Oncology

Question 1

benign tumor

Answer 1

• differentiated cells that reproduce at high rate and are encapsulated
• expand but do not spread to other tissues

Question 2

malignant tumor

Answer 2

• undifferentiated cells
• uncapsulated and grow uncontrollable
• invade other tissues and cause destruction to surrounding tissue

Question 3

primary vs secondary

Answer 3

primary - original tumor in original location

secondary - metastases that have moved from primary site

Question 4

dysplasia

Answer 4

variability of cell size and shape w/ increased rate of cell division
- can be precancerous change or result from chronic infection

Question 5

metaplasia

Answer 5

replacement of 1 mature cell type by a different mature cell type

Question 6

hyperplasia

Answer 6

increased number of cells resulting in enlarged tissue mass

- can be because of increased demand or pathological

Question 7

differentiation

Answer 7

cell resembles mature morphology and function

• well differentiated = physiological and functions as intended
• poorly differentiated = cell does not resemble a mature cell in both morphology and function

Question 8

S&S of cancer

Answer 8

• unusual bleeding or discharge
• unexplained weight loss of 10 lbs or more
• fever
• fatigue
• pain
• persistent cough or hoarseness w/o known cause
• skin changes

Question 9

stool guaiac

Answer 9

detects small quantities of blood in stool

Question 10

pap smear

Answer 10

type of biopsy in which cells from cervix are removed and examinated

Question 11

sputum cytology

Answer 11

sputum specimen is inspected for cancerous cells

Question 12

sigmoidoscopy

Answer 12

sigmoid colon is examined w/ sigmoidoscope

Question 13

colonoscopy

Answer 13

upper portion of the rectum is examined w/ colonoscope

Question 14

PET scan

Answer 14

dye injected to detect subtle changes in metabolic and chemical activity in body
- detect biopsy location, benign vs malignant, stage, cancer recurrence

Question 15

TNM system

Answer 15

T - extent (size/number) of primary tumor
N - lymph nodes involvement
M - presence or absence of metastasis

Question 16

TX, T0, Tis, T1-T4 meaning

Answer 16

TX - primary tumor cannot be assessed
T0 - no evidence of primary tumor
Tis - carcinoma in situ (site of origin)
T1-T4 - progressive increase in tumor size and local involvement

Question 17

NX, N0, N1-N3 meaning

Answer 17

NX - nodes cannot be assessed
N0 - no metastasis to local lymph nodes
N1-N3 - progressive involvement of local lymph nodes

Question 18

MX, M0, M1 meaning

Answer 18

MX -presence of distant metastasis cannot be assessed
M0 - no distant metastasis
M1 -presence of distant metastasis

Question 19

low grade vs high grade tumors

Answer 19

low grade - highly differentiated cells that more closely resemble original cells (less aggressive tumor)

high grade - less differentiated cells that are like original cells (more aggressive)

Question 20

GX, G1, G2, G3, G4 meaning

Answer 20

GX - undetermined grade, cannot be assessed
G1 - low grade, well-differentiated
G2 - intermediate grade, moderately differentiated tumor
G3 - high grade, poor differentiated tumor
G4 - high grade, undifferentiated tumor

Question 21

Undifferentiated cells have a _______ prognosis

Answer 21

poorer

Question 22

palliation

Answer 22

decreased tumor burden, improve QoL, relieve pain

• cure nor control possible
• focus on making patient as comfortable as possible

Question 23

adjuvent vs neoadjuvent

Answer 23

adjuvent - given in addition to primary treatment

neoadjuvant - given prior to “main” treatment to reduce size as much as possible

Question 24

What type of patient has the best chance of cure?

Answer 24

patient who has no lymph involvement (N0) and no metastases (M0)

Question 25

What type of patient has a poor chance of cure?

