Cancer and Neurological Systems

Question 1

What is cancer?

Answer 1

Cells in the body that divide without control or develop abnormally
- Resulting in a tumor (abnormal mass of cells)
Eventually “over taking” the productive cells

Question 2

What is carcinoma?

Answer 2

epithelial tissue (80-90%)

Question 3

What is sarcoma?

Answer 3

connective tissue (bone, muscle, tendon)

Question 4

Myeloma

Answer 4

plasma and bone marrow

Question 5

Leukemia

Answer 5

blood forming tissue

Question 6

Lymphoma

Answer 6

cancer of the lymphatic system

Question 7

Benign

Answer 7

growing slowly without the propensity to become malignant or metastasizing

Question 8

Metastatic

Answer 8

usually by way of blood stream or lymphatic system spread throughout the body

Question 9

Malignant

Answer 9

tumors have cells that grow uncontrollably and spread locally and/or to distant sites

Question 10

Causes of cancer

Answer 10

Diet
Infections from viruses
Physical inactivity
Overweight
Genetics
Alcohol use
Tobacco use
Occupational risk including radiation
Drug intake

Question 11

Carcinogenesis

Answer 11

have to potential to cause cancer

Question 12

Possible reasons for cancer increase in the aging

Answer 12

Carcinogenesis
Aging cells

Question 13

IARC Classifications

Answer 13

Group 1: sufficient evidence the agent causes cancer in humans
- solar radiation, alcohol, smoking, talc, processed meat
Group 2A: sufficient evidence the agent causes cancer in humans
- anabolic steroids, roundup, high temp frying
Group 2B: limited evidence in humans and less in animals
- aloe vera, diesel, gas, vegetables
Group 3: evidence in inadequate
- coffee, tea, printing ink, dental materials

Question 14

What primary prevention programs can be used with the aging to prevent cancer?

Answer 14

Avoidance of carcinogens
Increased activity
Changes to diet and lifestyle
Chemoprevention

Question 14

Curative approach to cancer treatment

Answer 14

Radiation
Chemotherapy
Surgery
- Limb or organ loss
Biotherapy
Hormone therapy

Question 15

Palliative approach to cancer treatment

Answer 15

Radiation
Chemotherapy
Therapy
Medication
Alternative medicine
Hospice

Question 16

Hospice vs. Palliative Care

Answer 16

Hospice:
- terminal
- final 6 months of life - no longer true
- pain management (no cure)
- can take place anywhere you call home
- dr, nurse, social work, chaplain, dietician

Palliative:
- serious, but doesn’t have to be terminal
- any time
- pain management and curative treatment
- can take place anywhere you call home
- dr, nurse, social work, chaplain, dietician

Question 17

Biotherapy

Answer 17

the treatment of disease using substances obtained or derived from living organisms.
Immunotherapy, immunosuppressives

Question 18

Hormone therapy

Answer 18

a cancer treatment that slows or stops the growth of cancer that uses hormones to grow

e.g.: prostate cancer… men take estrogen to stop the growth of the cancer because it can’t grow if estrogen is present - has many side effects

Question 19

Role of OT in curative care

Answer 19

Remediation of strength, AROM, endurance, cognitive impact and function
Accommodations for short term deficits
Lymphedema

Education on:
- Skin care
- Energy conservation
- Coping skills

Likely setting: inpatient, cancer center, outpatient, assisted living, HH, step down unit

Question 20

Role of OT is palliative care and hospice

Answer 20

Symptom management
- Caution regarding modalities
Function and ADLs
- Adaptations
Seating/pressure care
Adaptive equipment
Home assessment
Minimizing barriers to participation
Directing ones own healthcare/family education

Question 21

Palliative care benefits and how OT can contribute

Answer 21

Physical
- relieve pain: orthotics, PAMs, positioning, massage, ther ex, activity adaptation
- manage symtoms
- mitigate discomfort

Psychosocial
- provide emotional and mental support
- fulfill goals and desires
- family education, setting of appropriate achievable goals

Spiritual
- mobility to get them places, adaptations (virtual)
- empowerment
- finding purpose and closure

Question 22

Changes in the genitourinary system for the elderly

Answer 22

Kidneys decrease in volume, size and adaptability
Bladder muscles weaken
- Difficult to postpone voiding
- Bladder capacity can decrease by as much as 50%
Prostate Hyperplasia
- Over 80 have a 90% chance of developing benign hyperplasia
- Increase risk of cancer
Urethral closure pressure declines
“leaking”
Genital atrophy
- Decreased libido
- ED
- Dryness
- Prolapse

Question 23

Changes in the GI system for the elderly

Answer 23

Oral cavity changes
Decreased peristalsis in the esophagus
- reflux
Delayed emptying of the stomach
- indigestion
Decreased absorption in the intestines
- Wt loss
- Impact to medications
Increased bowel control and risk of impaction

Question 24

Integumentary system in the aging

Answer 24

Thinning of the skin
- Risk of shear injuries
Epithelial turn over rate slows down
- Slower healing
Loss of hair, decreased sebum and sweat gland production
- Increase in wrinkles
- Benign lesions
Weakening of blood vessels and nerves
- Bruising
- Increase risk of decubitus or pressure sores
Increase in skin disorders
- Cancer, itching, psoriasis etc

Question 25

Grade 1 pressure sores

Answer 25

Non-blanchable erythema of intact skin
Discoloration of the skin, warmth, edema, induration or hardness may also be used as indicators, particularly on individuals with darker skin

Question 26

Unstageable

Answer 26

Full-thickness pressure injuries in which the base is obscured by slough and/or eschar

Question 27

Grade 2 pressure sore

Answer 27

Partial thickness skin loss involving epidermis, dermis, or both.
Ulcer is superficial and presents clinically as an abrasion or blister

Question 28

Grade 3 pressure sore

Answer 28

Full thickness skin loss involving damage to or necrosis of subcutaneous tissue that may extend down to, but not through underlying fascia

Question 29

Grade 4 pressure sore

Answer 29

Extensive destruction, tissue necrosis, or damage to muscle, bone, or supporting structures with or without full thickness skin loss

Question 30

Vessel changes in the aging

Answer 30

Neurons and glial cells, synapses and nerve cells decline and slow
- PVD and PAD
- Loss of sensation
- Discomfort