11b: Cancer drugs and Immunosuppressants

Question 1

what are three main treatment options for cancer?

Answer 1

surgery, radiation, chemotherapy

Question 2

what is the goal of cancer drugs?

Answer 2

to limit cell proliferation by killing the cancer cells, but that often means killing harmless cells too

Question 3

what is the cell kill hypothesis?

Answer 3

each round of chemo will kill a certain percentage of cancer cells, which is why multiple rounds of chemo are needed

Question 4

do chemotherapy drugs have high or low therapeutic index?

Answer 4

very low TI

Question 5

what are some adverse effects of chemotherapy?

Answer 5

anemia, weight loss, hair loss, decreased bone density, cough, constipation, decreased immune system, pain, depression/anxiety, premature menopause

Question 6

what are 5 groups of chemotherapy drugs?

Answer 6

alkylating drugs, antimetabolites, anticancer antibiotics, antimicrotubular agents, topoisomerase inhibitors

Question 7

how are anticancer hormones used as an adjunct therapy?

Answer 7

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)

Question 8

what is unique about monoclonal antibodies?

Answer 8

target specific cancer cells – they are attracted to the cancer cells without effects on healthy tissues

Question 9

aspirin and other NSAIDs can prevent or decrease what types of cancer?

Answer 9

colorectal, stomach, esophagus, breast, prostate, lungs

Question 10

why might chemotherapy administered prior to an aggressive surgery?

Answer 10

attempts to shrink the tumor to allow the surgery to be more successful

Question 11

why can some precautions for modalities be overridden for cancer patients?

Answer 11

doctor may override precautions due to their pain-relieving benefits (although still cannot use ultrasound over tumors)

Question 12

what are neurotoxic effects that could affect rehab?

Answer 12

peripheral neuropathy and CNS abnormalities: convulsions, ataxia, confusion, anxiety

Question 13

what are other PT implications of cancer treatment?

Answer 13

– immunosuppression (infection control)
– hemorrhage (careful with compression devices, pressure, and strenuous exercise)
– monitor lab values & vitals
– mood changes
– chemo brain

Question 14

patients should not exercise within ____ hours of chemotherapy administration

Answer 14

2 hours

Question 15

when does fatigue rise sharply and peak after treatment?

Answer 15

rises sharply 24-48 hours after, and peaks 4-5 days after treatment

Question 16

what are exercise recommendations for cancer patients?

Answer 16

– RPE no more than 12
– both strength & aerobic
– high reps, low weight
– may need to start with interval training
– energy conservation

Question 17

what are long term effects of radiation?

Answer 17

– skin ulcers 10-20 years after (difficult to heal and painful)
– chronic changes in connective tissue
– CNS: neuropathies show up 20-30 years after

Question 18

what is the most commonly reported symptom of cancer and cancer treatment?

Answer 18

fatigue

Question 19

what is unique about cancer-related fatigue compared to typical fatigue?

Answer 19

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

Question 20

what cancers have the highest levels of reported fatigue?

Answer 20

lung, GI, UG, and hematologic

Question 21

what are techniques for energy conservation?

Answer 21

plan ahead/organize, schedule rest, pace, body mechanics, stress management, limit overhead and isometric work, nutrition/fluid intake, modify environment