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Complex Pt Management > Cancer Rehabilitation II > Flashcards

Cancer Rehabilitation II Flashcards

1
Q

What are the goals of chemotherapy?

A

Cure (remission)
Control (tumor size)
Palliation

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2
Q

What is chemotherapy?

A

Any drug used to treat disease

  • Systemic method of cancer treatment
  • Tailored to pt and tumor
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3
Q

What is the G0 phase in a cell cycle

A

Cells have not yet started to divide, (where most cells are)

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4
Q

What is the G1 phase in a cell cycle?

A

The cell starts making proteins and grows larger, new cells of normal size. last 18-30 hours

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5
Q

What is the S phase of the cell cycle?

A

DNA is copied, new cells formed have matching DNA strands

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6
Q

What is the G2 phase?

A

cell checks DNA and gets ready to start splitting into 2 cells
Last 2-10 hours

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7
Q

What is the M phase?

A

Mitosis - 30-60 minutes, cell splits into 2

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8
Q

What categories of chemo are cell cycle phase non specific?

A
  • Alkylating agents
  • Antitumor antibiotic
  • Platinum compounds
  • Mitotic inhibitors
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9
Q

What categories of chemo only affect S phase?

A

Antimetabolites

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10
Q

What categories of chemo only affect S and M phase?

A

Plant alkaloids

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11
Q

What categories of chemo only affect S and G2 phase?

A

Topoisomerase inhibitors

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12
Q

What is the goal of radiation therapy?

A

Curative or palliative

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13
Q

What are some methods of radiation therapy?

A
  • External beam radiation - teletherapy
  • Internal radiation - Brachytherapy
  • Systemic
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14
Q

Describe the radiation planning process w/ external beam?

A
  • Temp skin marks/tattos and positioning (make sure its the right spot)
    Treatment: 5-10 min
    Daily 5-6 weeks
    Measured in Grays (Gy)
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15
Q

Describe 40Gy dosage

A

Skin effects

  • hair loss occurs > 1 Gy
  • Dryness of glands
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16
Q

Describe 50Gy dosage

A

Bone effects

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17
Q

Describe 60Gy Dosage

A

Soft tissue effect

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18
Q

Describe 70Gy

A

Muscle and tendon effects

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19
Q

How is the Gy defined?

A

Irradiation absorbed by each kg of tissue expressed as Grays (Gy) - 2 Gy = 1J/kg of tissue

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20
Q

What is the purpose of Surgery for cancer?

A

physical removal of all or most of primary tumor, may involve removal of nearby lymph nodes that contain tumor mets

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21
Q

What is the purpose of External radiation?

A

Radiation outside of body, beams focused on tumor

22
Q

What is the purpose of Internal radiation?

A

Radiation source is inside body; capsules, seeds or needles of radioactive material placed in the tumor

23
Q

What is the purpose of systemic radiation?

A

Selective tumor absorption of all radioactive material

24
Q

What is targeted therapy?

A

Individualized therapies that target the underlying pathophysiology

25
Q

What are MSK side effects of cancer treatments?

A
  • OP (WB activities)
  • Change in body comp (cachexia or obesity) - PA, nutrition
  • Arthralgia (weight loss, AD, Thermo, Electro)
  • Decreased muscle strength (Progressive resistance, Ec, aquatic)
26
Q

What are neuro side effects of cancer?

A
  • cognitive changes (meditation, training)

- Peripheral neuropathy (Acupuncture, AD, aerobic/resistive ex)

27
Q

What are cardiopulmonary side effects of cancer?

A
  • L ventricular dysfunction (Cardiac rehab)
28
Q

What are the integumentary side effects of cancer?

A
  • Alopecia
  • Tissue fibrosis
  • Tissue necrosis
  • Hyperpigmentation
  • Lymphedma
29
Q

What populations have the higher symptom burder?

A
  • Women
  • Lung cancer patients
  • Person’s with lower income levels
  • Persons receiving palliative or hospice care
  • 1 in 2 reported pain or SOB
30
Q

What are the local effects of tumors?

A
  • Pain (absent until late stages (3-4)
  • Obstruction (tumor compresses)
  • Tissue necrosis and ulceration (may lead to bleeding or infection around the tumor)
31
Q

What are systemic effects of tumors?

A
  • Cachexia (loss of body weight and muscle mass - increased demands from tumor cells)
  • Anemia (blood loss at tumor site - nutritional deficits)
  • Infections - occur frequently as host resistance declines
  • Severe fatigue
  • Bleeding
  • Paraneoplastic syndrome - tumor cells secrete subances that cause neurological dysfunctions
32
Q

What is general exercise clearance for cancer?

