Lecture 05-Cancer Flashcards
___ are cells that have an abnormal growth pattern.
Neoplasms
What are 3 general categories of neoplasms?
- benign
- invasive
- metastatic
Which type of neoplasms are self-limited in their growth and do not invade or metastasize?
Benign neoplasms
Neoplasms have become ___ when they invade and destory adjacent tissues.
Invasive
The neoplasm has formed distant ___ when they spread to other locations in the body.
Metastases
- Note; metastisis = spread of cancer cells from primary site to secondary site
What are the 5 clinical modes of dissemination of metastic neoplasms?
- direct extension to surrounding tissue (A)
- permeation through lymphatic tissue (B)
- emolism to lymph nodes (through lympathic tissue) C
- emoblism via blood vessels (D)
- invasion of body activity through effusion (E)
What are unmodifiable risk factors for cancer?
- age
- ethnicity
- family history and genetics (skin color, gender, congential disease, mutations)
- previous infections
Modifable risk factors for cancer can include:
environment and lifestyle
- sexually transmitted infections (STI’s)
- tobacco
- occupation and local environment
- ionizing radiation
- military workers
- sedentary
What is the single most important risk factor for cancer in patient’s without a history of cancer?
Age > 50 yrs
What are common symptoms of metastic cancer with these sites (PT’s may be able to identify)
- brain
- respiratory
- liver
- MSK
- Brain: headaches, seizures, and vertigo
- respiratory: cough hemoptysis and dyspnea
- liver: jaundice
- MSK: pain, fractures and neurological signs (neural compression)
What are the ABC’s of early stage of melanoma?
- A = ASYMMETRY => uneven edges, lopsided in shape, one-half unlike the other half
- B = BORDER => irregularity, irregular edges, scalloped or poorly defined edges
- C = COLOR => black, shades of brown, red, white, occasionally blue
- D = DIAMETER => larger than a pencil eraser
- E = EVOLVING => mole or skin lesion that looks different from the rest or is changing in size, shape, or colore
Types of cancer:
- __ occurs in epithelial tissue and accounts for 85% of all cancers (skin, large intestine, stomach, breast, lung)
- __ occurs in connective tissue => named for specific tissue
- ___ => arise from bone marrow (lymphoma, leukemia, multiple myeloma)
- Carcinoma
- Sarcoma (i.e, osteosarcoma)
- bloodborne cancers
The following are symptoms of ___ metastasis, which, if present with recent onset, may be indicative of an acute case.
- pain
- fracture(s)
- mechanical instability
- neurological deficits such as paralysis and/or bowel and bladder dysfunction
Spinal mestastasis
- median survival is 10 months
- cord compression is typically seen as a pre-terminal event (median survival of about 3 months)
What are the 4 classic clinical factors for malignancy (according to to the American Cancer Society)?
- age > 50
- previous history of cancer
- unexplained weight loss (> 10 lbs over 6 months)
- failure to improve after 1 month of therapy
Note; absence of all four confidently rule out malignancy (CPR has 100% sensitivity, low specificity)
What is the single most sensitive clinical sign for ruling in/out cancer independent of the american cancer society CPG’s?
No relief with bedrest (sensitivity > 0.9)
- absense of this signficantly reduces the odds of malignancy to about a fifth of the starting odss
What is the only finding specific enough to signifcantly increase the odds of malignancy?
Previous history of cancer
- other factors [to be] considered: duration of symptoms (> 1 month), insidious onset of symptoms, no relief with bedrest
What are some ealry warning signs of cancer that PTs may be able to detect?
- changes in bowel/bladder habits
- a sore that does not heal in 6 wks
- unusual bleed or discharge
- thickening or lump in breast or elsewhere
- indigestion or difficulty swallowing
- obvious changes in a wart or mole
- nagging cough or hoarsness
All of which can be detected through the review of systems, subjective screen, or system assessment (integumentary)
What are primary prevention goals for PT?
What are secondary prevention goals?
Primary
- general health promotion
- risk factor assessment
- risk factor reduction
Secondary
- early identification (not diagnosis)
- prompt intervention
What are the 2 major factors of the cancer prevention model that PTs can help with?
- Screening: early detection of cancer => education to promote early diagnosis and screening
- health promotion/education: primary prevention = avoidance of exposure to cancer-causing agents (i.e, tobacco, industrial carcinogens, etc.)
