Algorithm of stepwise medical rehabilitation of patients with differentiated thyroid cancer

Abstract

Four stages of medical rehabilitation of patients with differentiated thyroid cancer in Russia are described. Specific rehabilitation programs and methods are described for every stage. The pre-rehabilitation program includes psychological and nutritional support, exercise therapy, consultations by the surgeon and anesthesiologist, correction of concomitant disorders, prevention of thromboembolic complications and local hemodynamic abnormalities. At the rehabilitation stage in the ICU antibacterial therapy, patient positioning, percussion massage of the chest, passive mobilization, massage of the extremities are performed. The rehabilitation program at the specialized surgical department includes psychological rehabilitation, adequate pain management, exercise therapy, massage, nutritional support, prevention of thromboembolic complications, treatment of early postoperative complications. The in-hospital rehabilitation at medical facilities additionally includes treatment of delayed and late surgical complications, correction of radioiodine therapy consequences. The outpatient rehabilitation program also involves correction of hypothyroidism and minimization of adverse effects of suppressive hormone therapy, health resort treatment.

Keywords

• thyroid cancer
• rehabilitation
• laryngeal paresis
• hypoparathyroidism
• plexopathy
• thyroid storm
• lymphedema
• radioiodine therapy
• hormone therapy