Cancer Class 3 - Medical Protocols & Massage Therapy - Surgery Flashcards
The most effective treatment option is to ______ localized cancer. It may include chemo and/or radiation pre/post-surgery.
Remove
______________ surgery is not really a cancer surgery. It improves the __________/function of an area impacted by cancer.
Reconstructive
Appearance
__________ surgery involves physically removing and examining a sample of cells called a ______.
Diagnostic
Biopsy
T/F - Diagnostic surgery is looking for metaplasia.
False - Diagnostic surgery is looking for ANAPLASIA.
____________ surgery is commonly referred to as preventative surgery, where no cancer cells are present yet.
Prophylactic
If there is increased an risk of breast cancer, a __________ can be performed as a ____________ surgery.
Mastectomy
Prophylactic
__________ surgery is for patients that are terminally ill and it improves their quality of life.
Palliation
__________ surgery is used to reduce the tumour load if there are multiple tumors present. They would remove the biggest ones and follow-up with ____________, in hopes that the immune system can deal with the smaller ones.
Debulking
Chemotherapy
When there is no presence of cancer cells in the periphery of the tissue sample.
Clear Margins
Some post-surgical ______________/precautions for a patient with any recent surgical procedure (__-__ weeks ago) include:
- Trauma to the body (e.g. physical, mental, emotional)
- Consider hygiene (e.g. incision from surgery)
- Be careful with traction and PROM
- Positioning
Considerations
1-2 Weeks
The expected presentation of post-surgical tissue (1-2 weeks ago) is _____.
S.H.A.R.P. (Swelling, Heat, Altered Function, Redness, Pain)
T/F - Massage therapists can begin onsite treatment to a post-surgical incision after 4-6 weeks.
False - Massage therapists can begin onsite treatment to a post-surgical incision ASAP.
The following are absolute general _________________ to treating a patient post-surgery:
- Fever
- Septicemia
- Patient unwillingness
- Unstable vital signs
- Certain drugs
Contraindications
The following are aspects of good ____ resolution:
- Aesthetically pleasing
- No pain
- Flexibility and proper collagen alignment following functional lines of stress and movement patterns
- Sufficient perfusion and drainage
- Normal sensation
- No nerve compression
Scar
Our role as massage therapists when beginning on-site work post-surgery for the general population is to promote good ____ tissue and help the patient with ____________ levels.
Scar Tissue
Dissociation Levels
From 24-48 hours post-surgery, a seal or _____ will develop as a barrier against germs. We want to use the __ inch avoidance rule, as this is a local contraindication for massage.
Crust
4 inch
For the first 5 days post-surgery, there will be formation of ___________ tissue, which is very delicate, sensitive and cannot withstand ________.
Granulation
Pressure
T/F - Formation of granulation tissue is not a local contraindication for massage.
False - Formation of granulation tissue IS a local contraindication for massage.
From __ to ___ days post-surgery, the sutures or stitches are removed.
5-10 days
From 7-10 days, there is light _______________ (aka. proliferation) if “clean healing” is happening. This means there is adequate _________ and absence of infection.
Collagenization
Perfusion
T/F - Ideally we would want to begin our scar work techniques at the 2 week post-surgery mark.
True
From __ to __ weeks, there is heavy collagenization (aka. consolidation/___________).
4-6 weeks
Remodelling
T/F - For cancer patients, it is much harder to follow a typical time frame when it comes to massage therapy post-surgery.
True
Some adverse __________ for cancer patients that would delay/absolutely contraindicate onsite manual work include:
- Acute inflammation (SHARP signs)
- Immunocompromised patients (presence of infection)
- Potential thrombosis (DVT)
- Oozing/lack of closure at surgical site (low WBC counts)
- Poor perfusion (less blood cells to promote healing)
- Actue sharp pain (aka. cancer pain, paradoxical pain)
- Skin is too fragile (modify techniques)
Indicators
There will be _________ immune function in the first week post-surgery. The concern for massage will depend on if clear _______ where achieved or not.
Decreased
Margins
T/F - If clear margins were achieved, it means that they managed to successfully take out the cancer. This is not a high level of concern for massage.
True
T/F - If clear margins were not achieved, there is still a high level of cancer cells. However, this is not a definite concern for massage and we don’t need to check-in with a professional prior to treating.
False - If clear margins were not achieved, there is still a high level of cancer cells. THIS IS a definite concern for massage and we NEED TO check-in with a professional prior to treating.
There may be more fluctuations in ____________ and tissue status, depending on their cancer journey.
Inflammation
T/F - Cancer patients are at a lower risk for infection, but if they do contract something they will have more difficulty fighting it.
False - Cancer patients are at a HIGHER risk for infection, AND if they do contract something they will have more difficulty fighting it.
Cancer patients can have an increased or decreased risk of ___________ problems, depending on the type of cancer they have and if their drug cocktail affects their ability to clot.
Coagulation
There may be slower or poorer quality of _______ for cancer patients.
Healing
____________ may be a factor for cancer patients, especially if they aren’t feeling well due to cancer toxicity and side effects of chemotherapy.
Malnutrition
T/F - Chemotherapy and radiation can delay, completely stop or even reverse healing of scar tissue for cancer patients.
True
_______ can be extensive and cause decreased function/vulnerability of multiple structures.
Surgery
T/F - Extra structures, such as lymph nodes or part of the esophagus, can be removed during surgery to ensure clear margins are achieved.
True
Involves a horizontal incision and short cut in the axillary area. They are placed at the end of an extensive surgery to prevent hematoma and decrease congestion.
Drains
______ are tunnelled under the skin to the surgical site and are kept in place with a stitch. _____ will fill with fluid and are then emptied, along with the tubes being flushed with ______.
Drains
Bulbs
Saline
T/F - Drains are kept in for 1 week, or when there is less than 2-3 tbsp of fluid collected in a day.
False - Drains are kept in for 2-3 WEEKS, or when there is less than 2-3 tbsp of fluid collected in a day.
T/F - Patients won’t typically complain about the small drain incisions compared to the large surgical incision.
False - Patients WILL typically complain MORE about the small drain incisions compared to the large surgical incision.
It is important to be aware that post-surgical _____ can create disablement, disfigurement and have an emotional impact on the cancer patient.
Scars
Some issues related to _____ for cancer patients include:
- Decreased ROM
- Increased pain
- Potential nerve entrapment
- Poor perfusion
- Secondary issues (e.g. compression syndromes)
Scars
A type of surgery related to intestinal cancer in which a hole is created in the abdominal wall (stoma) that allows waste to leave the body.
Ostomy
Some major concerns for RMTs related to _____ bags include:
- Don’t lay patient on bag
- Raise bag above level of body
- Be aware of infection
- Ensure proper communication during turning
- Check-in about emptying bag before treatment
Stoma
