Spotlight On: Occupational Therapists in Cancer Care

November 4, 2021
Alix Sleight, PhD, OTD, MPH, OTR/L

If you’ve been diagnosed with cancer, you will interact with a number of different members of the health care team at various times during treatment. When you walk into a doctor’s office, hospital, or cancer center, you may encounter nurses, physician assistants, social workers, doctors—the list goes on. In the Spotlight On series, we talk with some of these health care professionals to learn more about their jobs and the role they play in providing high-quality cancer care.

Alix Sleight, PhD, OTD, MPH, OTR/L, is a clinician-scientist with expertise in occupational therapy and cancer survivorship. At Cedars-Sinai Medical Center, Dr. Sleight leads RISE (Re-Invent, Integrate, Strengthen, Expand), a health self-management clinic for cancer survivors. Her research investigates behavioral interventions in oncology with a special interest in everyday activity, self-efficacy, and self-actualization. Dr. Sleight earned a PhD in Occupational Science, a Master’s in Public Health, a Master’s in Occupational Therapy, and a clinical doctorate (OTD) in Occupational Therapy from the University of Southern California. You can follow Dr. Sleight on Twitter.

Cancer can bring with it a variety of challenges, including difficulties performing everyday tasks. When this happens, a person with cancer may be referred to an occupational therapist. Occupational therapists work with people with cancer to help them adapt to changes in performing their daily activities, including at work, home, or school.

Here, occupational therapist Dr. Alix Sleight shares the important role occupational therapists play on the cancer care team, including the common concerns people with cancer have that lead them to occupational therapy and how to make the most of your visits with an occupational therapist.

Why did you become an occupational therapist? 

Alix Sleight (AS): After experiencing a cancer diagnosis in my immediate family, I was inspired to take action to improve supportive care in oncology. I saw the potential for occupational therapy to make a difference in that area. I particularly liked the focus of occupational therapy on finding the therapeutic value in everyday activity.

What role does an occupational therapist play on the cancer care team?

AS: Occupational therapists play a wide variety of roles in cancer care. Broadly, we help people to return to optimal physical, mental, and cognitive function and resume their valued everyday roles and routines during and after cancer.

What are some of the most important things you do to help people with cancer?

AS: One important task for occupational therapists is to help people optimize function in their activities of daily living. This might include helping with what we call “basic” activities of daily living, which are the fundamental things you need to do each day, like bathing, eating, and dressing. It also might include helping with “instrumental” activities of daily living, which are more complex tasks like shopping, cooking, and household maintenance. If our patients are unable to perform these tasks as well as they’d like to, we problem solve with them to either adapt to the activity or to build new skills until they are able to participate in the way they want to.

What are some common concerns your patients have, and how do you help address them?

AS: For many people who have been diagnosed with cancer, symptoms like fatigue, pain, and mild cognitive problems can make it difficult to participate in activities of daily living. As occupational therapists, we help people navigate these challenges through skill-building, collaborative problem-solving, and adapting activities. Many occupational therapists also work on physical impairments related to cancer, such as lymphedema (swelling in the arms and legs) and peripheral neuropathy (tingling or numbness in the hands and feet).

In my own practice, I focus more on instrumental activities of daily living. At Cedars-Sinai, I lead a health self-management program for cancer survivors called RISE (Re-Invent, Integrate, Strengthen, Expand). We define self-management as a person’s ability to manage the symptoms, treatment, physical changes, psychosocial consequences, and lifestyle changes that can come with a cancer diagnosis. RISE participants work 1-on-1 with an occupational therapist to set goals and develop practical strategies for establishing sustainable, positive habits around instrumental activities of daily living, such as returning to work and engaging in self-care. These goals and strategies may include physical activity, nutrition, stress management, and sleep. RISE is part of an emerging practice area in occupational therapy for cancer, so it’s exciting to work with people with cancer on this new frontier. 

What is one thing that people should be aware of when it comes to occupational therapy and cancer?

AS: Occupational therapists have a surprising number of tools in their professional toolboxes. We are trained to treat the whole person, so we can help with everything from physical concerns to mental, emotional, and cognitive issues. For people with cancer, seeing an occupational therapist is often a valuable first step toward feeling “normal” again.

How can people with cancer have better communication with their occupational therapist?

AS: As occupational therapists, we frame everything around how you “occupy” your time—that’s why it’s called occupational therapy. When you are talking to your occupational therapist, it helps if you can describe a typical day. What would you do with your time if you didn’t have the symptoms you’re experiencing? What are the little things that make you happy in life? What roles and routines are important to you on an everyday basis? This type of thought exercise helps guide and support our therapeutic process.

What are some of the most rewarding parts of your job?

AS: I love learning about what brings meaning to people’s lives. Many of my patients are passionate about their hobbies and interests and can’t wait to get back to them after cancer. It’s inspiring to absorb some of their enthusiasm, and it’s always rewarding to watch them succeed in resuming their most cherished activities.

Where can people with cancer find an occupational therapist for their care team?

AS: Most oncologists will be able to refer you to an occupational therapist on the care team, so asking your physician is always a good place to start. 

The author has no relationships relevant to this content to disclose.

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