Rehabilitation

Thursday 1 May, 2014

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On this page: Types of rehabilitation | Driving 


Rehabilitation

A brain or spinal cord tumour – or treatment for it – may affect some of the functions of the body and brain, such as speech, personality, memory, movement, balance and coordination. You or your family members may notice changes, such as how easily you can have a conversation or how you respond emotionally in certain situations. If you notice some differences in behaviour, talk to your doctor, nurse or care coordinator.

The brain can sometimes heal itself after treatment, but this can be a slow process. Many patients require some rehabilitation to help restore their abilities or manage changes. The type of therapy you have depends on your needs, choices and what is available.

School-aged children with brain tumours may benefit from tutoring as part of their rehabilitation. This may be available through some cancer charities, or you can talk to the student welfare coordinator, school counsellor or the principal of your child’s school. You can also ask the medical team for information about how the tumour and treatment may have affected your child.

Other helpful resources

Cancer Institute NSW has fact sheets to help people and families affected by a brain tumour. They cover a range of topics such as anxiety, anger, social behaviour, memory and concentration. 

The organisation BrainLink may also have rehab services.

Types of rehabilitation

Cognitive rehabilitation

If your memory, language skills or concentration is affected, a neuropsychologist may help you to improve your cognitive skills using memory activities, diaries and language puzzles.

Physiotherapy

In some cases, physiotherapy can help you to learn how to move more easily. It can also help you to develop, maintain or regain strength and balance. Moving and strengthening your muscles can help reduce tiredness.

If you can’t move easily, you may be able to learn compensation techniques, such as using a walking stick. You may also be given advice on how to exercise safely and stimulate parts of your body to improve circulation and reduce swelling.

Speech therapy

If your ability to talk has been affected, a speech pathologist may be able to help. Speech pathologists also work with people who have difficulty swallowing (dysphagia), which can cause problems with eating.

Occupational therapy

This helps you increase or maintain your independence.

Assistance for the vision impaired

Some people may lose some or all of their sight as a result of a brain tumour or surgery. Vision Australia can help people learn how to live independently with low or no vision. For more information, call 1300 847 466.

Driving

Benign and malignant tumours, seizures, and certain treatments and medications (such as anti-convulsants and some pain-killers) can cause changes in vision, mobility, coordination, perception and judgment. These changes can affect a person’s driving skills.

You must inform your local driver licensing authority that you have a tumour, especially if you have had brain surgery or have had seizures in the past six months. The licensing authority will request information from your doctor to decide if you are medically fit to drive.

You may have an occupational therapy driving assessment. This can determine the type of difficulties you are experiencing while driving (for example, a slow reaction time).

The focus of a driving assessment is not to suspend or cancel your licence. In some cases, an occupational therapist is able to teach you driving techniques to address your weaknesses or instruct you on how to use car modifications (such as additional mirrors). You may also be able to drive with restrictions, such as only in daylight, or only short distances from home.

Some people feel upset or frustrated if they are no longer able to drive or they have restrictions placed on their licence. These reactions are natural and understandable.

Changes in your ability to drive can affect your sense of independence and may impact on your family too.

However, it may help to remember that the decision is made for your safety and wellbeing. It is also made for the safety of passengers, pedestrians and other road users who could be injured if your driving is unsafe. If you have to stop driving, you may want to talk to a counsellor or someone who has been through a similar experience. Depending on your situation and your ongoing health, you may be able to return to driving at a later stage.

Cancer Institute NSW produces a free brochure, Brain Tumours and Driving, which has more information on these issues. Although it is a NSW resource, the information may be relevant to people in other areas of Australia. Call (02) 8374 5600 for a copy. 

The impact of licence changes

If your licence has been suspended or cancelled, but you keep driving, you may be fined. If you have an accident whilst driving, you could be charged with a criminal offence and your insurance policy will no longer be valid. If your licence has restrictions but you ignore them or drive unsafely, your licence may then be suspended or cancelled. 

"I was diagnosed with a grade 4 glioblastoma multiforme that couldn’t be operated on, so I had radiotherapy and chemotherapy. I needed to stop work and I couldn’t drive. I found it all mentally draining, but eventually my scans came back clear." – John

Reviewed by: A/Prof Kate Drummond, Neurosurgeon, Divisional Director of Neuroscience and Cancer and Infection Medicine, Director of Junior Surgical Training, The Royal Melbourne Hospital, VIC; Dr Dianne Clifton, Psychiatrist, Psycho-oncologist and Director, Department of Psychosocial Cancer Care at St Vincent’s Hospital, VIC; Dr Anthony Dowling, Medical Oncologist, St Vincent’s Hospital, VIC; Kate Fernandez, Clinical Nurse Coordinator, Central Nervous System Tumours, Women’s and Children’s Hospital, SA; Carmen Heathcote and Yvonne Howlett, Helpline Operators, Cancer Council Queensland, QLD; Dianne Legge, Brain Tumour Support Officer, Cancer Services, Olivia Newton-John Cancer and Wellness Centre, VIC; Scott Nussey, Consumer, SA; Dr Claire Phillips, Radiation Oncologist, Peter MacCallum Cancer Centre, VIC; and Janine Rhodes, Coordinator, Brain Tumour Support Service, Cancer Council Queensland, QLD.

Updated: 01 May, 2014