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KIN 187 Clinical Exercise Physiology > Cancer > Flashcards

Cancer Flashcards

1
Q

Cancer Stats

A

40% of Americans in their lifetime; nearly two-thirds of cancer survivors live for at least five years, not the leading cause of death, second behind heart disease

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2
Q

Causes of Cancer

A

Tobacco, obesity, diet, lack of exercise, occupation, viruses, family history, alcohol, UV and ionizing radiation, prescription drugs, reproductive factors, pollution, unknown
Physical activity reduces risk of colorectal cancer by up to 50%, obesity and physical inactivity increase risk of breast cancer in women by 50%

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3
Q

Pathophysiology of Cancer

A

A disease in which abnormal cells divide uncontrollably and destroy body tissue

  • results from DNA damage form internal or environmental factors
  • has potential to for metastasis
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4
Q

Carcinoma:

A

from epithelial tissues, most common (lung, colon, prostate, breast)

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5
Q

Sarcoma

A

from connective tissues like bone, fat, cartilage, nerves

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6
Q

Leukemia and lymphoma

A

from blood forming cells called hematopoietic cells

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7
Q

Development of Cancer

A

Normal tissue undergoes a progression of abnormal changes from hyperplasia (increase in number of cells but cells still appear normal under a microscope)
then dysplasia occurs (where cells look abnormal)
then cancer

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8
Q

Treatment/Management of Cancer

A

Medications
Chemo
Radiation Therapy: damage DNA of cancerous tissue
Surgery: primary method, remove the tumor
Hormone Therapy
Targeted Therapies( form of chemo): targets specific molecular differences between cancer and normal cells
Exercise: overall physical function is generally diminished because of losses of aerobic capacity, muscle tissue and ROM

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9
Q

Exercise Response (cancer)depends on

A

Tumor site, cancer stage, grade, treatment, timing since diagnosis and interactions of all elements with general health, well being and fitness

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10
Q

Medical Assessments before exercise

A

Recommend evaluation for peripheral neuropathies, musculoskeletal morbidities
If the patient has hormonal therapy it could lead to fracture risk

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11
Q

Breast Cancer Evaluation

A

Arm/shoulder morbidity to upper body exercise

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12
Q

Prostate Cancer Eval

A

Evaluation of muscle strength and wasting

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13
Q

Colon Cancer Eval

A

Eval patient as having established consistent and proactive infection prevention behaviors for an existing ostomy prior to engaging in exercise training that is more vigorous than a walking program

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14
Q

Gynecologic Cancer Eval

A

Patients that are morbidly obese may require additional medical assessment for the safety of activity beyond cancer-specific risk. Eval the lower extremity lymphedema prior to vigorous aerobic exercise or resistance training

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15
Q

Recommendation for Exercise Testing Cancer (High functioning)

A

an exercise test to establish current baseline and determine if treatments affected exercise response is useful

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16
Q

Recommendation for Exercise Testing Cancer (Low functioning)

A

an exercise test might provide a barrier to physical activity

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17
Q

Exercise Testing (general concepts)

A

No assessment required to start a light, walking progressive strength training, or flexibility program in survivors
Be aware of a survivors health history, comorbid chronic health conditions and diseases, and any exercise contraindications
Ideally patients with cancer should receive a comprehensive assessment

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18
Q

General Physical Activity Guidelines

A

Avoid Inactivity
Exercise as much as possible
require modifications to avoid fracture with matastatic bone disease
Walk up to 150 min/wk
Understand that setbacks with treatment might occur and make modifications
Monitor symptoms of disease and treatment
Exercise in a supervised setting with a certified cancer exercise trainer

19
Q

Exercise (breast)

A

fracture risk for aerobic training, take into consideration arm/shoulder morbidities, No upper limit on weight, watch fro arm and shoulder symptoms

20
Q

Exercise (Prostate)

A

Fracture in aerobic,
Add pelvic/floor exercises for those who undergo radical prostatectomy, watch for fracture (resistance), Include flexibility as normal

21
Q

Exercise (Colon)

