Oncology Flashcards
General signs and symptoms of cancer
CAUTION:
change in bowel/bladder routine
a sore that will not heal
unusual bleeding/discharge
thickening/lump develops
indigestion or difficulty swallowing
obvious change in wart/mole
nagging cough/hoarseness
Cancers of epithelium
carcinoma
adenocarcinoma
Connective tissue cancers
sarcoma
fibrosarcoma
liposarcoma
chondrosarcoma
osteosarcoma
hemangiosarcoma
leiomyosarcoma
rhabdomyosarcoma
Nerve tissue cancers
astrocytoma
glioma
neurilemma sarcoma
neuroblastoma
retinoblastoma
Hemotopoietic tissue cancers affect
examples
bone marrow and plasma cells
leukemia
myelodysplasia
myeloproliferative syndromes
multiple myeloma
Musculoskeletal pain complaints in cancer patients
should not be taken lightly
Bony pain complaints may relate to
primary site of malignancy or new matastasis
should be evaluated immediately as it could be indicative of spinal metastasis
Soft tissue complaints may relate to
medication side effects or physiological changes in tissue
What is used to classify tumors?
TNM
TNM classification system
T-malignancy based on size and extent of primary tumor
N-lymph node involvement
M- presence of metastasis
___ numbered stages are considered to have better overall prognosis.
lower
National Cancer Institute Staging:
0
1
2
3
4
early malignancy that is only present in layer of cells which it began. Not all cancers have a stage 0.
malignancy limited to tissue of origin with no lymph node involvement or metastasis.
malignancy spreading into adjacent tissues; lymph nodes may show signs of micrometastases.
malignancy that has spread to adjacent tissue showing signs of fixation to deeper structures. Lymph node invovlement is high.
malignancy that has metastasized beyond primary site like to bone or another organ.
Clinical staging vs pathologic staging
estimated extent of malignancy based on findings of physical exam, lab values, imaging and biopsy. Used in determining optimal course of treatment and establishes a baseline for ocmparison when assessing response.
vs.
staging based on pathology finding of tissue samples obtained during surgery.
Pathologic stage can differ from clinical stage when…
surgery reveals cancer has spread more than expected in relation to clinical staging.
gives health care team more precise info to predict treatment response and prognosis.
Most primary cancers outside the brain metastasize to
brain
If breast cancer returns, it is usually within
2 years of initial diagnosis
Usually signs and symptoms of bronchial carcinoma are
not present until disease is advanced
Cervical cancer has a precancerous condition called
dysplasia and is easily treatable
Primary cause of cervical cancer
HPV
Colorectal cancer types that account for majority
adenocarcinoma and primary lymphoma
There is ___ prognosis in lung cancer with expedited metastasis.
poor
Exercise guidelines for patients undergoing cancer treatments:
always check physician orders with those with bone metastases to verify WB status and clearance to perform mobility.
monitor blood values daily: esp platelets and hematocrit
exercise should be in range of 40-65% peak HR, HRR, VO2max; def under anaerobic threshold.
RPE should not exceed 12
visits should be scheduled during time of day when patient is at peak energy levels
modify treatment to accommodate side effects of medical treatment
____ disease is one of the most curable cancers.
Hodgkin
___ cancer is a prominent type with extremely high mortality rate.
pancreatic
____ is the most common type of prostate cancer.
____ cause of death in men.
Prognosis is ____ with treatment.
adenocarcinoma
second highest
good
_____ ____ carcinoma is a slow growing form of skin cancer that rarely metastasizes. Originates from epidermis and is most ___ form of skin cancer.
Prognosis is ___.
basal cell
common
good
Malignant melanoma peak incidence ___-___years old. Areas of metastases include
40-60
brain, lungs, liver, bone and skin
Astrocytoma accounts for ___% of pediatric brain tumors.
2 types
treatment
50
cerebellar
supratentorial
surgical resection offers 80-90% cure rate. Supratentorial also requires chemo/radiation.