A
  • Evaluate for comorbidities
  • Exercise testing not required for walking, flexibility and weight training
  • If needed follow ACSM testing and contraindications
  • Evaluate for lymphedema risk
33
Q

What is the preventative goal of PT?

A

Before the development of disability

Lessen severity or shorten duration

34
Q

What is the restorative goal of PT?

A
  • return to former status is expected w/o handicap or residual disease
  • return to gainful occupation
35
Q

What is the goal of supportive PT?

A
  • ongoing disease is controlled or slowly progressing

- maintain degree of function through training and care

36
Q

What is the goal of palliative PT?

A
  • Increasing disability is expected from disease

- Prevent or reduce complications

37
Q

What are the most common side effects of cancer?

A
  • Pain & fatigue = top 2
  • Anemia
  • Hair loss and integumentary issues
  • Gastrointestinal problems
  • Pain
  • Emotional distress
38
Q

How does physical activity affect anemia?

A

Aerobic exercise can increase total hemoglobin and reduce red cell mass

39
Q

What do you consider in exercise with GI patients?

A
  • Overdosing can inhibit gastric emptying, decrease GI absorption, or cause GI symptoms (including bleeding)
  • Know patients baseline
40
Q

What are the general exercise guidelines for older adults ?

A
  • 150 minutes a week moderate intensity aerobic exercise
  • 10 minute duration bouts
  • balance/fall prevention 3 times/week
  • Muscle strengthening 2 or more days a week
  • Start with low weights and reps
  • Assess exercise program weekly
  • avoid over training
41
Q

What is the FITT-VP principle

A
  • Frequency: up to 5x/wk - aerobic, 2-3 non consecutive -resistance
  • Intensity: 1-3 sets (8-16 reps) Progress second
  • Time: Progress first
  • Type: ACSM
42
Q

Describe how O2 is measured with exercise?

A
  • know pt’s baseline
  • norm = 95-100%
  • <90% = hypoxemia (temp due to exercise, can transition to hypoxia)
43
Q

What are the national standards for the Commission on Cacner?

A
    • Psychological distress screening
  • Patient navigation process
  • Survivorship care plan
44
Q

What is condition/region specific the best assessment?

A
  • assesses characteristic or activities most relevant to the condition or intervention
  • measures spectrum of health concepts including physical, social, and emotional
  • Characteristics of both generic health status and condition specific
45
Q

What is the prospective surveillance models?

A
  • Baseline assessments
  • regular screenings (3-6 months for first 3 years, 6-12 months for next 2 years, annually thereafter)
  • early ID and treatment side effects
  • Multidisciplinary approach
  • Model has been recommended
46
Q

Side effects of Methotrexate?

A
  • fever, chills, swollen lymph glands, night sweats, weight loss
  • Vomiting, white patches or sores inside your moth or on lips,
  • diarrhea, cough w/ mucus, stabbing chest pain, wheezing, feeling shortness of breath
  • Kidney problems
  • Live problems
  • Nerve problems
  • Signs of tumor breakdown (confusion, tiredness, numbness or tingling, muscle cramps, muscle weakness, vomiting, diarrhea, fast or slow HR)
47
Q

Side effects of 5FU antimetabolite

A

30%

  • Diarrhea
  • nausea and possible occasional vomiting
  • mouth sores
  • poor appetite
  • watery eyes, sensitivity to light
  • taste changes, metallic taste in mouth during infusion
  • discoloration along vein
  • Low blood counts
48
Q

Describe the dosage of radiation therapy and its effects?

A
  • 40gy = Skin, hair loss w/ <1 Gy, dryness of glands
  • 50gy = bone effects
  • 60gy= soft tissue effects
  • 70gy= muscle and tendon effects
49
Q

What are the 5 most common side effects and screening

A
  1. Fatigue (shortness of breath) - figure 8 walk test, stanford fatigue scale,
  2. Anemia - hemoglobin and hematocrit
  3. Hairloss or integumentary issues (symptom inventory tools)
  4. Gastrointestinal problems (symptom inventory tools)
  5. Pain (VAS, pain drawing, numerical pain scale)
50
Q

What is a possible intervention for anemia?

A

aerobic exercise to increase RBC production and hemoglobin

51
Q

What is a possible intervention for neuropathy?

A

aerobic exercise, therapeutic agents, balance

Complex Pt Management (12 decks)

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