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Boards: Other Systems > Cancer > Flashcards

Cancer Flashcards

1
Q

Cancer:

Define and Early Warning Signs

A

cancer is a broad group of diseases characterized by rapidly proliferating anaplastic cells - 2nd leading cause of death in the US

  • Early warning signs
    • usual bleeding or discharge
    • a lump or thickening of any area
    • a sore that does not heal
    • change in bowel/bladder habits
    • hoarseness or persistent cough
    • indegestion or difficulty swallowing
    • change in size/appearance of mole
    • unexplained weight loss
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2
Q

Types of Cancer:

Carcinoma

Sarcoma

Lymphoma

Leukemias and Myelomas

A
  • Carcinoma
    • malignant tumor originating in epithelial tissues - skin, stomach, colon, breast, rectum, etc. in situ = has not invaded basement membrane
  • Sarcoma
    • a malignant tumor originating in connective tissue and mesodermal tissues - muscle, bone, fat
  • Lymphoma
    • affects lymphatic system - Hodgkin’s, lymphatic leukemia
  • Leukemias and Myelomas
    • affecting the blood - unrestrained growth of leukocytes and blood forming orgrans (bone marrow)
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3
Q

Cancer Staging

0

1

2

3

4

A
  • 0 = carcinoma in situ
  • 1 = tumor is localized, = 2cm, has not spread to lymph
  • 2 = locally advanced, 2-5 cm, w or w/o lymph
  • 3 = locally more advanced; spread to lymph, designated 2 or 3 based on type
  • 4 =tumor has metastisized, spread to other organs
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4
Q

Cancer Grades

A
  • Grade 1 = low grade, cancer cells resemble normal cells (well differentiated) and are slow growing
  • Grade 2 = intermediate, cancer cells look more abnormal (mod diff) and are growing slightly faster
  • Grade 3 = high grade, cancer cells more abnormal (poor dif); grow and spread more agressively
  • Grade 4 = high grade, cancer cells are abnormal and undifferentiated
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5
Q

Cancer Red Flags w/ Treatment Strategies

Radiation

Chemo

Immunotherapy

Hormonal Therapy

A
  • Radiation
    • ​pain and fatigue
    • radiation sickness
    • immunosuppression
    • fibrosis
    • burns
    • delayed wound healing
    • edema
    • hair loss
    • CNS effects
    • radiation encephalopathy, demyelenation
  • Chemo
    • fatigue
    • gastrointestinal symptoms**
    • bone marrow suppression
    • fatigue
    • skin rashes
    • neuropathies**
    • phlebitis
    • hair loss
  • Immunotherapy
    • fatigue
    • weight loss
    • flu like symptoms
    • fever - chills
    • nausea
    • vommiting
    • anorexia
    • fluid retention
  • Hormonal Therapy
    • gastrointestinal symptoms
    • HTN
    • steroid induced diabetes and myopathy
    • weight gain
    • hot flashes
    • sweating
    • altered mental status
    • impotence
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6
Q

Physical Therapy Exam Cancer Patients

A
  • Pain
    • p! at site distal to tumor - metastasis
    • nerve/root compression
    • ischemic response
    • sympathetic signs
  • Cancer related fatigue CRF
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7
Q

Physical Therapy Goals Outcomes and Interventions

A
  • identify and support pt family
  • positioning
  • edema control
  • pain control
  • maintain or correct ROM and strength
  • Improve aerobic capacity
  • assess fatigue 12 hrs later
  • teach energy conservation
  • remember precautions/contra = check labs before each treatment!!
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8
Q

Specific Considerations for Exercise:

Post Mastectomy

Post - Bone Marrow Transplant

A
  • Post Mastectomy
    • focus on restoring pain-free full ROM of shoulder, prevention/reduction of edema, restoration of function
    • early post op exercise is stressed - sometimes day 1
  • Post - Bone Marrow Transplant
    • average 30 day hospital stay
    • prolonged chemo, radiation, strict isolation
    • focus on restoration of funx, and effects of deconditioning
    • exercise contraindicated in pts w/ PLT < 20k and use caution 20-50K
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9
Q

