbursement - making allowance for the realities and needs of modern oncology.