Answer 25

patient who has widespread lymph involvement (N2-3) and metastases (M1)

Question 26

indications for surgical management

Answer 26

- removal of precancerous or primary cancer - establish diagnosis by biopsy - assist in staging by sampling lymph nodes - reconstruction of limb or organ - palliative care - decompressive or bypass procedures

Question 27

primary objective to radiation

Answer 27

eradicate tumor while minimizing damage to healthy tissue

Question 28

3 options for radiation

Answer 28

- external beam radiation therapy (EBRT) - most common - brachytherapy - intraoperative radiation therapy (IORT)

Question 29

indications for radiation

Answer 29

- definitive treatment w/ intent to cure - neoadjuvant treatment - adjuvant treatment - prophylactic treatment - prevent growth of cancer - control to limit growth of existing cancer cells - palliation to relieve pain, prevent fracture, and enhance mobility when cure is not possible

Question 30

radiation considerations

Answer 30

- side effects - site-specific toxicities - antiemetics - use caution w/ skin that it has become fragile from radiation

Question 31

purpose of chemotherapy

Answer 31

inhibit various signaling pathways that control cancer proliferation, invasion, metastasis, angiogenesis, and cell death

Question 32

why does chemo affect multiple areas of the body?

Answer 32

Targeting replicating cells which is why hair loss, N&V (GI cells), and reproductive issues occur after chemo because they are affected as well

Question 33

chemotherapy PT considerations

Answer 33

- N/V may limit participation - nutritional status - decreased ability to consume/absorb nutrients - modifications in activities - fatigue - monitor vitals - nadir - 10-28 days after chemo and WBC are lowest - high risk for infection

Question 34

At what point does neutropenic precautions kick in?

Answer 34

< 1500 mm^3

Question 35

At what platelet level do you hold PT?

Answer 35

< 10,000 hold PT

Question 36

At what platelet level is no resisted exercise appropriate?

Answer 36

10k - 20k

Question 37

At what platelet level can the patient exercise w/ or w/o resistance?

Answer 37

> 20k

Question 38

specific chemo considerations

Answer 38

- neutropenia - lymphedema - memory problems - peripheral neuropathy - pain

Question 39

When should you withhold or stop exercise for patients on chemo?

Answer 39

- rest HR > 100 bpm - dyspnea - low diastolic BP - during exercise - abnormal BP response, abnormal fatigue, dizziness, nausea, pallor, excessive sweating

Question 40

What is biotherapy?

Answer 40

aka immunotherapy - uses the patient's native host defense as mechanisms to treat cancer - including cytokines, monoclonal antibodies, and vaccines

Question 41

Pain is a ______ risk for cancer patients

Answer 41

fall risk

Question 42

Why would a cancer patient have a deficit in ROM?

Answer 42

- scar formation after surgery - disuse of a joint following chemotherapy or surgery - fibrosis caused by irradiation

Question 43

______ leads to muscle weakness that is linked to poor balance and falls

Answer 43

sarcopenia

Question 44

Decreased endurance can lead to decreased ability to complete_______ related tasks

Answer 44

balance

Question 45

What Increases risk of postural control impairments, falls, and gait alterations in cancer patients?

Answer 45

sensory impairments from chemotherapy-induced peripheral neuropathy

Question 46

What is a predictor of falls in older cancer survivors?

Answer 46

limitations in full tandem stance

Question 47

________ is a leading cause of emotional distress in cancer survivors

Answer 47

physical disability

Question 48

_______ is more strongly related to level of disability than to the cancer diagnosis itself

Answer 48

distress

Question 49

general PT guidelines for cancer patients

Answer 49

- optimize functional mobility - minimize or prevent cancer-related fatigue - prevent joint contracture and skin breakdown - prevent or reduce limb edema - prevent postoperative pulmonary complications

Question 50

What should be done before and during exercise treatment for cancer patient? What kind of exercise should be done?

Answer 50

aerobic and resistive exercise before - rule out instability or decline in medical status before and during - monitor vitals

Question 51

Basal vs squamous cell cancer

Answer 51

basal - noduloulcerative lesion from sun on head, ears squamous - variable presentation of pink lesions to scaly plaques

Question 52

ABCDE rules

Answer 52

``` Asymmetry Border - irregular Color - varied Diameter - > 6mm Evolving - appearance changes ```

Question 53

What is the gold standard treatment for stage 1 and 2 lung cancer?

Answer 53

lobectomy

Question 54

What results in a very painful incision?

Answer 54

thoracic surgery for lung cancer