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pt management 3 > Cancer > Flashcards

Cancer Flashcards

1
Q

what is the reccomended exercised dosage for those with cancer - minutes

A

150 min

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1
Q

what is the reccomended exercised dosage for those with cancer - aeorbic

A

moderate-intensity aer-
obic exercise spread over 3–5 days

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2
Q

what is the reccomended exercised dosage for those with cancer - resistance

A

2-3 days per week

8–10 muscle groups,
8–10 repetitions, 2 sets

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3
Q

each session should include

A

Each session should include a warm-up and
cool-down

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4
Q

what is the best risk predictor for cancer

A

age

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5
Q

80% of all cancers are diagnosed in people age BLANK

A

55+

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6
Q

~1/3 of projected cancer deaths related to what modifiable factors

A

obesity/ overweight,
inactivity,
poor nutrition

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7
Q

cancer and SES relationship

A

People with low SES have higher death rates than those with higher SES

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8
Q

Uninsured and minority patients are more likely to be diagnosed in what stage of cancer

A

later stage

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9
Q

what is the most common type of cancer

A

non-melanoma skin cancer

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10
Q

other leading cancers

A

Breast
Lung
Prostate
Colorectal

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11
Q

What is Cancer?

A

A large group of diseases characterized by uncontrolled cell proliferation and spread of abnormal cells.

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12
Q

Benign

A

non-cancerous

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13
Q

Pre-Cancerous

A

Carcinoma in Situ

A group of abnormal cells that could become cancerous

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14
Q

Malignant

A

Cancerous

Cells have the ability to invade and destroy nearby tissue and spread to other parts of the body

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15
Q

why is cancer staging important

A

Important to determine prognosis and to be able to compare one type of cancer to another

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16
Q

is staging the same for every cancer

A

Staging is different for every cancer!

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17
Q

TNM Staging - T

A

size and invasiveness of the primary tumor (0-4)

If multiple tumors are present in one organ, use highest T

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18
Q

TNM Staging - N

A

regional lymph node involvement (usually 0-4)

The N# does NOT reflect the exact # of nodes involved!

Low N = better prognosis
High N = surgically inaccessible, worse prognosis

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19
Q

TNM Staging - M

A

Distant spread (mets) to anatomical sites

X = not determined
0 = no distant mets
1 = distant metastasis

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20
Q

Anatomic Staging - what is it based on

A

0-IV staging based on size and spread

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21
Q

Anatomic Staging 0

A

Pre-malignant; “carcinoma in situ”

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22
Q

Anatomic Staging 1

A

Like stage 0, but confirmed malignant

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23
Q

Anatomic Staging 11

A

Local, but high risk of spread due to size

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24
Q

Anatomic Staging 111

A

Local cancer beginning to spread locally

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25
Q

Anatomic Staging 1V

A

Confirmed Metastasis (distant site)

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26
Q

what is Grading

A

A measure of cancer cell abnormality when compared to healthy cells.

Each cancer has unique grading systems

Generally, follows grade 1-4:

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27
Q

Grading 1

A

Most closely resemble normal cells; well-differentiated tumors; low grade.

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28
Q

Grading 2

A

Somewhat abnormal; moderately differentiated; intermediate grade

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29
Q

Grading 3

A

Very abnormal; poorly differentiated, since they no longer have an architectural structure or pattern; high grade

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30
Q

Grading 4

A

undifferentiated cancers; most abnormal looking cells; highest grade and typically grow and spread faster than lower grade tumors.

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31
Q

What is Metastasis?

A

cancer cells break away from where they first formed (primary cancer), travel through the blood or lymph system, and form new tumors (metastatic tumors) in other parts of the body.

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32
Q

Is the metastatic tumor is the same type of cancer as the primary tumor?

A

yes

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33
Q

Cells break away from the primary tumor site and travel through the body via 3 pathways:

A

Hemotogenous
Lymphatic
Transcoelomic (direct extension)

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34
Q

Most Common Sites of Metastases

A

Lymph nodes
Liver
Lungs
Bone
Brain

35
Q

Osteolytic

A

a progressive condition where bone tissue is destroyed.

36
Q

Osteoblastic

A

bone formation

37
Q

Initial Signs of Cancer

A

Anemia
Thrombocytopenia
Elevated CRP, ESR
Pallor/Jaundice
Fever
Constipation/Diarrhea

38
Q

Initial Symptoms of Cancer

A

Pain
Changes in Basic Functions
Changes in Normal Appearance
Bleeding/Bruising
Cough
Indigestion
Fatigue out of proportion to exertion
Poor temperature regulation
Swelling/Lumps
Weight gain/loss of unknown origin

39
Q

what is Antiangiogenic

A

a type of cancer treatment

suppresses blood supply formation

40
Q

Diagnose surgery

A

biopsy

determine extent of disease

41
Q

Traditional axillary lymph node dissection removes removes what

A

portion of lymph nodes

42
Q

what is Sentinel lymph node dissection

A

Instead of removing 10 or more lymph nodes and analyzing all of them to look for cancer, remove only the one node that is most likely to have it.
If this node is clean, chances are the other nodes have not been affected.

43
Q

tumor removal surgery

A

often curative and is sometimes followed by additional treatment to be sure any remaining cancer is eradicated

44
Q

reconstruction following removal surgery

A

Sometimes tumor removal may result in significant body changes such as amputation or breast removal

45
Q

BRCA+. surgery indication

A

BRCA are the breast cancer genes 1 & 2.

People who inherit harmful variants in one of these genes have increased risks of several cancers - most notably breast and ovarian cancer

46
Q

palliative surgery

A

aimed at removing some of the tumor in an effort to make a patient more comfortable and diminish negative side effects.