A

If an ostomy is present, modifications will be needed for swimming or contact sports, flexibility is the same but watch for intra-abdominal pressure with patients with ostomies, In resistance training, patients with a stoma need to start with low weight and be progressive to avoid hernation at the stoma, is ostomy- patient needs medical clearance

22
Q

Exercise (Adult Hematologic))

A

not many reccomendations

23
Q

Exercise (Adult HSCT)

A

avoid overtraining given the immune effects of vigorous exercise, resistance training may be more important,

24
Q

Exercise (Gynecologic)

A

If peripheral neuropathy is present, a stationary bike might be preferable over weight bearing cardio, Proceed with caution in resistance training if the patient has had lymph node removal and or radiation to lymph nodes in the groin

25
Q

FITT REC for cancer

A

aerobic: gradual increase to 3-5 dys/wk, mod to vig, several short bouts per day during active treatment, prolonged rhythmic
resistance: 2-3 d/wk, moderate (60-70% of RM), any kind
Flexibility: daily
Tolerance of intensity, several short bouts and no different amount of time then healthy population

26
Q

Special Considerations for Cancer

A

90% of all survivors experience fatigue from chemo, radiation
This fatigue persists for months-years
avoid physical inactivity
Bone is the most common site for metastases so modify exercise program and watch for bone fragility and fractures
Cachexia
Identify when a patient is in an immunosuppressed state due to those medications after a bone marrow transplant or undergoing chemo/radiation therapy

27
Q

Cachexia

A

muscle and fat wasting-may limit exercise capacity

28
Q

If platelets are

A

50,000

Avoid activities that increase risk of injury, bruising or bleeding

29
Q

If white blood cells

A

3,000

Avoid public facilities where risk of exposure to bacteria is high and adhere to infection control guidelines

30
Q

If hemoglobin

A

10g*dL^-1

Prescribe only low intensity activities, shorter periods and allow adequate rest

31
Q

If fever of vommitting

A

no formal exercise training, wait until asymptomatic for 48 hours

32
Q

Peripheral neuropathy;

A

categorized by loss of sensation and poor balance-avoid free weights and treadmill, use well-supported positions for exercise

33
Q

Osteoporosis bone issues

A

avoid high impact activities

34
Q

General Pain

A

investigate the pain and make modifications

35
Q

Radiotherapy cancer related fatigue and severe reaction in region

A

closely monitor exercise response

avoid exercises that compromise the skin and tissue in the region

36
Q

Side effects of surgery

A

swelling pain constipation

pain lymphedema, limited ROM, lymphedema, difficulty communicating/swallowing/eating, sexual dysfunction, hernia, bowel or bladder dysfunction, difficulty breathing, pain , fatigue

37
Q

Side effects of radiation

A

fatigue, vomitting, hair loss, skin changes, pain limited rom, fatigue, lymphedema, second cancers, fibrosis in the area tested

38
Q

Side effects of chemo

A

fatigue, nausea, hair loss, peripheral neuropathy, altered executive cognitive function

39
Q

Side effects of hormone therapy-antiestrogens

A

hot flashes, cognitive impairment, arthralgia, myalgia, eight gain, osteoporosis, metabolic syndrome

40
Q

Side effects of hormone therapy-anti-androgens

A

vasometer flushing, fatigue, vertigo, weakness, altered body comp, decreased muscle, decreased bone mass, depression, frailty, osteoporosis, metabolic syndrome

41
Q

Effect of Exercise

A

improved quality of life, decreased fatigue, improved aerobic capacity, sleep, mood and energy levels
decreased side effect severity, recurrence and death from breast and colon cancers
Greater body satisfaction and maintenance of body weight

42
Q

_______ is a type of cancer that is identified from connective tissues, such as bone and cartilage.

A

Sarcoma

43
Q

More than half of the causes of cancer is related to individuals’ lifestyle choice. T/F

A

True

44
Q

Cancer patients in early stage treatment should avoid physical activity. T/F

A

False

KIN 187 Clinical Exercise Physiology (16 decks)

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