Ch. 21 - Cancer Flashcards
What is cancer’s ranking as a cause of death in the U.S.?
The second leading cause of death
What are some recommendations to lower the risk of cancer?
- Avoid tobacco use
- Maintain healthy body weight
- Avoid or limit alcohol
- Be physically active
What was the ranking of malignant neoplasms (cancer) as a leading cause of death in Canada in 2023?
1
How is cancer defined?
As a group of diseases that arise from the uncontrolled growth and spread of abnormal cells
What are the two main categories of risk factors for cancer?
- Non-modifiable (e.g., genetic mutations)
- Potentially modifiable (e.g., tobacco use, physical activity, diet)
Who are the authors referenced for the Cancer Exercise Programming section?
Hayes et al.
What are the recommended FITT principles for aerobic exercise for cancer patients?
- F: 3 days/wk (not deconditioned) or daily (deconditioned)
- I: Moderate intensity (40-60% HRR; 12-13/20 RPE)
- T: 20 min (not deconditioned) or accumulating bouts of 20 min (deconditioned)
- T: Various large muscle group activities
What are the recommended FITT principles for resistance training for cancer patients?
- F: 2 sessions/wk with 48 hours of recovery between them
- I: Moderate to high intensity
- T: Maximize hypertrophy training (increased volume) to combat cachexia and sarcopenia
- T: Dynamic and isometric training may be used (various modalities)
What are some benefits of exercise in the context of cancer?
Benefits in the prevention of many cancers as well as after a cancer diagnosis, during the treatment phase, and into recent posttreatment or long-term survivorship
What is key for individuals undergoing cancer treatment regarding exercise?
Medical evaluation
1. What is lymphedema?
2. What is a common cause?
3. What type of exercise is recommended?
1. Accumulation of protein-rich fluid resulting in swelling in various body regions
2. Usually a result of surgical procedures (excision of cancerous tumor)
3. Combined aerobic and RT Ex
1. What are bone metastases?
2. What are some risks associated with bone metastases?
3. What are some exercise modifications for bone metastases?
1. Secondary cancerous lesions that affect a bone or bones
2. Increases fracture risk, bone marrow suppression (infection), nerve and spinal cord suppression
3. Avoid exercise directly loading area of lesion; jumping exercise contraindicated; EX intensity determined by pain tolerance
1. What is neuropathy in the context of cancer treatment?
2. What are some exercise considerations for neuropathy?
1. Associated with chemotherapy Tx and involved pain, numbness, balance issues, ‘pins and needles’ feeling
2. If unstable due to balance issues provide appropriate mode of exercise to ensure stability (supported TM walking, seated vs. standing RT exercises)
* Low impact exercises may be necessary; supervision recommended until deemed safe on their own
Why is infection a significant concern for cancer patients?
Due to immune suppression
When is exercise contraindicated in the presence of infection?
Until infection has resolved
1. What cancer treatments can result in cardiovascular toxicity?
2. What are some potential heart effects?
1. Chemotherapy, immunotherapy and radiation
2. Changes in resting myocardial function (SBP/DBP/MAP)
* Decreased left ventricular ejection fraction
* Development of heart failure
* Decreased aerobic fitness
What is recommended regarding exercise for individuals with cardiovascular toxicity?
Supervision for Ex is recommended; be aware of contraindications to Ex
What is cancer-related fatigue?
Subjective feeling of physical and emotional tiredness due to cancer and/or cancer Tx
What is the exercise recommendation for cancer-related fatigue?
Follow recommendations but monitor for changes in fatigue related to Ex prescription; total rest will exacerbate fatigue
Should exercise be continued if fatigue is present?
Lower intensity if necessary but continue to use Ex to help combat fatigue
What is cachexia?
Involuntary weight loss adversely affecting function, QoL, and survivability
What are some considerations for exercise in the presence of cachexia?
- Consider monitoring diet to see if low in total kcal; persistent catabolic state present?
- Lower the amount of high energy expenditure Ex; consult dietician, increase energy intake and protein rich foods
What might cachexia indicate?
That end of life care may be necessary