Leukemia sxs
Over ___% patients with ALL achieve remission and ___-___% patients with AML achieve remission.
anemia, leukocyte count greater than 500,000 mm and thrombocytopenia
90%
70-80%
Neuroblastomas are found in
sympathetic nervous system
adrenal glands or paraspinal ganglia
most common malignant tumor in children
Prognosis is best for children diagnosed with neuroblastoma in first ___.
They can
year of life
spontaneously regress in rare cases
Osteogenic sarcoma occurs at
Most common form of ____ in _____.
peak ages it occurs ____-___.
Treatment____.
What is not effective against it?
epiphyses of long bones
most common form of bone cancer in children
peak ages 10-20
treatment is amputation
radiation is not effective with this type of tumor
Wilms’ tumor is an
most cases are diagnosed between what ages?
5 year cure rate
embryonal nephroblastoma found in the kidney
1-4
75%
Chemo can alter blood counts:
anemia, thrombocytopenia, neutropenia
all part of CBC
Patients who are anemic are advised to
change positions slowly, rest frequently, allow a full nights sleep
Thrombocytopenia refers to
low platelet levels
bruise easily
Neutropenia causes those with it to
develop serious infections
Biotherapy
utilizes various agents and/or techniques to change relationship between malignancy and its host.
acts to strengthen patient’s biological response to malignant cells
Antiangiogenic therapy
focuses on use of thalidomide and its suppression of blood supply formation.
It has had initial success in treatment of multiple myeloma.
Strenuous activity should be initially ____ following implantation of radioactive seeds in brachytherapy.
Communication with radiation oncologist is imperative because further…
avoided
contraindications or precautions may be advised depending on individual case.
Brachytherapy
treatment especially with prostate cancer of radioactive implantations
Skin tattoos are used to guide beam alignment for radiation. PTs must be cautious and ___ interventions that would alter these. Examples of these treatments:
defer
taping , soft tissue or myofascial mobilizations
Irradiated skin requires
special care
___ and ___ are contraindicated over irradiated areas for a minimum of 12 months.
massage and heat
Certain chemo agents may cause patients to have a level of toxicity that requires…
staff and visitors to take additional precautions before making physical contact
Pt vomiting during therapy should be
reported to nurse/physician especially if they are taking antiemetic medication
Palliative oncology treatment includes
radiation, chemo, PT, chiro, acupuncture ,alternative and homeopathic medicines, relaxation, biofeedback, pharmacological intervention and hospice.
Palliative care can be implemented
any time in the disease process
Alkylating agents do what?
Implications for PT with them?
bind to DNA to prevent replication
extreme fatigue, GI issues, cancer pain, and blood disorders
Most ___ and ____ modalities are contraindicated for use over active malignancy but not necessarily for use elsewhere on body.
heat
electrotherapeutic
Why are heat and electrotherapeutic modalities contraindicated?
potential for facilitating growth of malignant mass or hematogenous spread. With physician guidance, these can be overlooked in lieu of palliative goals for terminally ill patients.
Biologic response modifier agents
enhance body’s own ability to respond to neoplastic growth.
They are not cytotoxic but facilitate patients immune response to destroy malignant tissues.
Heavy metal compounds to treat cancer include
platinum coordination complexes
act as alkylating agents
Hormones are used as
adjunct therapy along with other forms of treatment specific to malingnancy
Plant alkaloid agents target
replication process prior to and during mitosis to inhibit cell division
differentiated cells
cells that have matured from a less specific to a more specific cell type
dysplasia
abnormal development of cells or tissue that is often an early sign of neoplasia
hyperplasia
increase in cell number that may be normal or abnormal depending on additional characteristics.
Malignant neoplasm
abnormal uncontrolled cell growth that invades and destroys adjacent tissues and may metastasize to other sites and systems of the body
Metaplasia
change in a cell from one type to another that may be normal or abnormal
Neoadjuvant
chemo or radiation given prior to surgical oncology intervention
