4: Oncology Flashcards
What are some of the most common cancers?
Breast, prostate, lung, colon, melanoma, bladder, kidney
What makes up 48% of all cancers in men?
Prostate, lung, and colorectal
What are the three most common cancer’s among women?
Breast, lung, colorectal
Is the cancer mortality rate higher in men or women?
Men
What population has the highest risk of mortality with cancer?
Non-Hispanic Black Men
What population has the lowest risk of mortality with cancer?
Non-Hispanic Asian/Pacific Islander Women
What % of people will be diagnosed with cancer in their life?
40.5%
What are six factors that impact the risk of cancer?
- Diet
- Alcohol
- Physical activity
- Obesity
- DM
- Environment
High levels of activity are linked to lower risk of what cancers?
- Bladder
- Breast
- Colon
- Endometrial
- Esophageal
- Kidney
- Stomach
- Lung
What are the most common cancers that are associated with obesity?
- Breast
- Colon and rectum
- Kidney and renal pelvic
- Endometrial
- Pancreatic
- Thyroid
- Liver
How can exercise help to prevent cancer?
- Regulate hormones
- Prevent high levels of insulin
- Reduce inflammation
- Improve immune function
- Weight
Why does metabolism and digestion have an effect on cancer development?
High metabolism and increased digestion speed decreases the exposure to carcinogens
What duration of prolonged sitting can increase your risk of cancer?
> 4 hrs
What are benefits of exercise prior to treatment?
- Exercise adherence
- Tolerance to treatment
- Prolong functional decline
- Reduce post-op stay and complications
- Return to pre-op function
When will a pt have better tolerance to chemo?
With pre-treatment exercise program
What is a positive prognostic predictor for pt’s with lung cancer?
Walking > 400 m in 6 min
What are gross benefits of exercising during cancer treatment?
- QOL
- Aerobic capacity
- Strength
- Symptom relief
- Treatment tolerance
- Boost immune
- Decrease hospital stay
- Anxiety and depression
What are cellular benefits of exercising during cancer treatment?
- Bone mineral density
- Creatinine exertion
- Improved cell counts
- Higher hemoglobin
What are gross benefits of exercise after cancer treatment?
- Aerobic
- Fatigue, anxiety, depression
- QOL
- Strength
- Walking distance
- Flexibility
- Cardiovascular
What cellular benefits are there to exercising after cancer treatment?
Positive changes in IGF-1 and IGFBP-3,1 - decreased risk of recurring cancer
What are the ACSM guidelines for aerobic exercise for cancer patients?
30 min 3x/week for 8-12 weeks
What are the ACSM guidelines for resistance exercise for cancer patients?
- Major muscle groups
- 2x/week
- 2 sets of 8-15 reps, 60% 1RM
What are side effects of cancer surgery?
- Pain
- Soft tissue restrictions, ROM
- Weakness
- Lymphedema
- Incontinence
What are side effects of chemothearpy?
- Fatigue
- Nausea
- Mucositis
- Cardiomyopathy
- Pulmonary fibrosis
- Cognitive deficits
- Peripheral neuropathy
- Myelosuppression
What are side effects of radiation?
- Radiation dermatitis
- Fatigue
- Pneumonitis
- Dysphagia
- Fibrosis
- Lymphedema
- Sexual dysfunction
- Incontinence
- Myelopathy
What should you focus on during PT post radiation treatment?
- Stretching to affected joints and tissues
- Postural strengthening
- Monitor cardiac and pulmonary changes
Describe anxiety and depression with pt’s following cancer
- 2x more likely to develop anxiety
- 3x more likely to develop depression
How can you decrease anxiety and depression following cancer treatment?
Significantly reduce symptoms by incorporating aerobic training
Is resistive training alone effective to decrease anxiety and depression?
No - need some form of aerobic
What is CRF?
Cancer related fatigue - distressing, persistent, subjective sense of tiredness or exhaustion related to cancer or treatment
What % of pt’s have CRF?
80%
What is reported as the most distressing symptoms with cancer treatment?
CRF
How do you combat CRF?
- Monitor fatigue levels
- Energy conservation
- Naps < 1 hr
- Daily routine
- Exercise regularly
Describe the effects of chemotherapy induced neuropathy
- Loss of pain and sensation
- Balance deficits
- Gait deficits
- Fine motor loss
- Decreased QOL
What are PT considerations due to chemo induced neuropathy?
- Assess balance and gait
- Safety with aerobic exercise
- Functional deficits
- Safety at home
What are CV changes that happen as a response to chemotherapy and cardiotoxicity?
BP changes, thrombosis, ECG, arrhythmias, myocarditis, pericarditis, MI, cardiomyopathy, L ventricle failure, CHF
How long can symptoms from radiation last?
5-10 years
What are long-lasting changes associated with radiation?
- Fibrotic changes to myocardium
- Radiation-induced accelerated atherosclerosis
- Decreased renal function
What symptoms will present 20-30 years after childhood cancer?
50% chance of cardiac issues
What may be protective to CV effects during chemo?
Low intensity exercise
What should you monitor during treatment of a cancer pt?
- Vitals
- RPE, Borg
- SOB, edema, color
- ROM activities with radiation
- Deep breathing
- Encourage aerobic conditioning
What are exercise precautions for cancer based on?
- Cancer type
- Treatment side effects
- Individual characteristics
What are general precautions for osteoporosis?
- Avoid high impact
- Gentle increases
- Balance
- No MMT if in long bones
- No PRE for bone METs
What are general precautions for
lymphedema?
- Avoid overuse
- Gradual progression
- Weight reduction
- Education
- Refer for compression or specialist
What are general precautions for
incontinence?
Include kegel and pelvic floor exercise
What are general precautions with a history of radiation?
- ROM for 1 year
- Cardiac compromise
- Monitor vitals
What are general precautions for
a compromised immune system?
Clean
What are general precautions for
CV disease?
- Comorbidities
- SOB, lung congestion, pallor
- Vitals
What are general precautions for
fatigue?
Exercise can help improve symptoms
What are general precautions for
peripheral neuropathy?
Balance, safety, fall prevention
What are general precautions for
anemia?
- Reduce exercise capacity
- < 8 g/dL
What are red flags to be on the lookout for with treating a cancer patient?
- Pain
- Difficulty sleeping
- Weight loss
- Not responding typically
- CV signs
