Cancer and Neurological Systems Flashcards
What is cancer?
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
What is carcinoma?
epithelial tissue (80-90%)
What is sarcoma?
connective tissue (bone, muscle, tendon)
Myeloma
plasma and bone marrow
Leukemia
blood forming tissue
Lymphoma
cancer of the lymphatic system
Benign
growing slowly without the propensity to become malignant or metastasizing
Metastatic
usually by way of blood stream or lymphatic system spread throughout the body
Malignant
tumors have cells that grow uncontrollably and spread locally and/or to distant sites
Causes of cancer
Diet
Infections from viruses
Physical inactivity
Overweight
Genetics
Alcohol use
Tobacco use
Occupational risk including radiation
Drug intake
Carcinogenesis
have to potential to cause cancer
Possible reasons for cancer increase in the aging
Carcinogenesis
Aging cells
IARC Classifications
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
What primary prevention programs can be used with the aging to prevent cancer?
Avoidance of carcinogens
Increased activity
Changes to diet and lifestyle
Chemoprevention
Curative approach to cancer treatment
Radiation
Chemotherapy
Surgery
- Limb or organ loss
Biotherapy
Hormone therapy
Palliative approach to cancer treatment
Radiation
Chemotherapy
Therapy
Medication
Alternative medicine
Hospice
Hospice vs. Palliative Care
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
Biotherapy
the treatment of disease using substances obtained or derived from living organisms.
Immunotherapy, immunosuppressives
Hormone therapy
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
Role of OT in curative care
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
Role of OT is palliative care and hospice
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
Palliative care benefits and how OT can contribute
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
Changes in the genitourinary system for the elderly
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
Changes in the GI system for the elderly
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
Integumentary system in the aging
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
Grade 1 pressure sores
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
Unstageable
Full-thickness pressure injuries in which the base is obscured by slough and/or eschar
Grade 2 pressure sore
Partial thickness skin loss involving epidermis, dermis, or both.
Ulcer is superficial and presents clinically as an abrasion or blister
Grade 3 pressure sore
Full thickness skin loss involving damage to or necrosis of subcutaneous tissue that may extend down to, but not through underlying fascia
Grade 4 pressure sore
Extensive destruction, tissue necrosis, or damage to muscle, bone, or supporting structures with or without full thickness skin loss
Vessel changes in the aging
Neurons and glial cells, synapses and nerve cells decline and slow
- PVD and PAD
- Loss of sensation
- Discomfort
