Oncology Flashcards
What type of cancer is responsible for the greatest number of deaths in men and women?
Lung and Bronchus
Which cancer will have the most new cases in men in 2013?
Prostate cancer
Which cancer will have the most new cases in women in 2013?
Breast cancer
What is a primary tumor?
arises from cells that are normally local to the given structure.
What is a secondary tumor?
Arises from cells that have metastasized from other parts of the body.
What is a benign neoplasm?
New growth that is usually harmless, doesn’t spread
What is a malignant neoplasm?
New growth that is harmful and usually spreads.
What is the somatic mutation theory?
neoplasm arises from a single cell that with a genetic change. A chromosomal aberration creates tumor cell proliferation due to addition, deletion, translocation or inversion of part or an entire chromosome.
Why is tumor staging important?
Gives info about potential for metastasis
What are some non-modifiable risk factors for cancer?
Age (>50), family history (1st gen), Previous history of CA, Ethnicity, skin color, gender, heredity, Age of menopause, inflammatory bowel dz, fat distribution patterns, congenital dz
What are some modifiable risk factors for CA?
smoking, chemical exposure, urban dwelling, ETOH (>1-2 drinks/day), Sedentary lifestyle, obesity, insulin resistance, estrogen replacement, STD’s, organ transplant, chronic exposure to UV, geographic location, lack of access to or use of healthcare.
What does CAUTIONS relate to for early warning signs of cancer?
Changes in bowel or bladder habbits A sore that doesn't heal in 6 wks Unusual bleeding or discharge Thickening or limp in breast, elsewhere Indigestion or difficulty in swallowing Obvious change in wart or mole Nagging cough or hoarseness Supplemental signs and symptoms (rapid unintentional weight loss, changes in vital signs, freq. infection, night pain, pathologic fracture, proximal muscle weakness, changes in DTR)
What are some early warning signs for PT’s?
Night pain that cant be reproduced with testing Proximal muscle weakness Changes in vital signs Changes in DTR pathologic fracture rapid, unintentional weight loss
What are the ABC(DE)’s of early melanoma signs?
A-assymetry, 1/2 doesn't look like other B-border, irregular, poorly defined C-color,shades of brown, red, white D-diameter, larger than a pencil eraser E-Elevation, raised above surface of skin, uneven
What are some general systemic effects of Cancer?
Nausea, vomiting, anorexia, fever without infection, depression and/or anxiety
What is the occurrence of pain in cancer patients?
50-70% of early stage pts experience pain while 60-90% of late stage pts experience pain.
What are the different factors that cause pain in cancer patients?
Nerve infiltration or compression (sharp stabbing pain)
Ischemic pain (throbbing)
From diagnostic or therapeutic procedures
from bone destruction
from compression of viscera
Which cancer sites will PT’s note?
Skeletal, CNS (spinal or nerve root compression, seizures and or changes in mental status), Pulmonary (persistent cough, pleural pain etc_), Hepatic (associated with increase likelihood of bilateral carpal tunnel syndrome)
What percentage of patients w/ newly diagnosed canger have clinically detectable metastasized cancer
30%
What percentage of patients w/ newly diagnosed canger have hidden metastasized cancer?
30-40%
How soon after initial diagnosis is metastasized cancer usuall seen?
around 3-5 years
What % of tumor cells released into blood stream are killed and in what time frame?
99% of tumor cells within 24 hrs
What type of vessel is more common for cancer to metastasize through?
veins due to the much stronger arterial walls
What is the primary metastasis site for breast cancer?
Bone (shoulder, hip, ribs, vertebrae) CNS
What is the primary metastasis site for colon CA?
Bone (vertebrae, hip), peritoneum, liver, lung
What is the primary metastasis site for kidney cancer?
pelvis, groin, lungs, pleural cavity, bone, liver
What is the primary metastasis site for Lung cancer?
CNS, bone (post rib), mediastinum
What is the primary metastasis site for ovarian cancer?
Nearby organs, liver, lungs (not usually past abdomen)
What is the primary metastasis site for prostate cancer?
Lymphatics, pelvis, vertebrae, bladder, rectum
What are the most common sites for bone metastasis?
Vertebrae (60% thoracic, 30% lumbar), pelvis, ribs (posterior), skull, femur (proximal), humerus (proximal)
What are the most common sites of metastasis?
Pulmonary systems, hepatic systems, bone, CNS, lymphatic system
What type of cancer is more likely to present with musculoskeletal signs and symptoms?
Secondary cancer metastasized from a different part of the body (as opposed to primary cancer arising from a bony structure)
What are the three different types of surgical resection?
Primary tumor resection (therapeutic/prophylactic lymph node removal) Cytoreductive resection (debulking) Pallative resection (reduce pain, correct obstruction, alleviate pressure)
Side effects of surgical resection?
fatigue, disfigurement, loss of function, infection, increased pain, bleeding, scar tissue, fibrosis
What is biotherapy?
change/modify relationship btwn tumor and host by strengthening the hosts biological resopnse to the tumor
What are examples of biotherapy?
Bone marrow or stem cell transplant
What is the difference btwn an autogenic or allogenic transplant?
autogenic-transplant from self
allogenic-transplant from someone else
When is the nadir for biotherapy?
5-7 days
What is radiation therapy ideal for?
Localized lesions
What are the two different delivery methods?
External and internal delivery
What is the goal for external delivery of radiation?
deliver the maximal dosage for maximal tumor control, while minimizing severe sequelae in normal tissue
What type of device is used for radiation therapy?
An ionizing beam via a linear accelerator
What does stereotactically refer to in radiation therapy?
You apply the radiation to the same spot every time
How is internal delivery of radiation administered?
intracavity & interstitial implants
What type of cancer does chemotherapy work best for?
Widespread or metastatic disease
What type of cells do chemotherapeutic agents affect?
Dividing cells
What is the goal of chemotherapy?
deliver maximal dosage to maximize cell kill often limited by toxicity.
Are all CA cells killed with chemotherapy?
no, not all killed by chemotherapy.
Are cancer cells stable or unstable?
Unstable, can replicate into other tumor cells that won’t be treated by the same chemo agent
What are the different mechanisms of delivery for chemotherapy?
Intravenous, arterial infusion, intrathecal, intramuscularly, orally, interstitial
What is leukopenia?
decrease in WBC
What WBC range poses a minimal risk of infection?
1000-5000
What WBC range poses a moderate risk of infection?
500-1000
What WBC range poses a serious risk of infection?
<500
What percentage of cancer pts have abnormalities in the clotting mechanism?
~50%
What elements of the tumor disrupt the clotting sequence?
mechanical and cellular products
What is the most prevalent sign of hypercoagulability in cancer patients?
Deep vein trhombosis
What is the most frequent, non-specific complaint of cancer patients?
fatigue
What effect does exercise have on cancer patients?
exercise reduces fatigue in cancer patients
When is cancer cured/complete remission?
After 5 years, all signs of disease gone
How is survival rate expressed?
chance of being alive @ 1-, 5-, and 10- year mark
What is partial remission?
tumor is 1/2 of original size
What are the three question when a PT observes, palpates or receives a patients report of a lump or nodule?
Is this new?
Has the size changed?
Dose your MD know?
What are some areas to focus on during PT with a CA patient?
Pain endurance, fatigue Therex Modalities Current or future treatments Pt and family goals Pt and family knowledge of diagnostic, prognosis
What are some interventions for CA patients?
Energy conservation and functional retraining