47
Q

is Radiation (XRT) selevtive

A

no it is non-selective

target all tissue is that area

48
Q

what does radiation do

A

a cancer treatment that uses high doses of radiation to kill cancer cells and shrink tumors

Targets DNA; Breaks hydrogen bonds to prevent ongoing replication of cancerous cells

49
Q

Side Effects of XRT depends on what

A

DOSE and FIELD

50
Q

XRT Pre-operatively

A

Shrink tumor

51
Q

XRT Intra-operative

A

bolus dose to shrink tumor

52
Q

XRT Post-operatively

A

to kill micrometastasis

53
Q

XRT Palliatively

A

to decrease pain; seizure activity

54
Q

XRT normal dosage

A

5 days/week for 4 weeks

55
Q

Radiation methods

A

Teletherapy: external beam, most common

Proton Therapy

Brachytherapy: short distance from sealed radiation source & target, implant radioactive seeds. Best for localized tumors

Systemic – ingestion or injection of radioactive substance

56
Q

what are the side effects of radiation

A

radiation dermistis

Mucositis

Fibrosis

Pain

Bone necrosis/ demineralization

High dose XRT causes Osteolysis & AVN

Epiphyseal plate in children is sensitive

Radiation-induced malignancy

57
Q

signs to watch for in a patient who might be developing radiation dermatitis:

A

Reddening of white skin or darkening of skin that is black or brown.

Itchy skin.

Dry and peeling skin.

Swelling.

Blistering.

Open sores that may appear where your skin is sweaty or damp, such as your armpits or under your breasts

common side effect of external radiation

58
Q

Mucositis

A

when your mouth or gut is sore and inflamed

GI symptoms such as: emesis, cramps, diarrhea, and/or hemorrhage

59
Q

Radiation fibrosis syndrome (RFS)

A

a progressive fibrotic tissue sclerosis

late complication of radiation therapy and may occur weeks or even years after treatment

chronic vascular dysfunction and lymphatic issues

60
Q

myelo-radiculo-plexo-neuro-myopathy

A

Radiation can damage the spinal cord, nerve roots, plexus, local peripheral nerves, and muscles within the radiation field.

can result in pain, sensory loss, weakness, and other signs and symptoms.

61
Q

what is Osteoradionecrosis

A

bone death due to radiation

62
Q

Bone necrosis/ demineralization

A

usually reversible

Bone softening in 1st 6-8 weeks

Return to full density may take 6 months

63
Q

High dose XRT causes what to happen to the bones

A

Osteolysis & AVN

64
Q

Epiphyseal plate in children is sensitive so what long term effect can we see

A

Irreversible LLD and scoliosis

65
Q

what is Chemotherapy

A

A wide variety of chemical agents used to destroy cancer cells. These drugs affect cell DNA synthesis or function within the cell cycle

66
Q

is chemo selevtive or non-selective

A

Nonselective

Can destroy normal cells, especially hepatic, epithelial, bone marrow and hair cells.

Generally results in toxicities and side effects.

67
Q

Cocktails chemo

A

Combinations of drugs used to target cancer cells in various stages of the cell cycle.

68
Q

Chemotherapy system Side-Effects depends on what

A

Depends on drug AND combination

69
Q

chemo dosing - general

A

Depends on the type of cancer, the drug, the patient, etc

70
Q

chemo dosing - infusion

A

1 infusion every 2-4 weeks x6 treatments

each infusion lasts a few hours

71
Q

chemo dosing - oral

A

1 week on, 2 weeks off

72
Q

chemo ADE

A

CICI

system toxicity

Induced Peripheral Neuropathy

73
Q

what is Chemotherapy-Induced Cognitive Impairment (CICI)

A

subtle to moderate impairments in several cognitive domains

74
Q

what causes CICI

A

Chemotoxicity

Reduced hormone levels

Proinflammatory immune response

Fatigue, Distress

75
Q

signs/symptoms of CICI

A

Disorientation & difficulty multitasking

Slowed performance

Trouble concentrating & learning

Short attention span, Mental fatigue

76
Q

what should you do if you think someone has CICI

A

MOCA

MMSE

and then refer the patient

77
Q

what impact chemo inducer peri neuropathy

A

can develop or worsen with increasing doses

often occurs as stocking/ glove polyneuropathy

Sesnory fibers are usually affected more than motor and motor more than autonomic.

78
Q

“coasting” and CIPN

A

gets worse after chemotherapy is stopped.

Commonly, symptoms occur weeks to months after chemotherapy.

They can get worse with additional cycles of chemotherapy.

79
Q

what is immunotherapy

A

uses certain parts of a person’s immune system to fight cancer cell replication and spread.

Stimulate or boost your own immune system

Receive lab-formulated immune cell “assistance”

cancer specific and there are many different types

80
Q

Cachexia

A

wasting” disorder that causes extreme weight loss and muscle wasting, and can include loss of body fat.

81
Q

Sarcopenia

A

involuntary loss of skeletal muscle mass

82
Q

what is Cancer Related Fatigue

A

A persistent, subjective sense of tiredness related to cancer or cancer treatment that interferes with usual functioning

83
Q

Cancer-Related Fatigue intensity

A

Intensity generally increases with Rx time

84
Q

Cancer-Related Fatigue symptoms

A

Fatigue not relieved by rest
Dyspnea
Decreased concentration
Decreased endurance for daily tasks

85
Q

factors that influence survivorship

A

type

stage

treatment protocol

co-morbidites

individual behaviors

pt management 3 (10 decks)

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