Red Flags: Radiation Tx

A
  • pain and fatigue
  • radiation sickness
  • immunosuppression
  • fibrosis
  • burns
  • delayed wound healing
  • edema
  • hair loss
  • CNS effects
  • radiation encephalopathy, demyelenation

<!--EndFragment-->

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10
Q

Red Flags: Chemotherapy Tx

A
  • <!--StartFragment-->
  • fatigue
  • gastrointestinal symptoms**
  • bone marrow suppression
  • fatigue
  • skin rashes
  • neuropathies**
  • phlebitis
  • hair loss

<!--EndFragment-->

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11
Q

Red Flags: Immunotherapy Tx

A
  • <!--StartFragment-->
  • fatigue
  • weight loss
  • flu like symptoms
  • fever - chills
  • nausea
  • vommiting
  • anorexia
  • fluid retention

<!--EndFragment-->

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12
Q

Red Flags: Hormonal Therapy

A
  • <!--StartFragment-->
  • gastrointestinal symptoms
  • HTN
  • steroid induced diabetes and myopathy
  • weight gain
  • hot flashes
  • sweating
  • altered mental status
  • impotence

<!--EndFragment-->

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13
Q

Adverse Signs of Cancer Tx: w/ Immunosuppressed patient

A
  • <!--StartFragment-->
  • Monitor vital signs
  • Physiological responses to exercise
  • May see elevated HR and BP
  • Dyspnea
  • Pallor
  • Sweating
  • Fatigue w/ minimal exertion

<!--EndFragment-->

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14
Q

Adverse Signs of Cancer Tx: Muscle Atrophy and Weakness

A

<!--StartFragment-->

Secondary to high doses of steriods

Disuses

Tumor compresssion/invasion

<!--EndFragment-->

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15
Q

Adverse Signs of Cancer Tx: ROM deficits

A

<!--StartFragment-->

Esp w/ high dose radiation around joints

<!--EndFragment-->

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16
Q

Adverse Signs of Cancer Tx: Hematologic Disruptions

A
  • <!--StartFragment-->WBC supression (leukopenia) = increased infection risk
  • Platelet suppresion (thrombocytopenia) = increased bleeding
  • RBC suppression (anemia) = diminished aerobic capacity

<!--EndFragment-->

17
Q

Red Flags: Cancer Patients: Pathological Fractures

A

<!--StartFragment-->

lung, breast, prostate, thyroid, and lymph met to bone

<!--EndFragment-->

18
Q

Red Flags: Cancer Patients: Paraneoplastic Syndrome

A

<!--StartFragment-->

s/s at a site distant from tumor or met sites, from ectopic hormone production by tumor cells or metabolic abnormalities from secretion of tumor-vasoconstrictive products

<!--EndFragment-->

19
Q

Red Flags: Cancer Patients: Cushing Syndrome

A

<!--StartFragment-->

small cell lung cancer

<!--EndFragment-->

20
Q

Red Flags: Cancer Patients: Neurological Syndromes

A

<!--StartFragment-->

Cerebellar degeneration

Peripheral neuropathy

Myasthenia gravis

<!--EndFragment-->

21
Q

Red Flags: Cancer Patients: Cancer stimulation of antibody production

A
  • <!--StartFragment-->
  • Anorexia
  • Malaise
  • Diarrheas
  • Weight loss
  • Fever
  • Progressive muscle weakness (type II atrophy)
  • Diminished DTRs
  • Myositis
  • Joint pain

<!--EndFragment-->

22
Q

Red Flags: Tx Methods in Patients w. significant bone metastasis

A
  • Platelets < 20k
  • AROM, ADL only
  • WB may be restricted
  • Provide appropriate ambulatory aids, orthoses
  • High risk of vertebral compression and other fractures w. metastatic disease. Use light exercise only

<!--EndFragment-->

23
Q

Red Flags: Use of Modalities in Cancer Patients

A
  • <!--StartFragment-->Thermal Agents, Cryotherapy, Hydrotherapy
  • Do not use directly over tumor
  • Do not use over dysvascular tissue
  • Decreased sensation to pressure or pain
  • Delayed wound healing
  • Increased bleeding or hemorrhage or open wounds

<!--EndFragment-->

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