Occupational Therapy in Oncology: From Prehabilitation to Palliation-Optimizing Function, Quality of Life, and Lymphedema Management

Cancer and its treatments can adversely affect physical function, cognition, emotional well-being, sleep, self-care, occupational performance, and social participation, thereby compromising independence and health-related quality of life. Occupational therapy (OT) addresses these challenges by facilitating engagement in meaningful occupations and supporting functional independence throughout the cancer care continuum. This narrative practice review examines the role of occupational therapy in oncology, encompassing prehabilitation, active treatment, long-term survivorship, and palliative care, with particular emphasis on functional outcomes, quality of life, and cancer-related lymphedema management. Occupational therapy assessment integrates impairment-level measures with evaluations of activities of daily living (ADLs), instrumental activities of daily living (IADLs), occupational performance, sleep, leisure, environmental barriers, and caregiver needs. Interventions may include task-specific training, graded activity, fatigue and energy conservation strategies, cognitive and psychosocial support, falls prevention, adaptive equipment, orthoses, caregiver education, and environmental modification. In cancer-related lymphedema management, occupational therapists may contribute to surveillance, functional assessment, lymphedema management, self-management education, activity adaptation, and coordinated multidisciplinary care. In advanced disease and palliative care, intervention priorities shift toward comfort, autonomy, energy conservation, meaningful occupational engagement, and caregiver support, guided by the individual's goals and changing clinical needs. This review presents a participation-centered framework for integrating occupational therapy into comprehensive oncology care. The synthesis is based primarily on literature and references identified in the source conference presentation; no formal systematic search, structured risk-of-bias assessment, or independent grading of evidence certainty was undertaken. Consequently, the findings should be interpreted as a narrative synthesis rather than a systematic evaluation of intervention effectiveness. Future research should examine intervention components and dosage, patient-reported occupational outcomes, equitable access to rehabilitation, and the effectiveness of integrated oncology rehabilitation pathways.