Cancer Flashcards
Lab values used for diagnosis
- leukemias, lymphomas, immunological cancers
- leukocytes >150,00 plateletes >400,000
- Prostate: PSA< 4 ngmL
- ovarian cancer antigen
- medullar thyroid cancer
- liver calcitonin > 10g/mL or alpha fetoprotein > 500 g/mL
Medical treatment for cancer
- chemo
- radiation shrink
- surgery
- targeted genetic and biological interventions
Percentage of cancer at
1. all ages
2. 10-14
3. 15-19
- 23.1
- 13.1
- 4.7
Most common childhood cancers
- lymphomas
- leukemia
- CNS
- endocrine
- melanoma
Most common deaths by cancer
- Leukemias
- brain/nervous
- bone.joint
- endocrine
- soft tissue
Top 5 most common cancers
- breast
- prostate
- lung and bronchus
- colon and rectal
- melanoma
Primary vs seconary cancers
- primary = initial site
- secondary = mets that develop
What can increase risk of recurrence of mets
- lymph nodes
- tumor > 2cm
- higher grade histopathlogical designation
- hormone levels - progesterone and estrogen
Benign Neoplasms
- non cancerous localized encapulated slow growing unable to move
Invasive carcinoma
- malignant invade surrounding tissue
- regional-regional lymph
- distal or distal mets = malignant lesions in another organ = lung, liver, brain
- note primary chance arising from specific body structure are not as likely to result in MSK S&S
Metastatic
- 15-20 years later
- 70% spine
Modes of metastases
- blood streem
- lymphatic system
- direct extension into adajcent tissues
- requires f/u anytime you suspect mets
common areas of METs
- adjacent tissues
- lymph nodes
- bone
- brain
- organs
common breast
mets
- bones (shoulder, hip, spine, ribs, sacrum)
- CNS
- brachial plexus
- spinal fluid
- lungs
Mets from
lung cancer
- CNS
- bone
- brachial plexus
MEts from
prostate cancer
- pelvis
- sacrum
- vertebrae,
- sacral plexus
- bladder
common mets
pancreatic cancer
liver
common mets from
stomach cancer
- liver
- vertebrae
- abdominal cavity
Early warning signs of cancer
- Changes in bowl or bladder
- A sore that does not heal within 6 weeks
- Unusual bleeding or discharge
- Thickening or lump in breast or elsewehere
- Indigestion or difficulty in swallowing
- Obvious chnage in a wart of mole
- Nagging cough or hoarseness
- Supplemental signs and symptoms
What to watch as a PT
- changes in vital signs
- proximal muscle weakness
- change in deep tendon reflexes
Important considerations when reviewing history
- Age 50 or above
- previous hx of cancer
- family history
- gender
- ethnicity
- system screeening
- environmental and lifestyle
signs of cancer in children
- eyes: white glow in pupil, visual disturbance, new suint
- palpable mass
- abdomen: distension, organmegaly, refractory constipation nausea
- system: recurrent viral illness, weight loss, night sweats
- brain: headaches, vomittin, change in behavior
- pallor
- Genitourinary: hematuria or difficulty voiding
- bone: back pain, new limp or persistent pain
As a PT what should paid attention to in reguards to cancer
- exercise guidlines perceived exertion
- blood values
- side effects of treatments
- precautions and contra-indications with modalities
- patient response
Lymphedema PT concerns
- post-op patients are at risk for developing lymphedema
- BP not to be taken in arm with lymphedema
- compression garments
- caution with massage techniques special training
lymphedema treatment
- complete decongestive therapy (manual techniques, bandaging, wrapping)
- compression garments both custom or off the shelf