Episodic Diseases - oncology, anemia, neutropenia, thrombocytopenia, Lymphedema Flashcards
___/___ canadians will get cancer, __/___ will die from cancer
2/5, 1/4
Which forms of cancer are most common in men
Prostate
Lung
Colon
Which types of cancer are most common in women
Breast
Lung
Colon
What TMN system used for the staging cancer
tumour, nodes, mets
What are the stages of tumours (extent/spread)
TX - cannot be evaluated
T0 - tumor in situ
T1-4
What are the stages of nodes (lymph)
- Nx
- N0 (no lymph nodes involvement)
- N1-3 (extend of spread or # involved)
What are the stages of mets (distant ones)
- Mx
- M0 (no)
- M1 (distant metastasis present)
What are the stages of cancer
- Stage 0 = carcinoma in situ
- Stage 1-3 (cancer has extended beyond organ in which it first developed)*?
- Stage 4 (cancer has spread to different organs)
5 Medical treatment options for cancer
- Surgery
- Chemotherapy
- Radiation
- Hormone replacement surgery
- Biological or genetic treatment to destroy cancer cells
Side effects of chemotherapy
- alopecia
- mucositis
- pulmonary fibrosis
- cardiotoxicity
- renal failure
- sterility
- myalgia
- neuropathy
Side effects of radiation
- skin irritation
- scar tissue
- hair loss (permanent or transient
- temp change in skin colour
- FATIGUE
- swallowing discomfort
What is oncology
The study and treatment of tumours
What is the clinical presentation of oncology (tumour treatment)
- ROM limitations (need shoulder range for radiation in breast cancer)
- fatigue
- myalgia
- arthralgia
- chemotherapy induced peripheral neuropathy
- deconditioning
- look for any recurring signs of cancer
Oncology PT Rx
- fatigue management
- function and mobility management
- physical symptom management
- psychological symptom management
REHAB
- preventive, supportive, or restorative
ACUTE SETTING
- mobility (including eqp), general strength and mobility, and bed positioning
Oncology exercise precautions
- Swollen ankle
- fatigue
- vomiting and diarrhea
- unexplained weight loss/gain
- SOB with low level of exertion
Oncology exercise precautions
- racing pulse, fever, pain in back or neck or bone, calf pain, chest pain
- nauseated while exercising, confused or disorientated, dizzy or faint
- blurred vision, sudden SOB, very weak or tired
Safety guidelines for metastatic disease
- follow protocols from MD (need weight bearing order not just AAT)
- ask about any new neurological symptoms (B/B, unrelenting pain)
What is anemia
Condition in which you lack enough healthy red blood cells to carry adequate oxygen to your body’s tissues.
What are safety guidelines for exercise with people with anemia
Exercise needs to be scaled back if below 8G/DL
What is Neutopenia?
Decreased WBC
• relates to body’s ability to fight infection
What should WBC levels be
> 1000 mcL
The rate of infection increases if absolute neutrophils falls below ___
500MCL
Safety guidelines for exercise with neutropenia
- avoid public fitness or areas, facilities and activities with inc exposure to viral and/or bac infection
- avoid exercise if have fever (temp greater than 37.5 degree F)
What is thrombocytopenia ? what does it increase your risk of?
low platelet count (normal = 150-400, 000/mcL)
-Increased risk of bruising or bleeding (report any unusual bruising or symptoms to MD)
Safety guidelines for exercise with thrombocytopenia if <50,000 MCL
avoid activities with contact or risk of falling
What is appropriate exercises prescription if 40,000-60,000 MCL in Thrombocytopenia
low weights (1-2 lbs.), stationary bike low resistance, walking or ADLs
What is appropriate exercises prescription if 20,000-40,000 MCL in Thrombocytopenia
low intensity exercise, low weights (0-2 lbs.), stationary bike no resistance or minimal, walking, and ADLS
Safety precautions for exercise with thrombocytopenia if <20,000 MCL
Increased risk of spontaneous bleed unrelated to trauma
What is appropriate exercises prescription if <20,000 MCL in Thrombocytopenia
doctor approval, active ROM exercises, walking, ADLS (may need supervision)
Safety precautions for exercise with thrombocytopenia if <10,000 MCL
spontaneous CNS, GI, or respiratory tract bleeding may also occur
What is appropriate exercises prescription if <10,000 MCL in Thrombocytopenia
no exercise, only essential ADLs, prevent falls and injury
What is the function of the lymph system? via what mechanism does it accomplish this function
- removal of fluid, proteins, bacteria, viruses
- smooth mm in walls contract to move lymph
What are the two types of lymphedema
Primary
Seconday
What is primary lymphedema
rare, inherited condition that development problems occur in lymph vessels
What is secondary lymphedema
D/T damage to or obstruction to normally functioning lymph vessels and nodes
Lymphedema risk factors
- Radiation
- axillary node dissection
- Arm infection/virus (primary thought cause)
- weight gain since operation
- obesity (BMI >25)
- older age
Lymphedema prevention
- skin care
- activity/lifestyle (body weight gradual buildup of activity)
- avoid limb constriction (jewelry, clothes, BP cuffs on that side)
- avoid extreme temp
Lyphedema outcome measures
- circumferential (greater than 2 cm difference side to side)
- water displacement
- perometer and bioelectrical impedance
PT role is treating lymphedema
- Prevention à weight loss through exercise
- Education: what to avoid, S/S to watch for
Is physical activity safe for those with lymphedema
Yes, o prior, during, and post treatment is safe, however may have other variable to consider & check on change daily
