11b: Cancer drugs and Immunosuppressants Flashcards
what are three main treatment options for cancer?
surgery, radiation, chemotherapy
what is the goal of cancer drugs?
to limit cell proliferation by killing the cancer cells, but that often means killing harmless cells too
what is the cell kill hypothesis?
each round of chemo will kill a certain percentage of cancer cells, which is why multiple rounds of chemo are needed
do chemotherapy drugs have high or low therapeutic index?
very low TI
what are some adverse effects of chemotherapy?
anemia, weight loss, hair loss, decreased bone density, cough, constipation, decreased immune system, pain, depression/anxiety, premature menopause
what are 5 groups of chemotherapy drugs?
alkylating drugs, antimetabolites, anticancer antibiotics, antimicrotubular agents, topoisomerase inhibitors
how are anticancer hormones used as an adjunct therapy?
they block the effects of hormones because some types of cancer are exacerbated by certain hormones (ex: estrogen receptor blockers to prevent and treat breast and uterine cancers)
what is unique about monoclonal antibodies?
target specific cancer cells – they are attracted to the cancer cells without effects on healthy tissues
aspirin and other NSAIDs can prevent or decrease what types of cancer?
colorectal, stomach, esophagus, breast, prostate, lungs
why might chemotherapy administered prior to an aggressive surgery?
attempts to shrink the tumor to allow the surgery to be more successful
why can some precautions for modalities be overridden for cancer patients?
doctor may override precautions due to their pain-relieving benefits (although still cannot use ultrasound over tumors)
what are neurotoxic effects that could affect rehab?
peripheral neuropathy and CNS abnormalities: convulsions, ataxia, confusion, anxiety
what are other PT implications of cancer treatment?
– immunosuppression (infection control)
– hemorrhage (careful with compression devices, pressure, and strenuous exercise)
– monitor lab values & vitals
– mood changes
– chemo brain
patients should not exercise within ____ hours of chemotherapy administration
2 hours
when does fatigue rise sharply and peak after treatment?
rises sharply 24-48 hours after, and peaks 4-5 days after treatment
what are exercise recommendations for cancer patients?
– RPE no more than 12
– both strength & aerobic
– high reps, low weight
– may need to start with interval training
– energy conservation
what are long term effects of radiation?
– skin ulcers 10-20 years after (difficult to heal and painful)
– chronic changes in connective tissue
– CNS: neuropathies show up 20-30 years after
what is the most commonly reported symptom of cancer and cancer treatment?
fatigue
what is unique about cancer-related fatigue compared to typical fatigue?
cancer related fatigue is usually not relieved with rest, not related to excessive amount of activity, can last for over 2 weeks, and can persist for months and years after completion of therapy
what cancers have the highest levels of reported fatigue?
lung, GI, UG, and hematologic
what are techniques for energy conservation?
plan ahead/organize, schedule rest, pace, body mechanics, stress management, limit overhead and isometric work, nutrition/fluid intake, modify environment
