Oncology

Question 1

Cancer

Answer 1

indicates any of various types of growths that are uncontrolled by normal cellular mechanisms

Question 2

Malignant Neoplasm Synonyms

Answer 2

• Tumor
• malignancy
• carcinoma

Question 3

Types of Cancer

Answer 3

• Primary
• Secondary
• Carcinoma in situ

Question 4

Primary Cancer

Answer 4

• arising from cells local to the structure

- primary cell usually determines behavior of cancer

Question 5

Secondary Cancer

Answer 5

-arising from cells that have metastasized from other sites

Question 6

Carcinoma in Situ

Answer 6

-malignant cell changes in epithelial tissue that do not extend beyond the basement membrane (pre-invasive)

Question 7

Metaplasia

Answer 7

-Reversible change in cell

Question 8

Dysplasia

Answer 8

-permanent abnormal changes in cells

Question 9

Classifications of Neoplasms

Answer 9

• Epithelial
• Connective/Muscle Tissue
• Lymphoid
• Hematopoietic
• Miscellaneous (reproductive glands, placenta, thymus)

Question 10

Staging of Cancer

Answer 10

• distinct phase or period in development of disease

- what is the EXTENT of the disease?

Question 11

Grading of Neoplasms

Answer 11

• degree of malignancy and differentiation of malignant cells
• Grade I-IV
• less differentiated=worse
• what is the severity of the tumor?

Question 12

TNM System

Answer 12

• Classifies cancer based on Tumor size, lymph Node status, Metastases presence
• Tumor, Node, Metastases

Question 13

Grade I

Answer 13

well-differentiated cells

Question 14

Grade II

Answer 14

moderately-differentiated cells

Question 15

Grade III

Answer 15

poorly-differentiated cells

Question 16

Grade IV

Answer 16

Undifferentiated

worst

Question 17

Sources of Cancer (2)

Answer 17

• Endogenous

- Exogenous

Question 18

Endogenous Origin

Answer 18

• factors that are outside the patient’s control

- familial pattern/genetic

Question 19

Exogenous Origin

Answer 19

• risk factors, within patient’s control
• chemical agents, physical agents, drugs/EtOH, hormones
• inflammatory disease

Question 20

Risk Factor Examples

Answer 20

• Age
• Lifestyle (tobacco, diet, nutrition, sexual behaviors)
• Geography
• Ethnicity
• Stress

Question 21

What are oncogenes?

Answer 21

-gene that is likely to produce or is a marker of cancer

Question 22

What are tumor suppressor genes?

Answer 22

-genes that are good at minimizing tumor growth

Question 23

What are the mechanisms of the spread of cancer?

Answer 23

• Metastasis

- Invasion

Question 24

Invasion

Answer 24

-growth by direct or continuous extension of the tumor into neighboring tissue

Question 25

Metastasis

Answer 25

-growth of neoplastic cells at a remote or non-contiguous site in the body

Question 26

How do metastasis cells travel to new sites?

Answer 26

- bloodstream | - lymphatic system

Question 27

Angiogenesis

Answer 27

-creation of new circulation (for secondary tumor)

Question 28

Most common sites of metastasis

Answer 28

(L3B2) | -Lymphnodes, lungs, liver, bone, brain

Question 29

Other sites of metastasis

Answer 29

-skin, ovaries and adrenal glands

Question 30

Most metastases occur within ________

Answer 30

- 3-5 years; | - but can occur 15-20 after original appearance of disease

Question 31

Common Manifestations of Cancer

Answer 31

- NVR - Anorexia and weight loss - Pain - Fever - Cancer related fatigue

Question 32

Primary Prevention

Answer 32

- decrease number of cases/prevalence of cancer | - risk reduction

Question 33

Secondary Prevention

Answer 33

- prevent morbidity and mortality of cancer | - early detection

Question 34

Tertiary Prevention

Answer 34

- managing symptoms, limiting complications, preventing disability disability - palliative treatment

Question 35

CAUTION: clinical manifestations of cancer

Answer 35

``` C-change in bowel/bladder A-a sore that doesn't heal in 6 weeks U-unusual bleeding/discharge T-thickening or lump in breast or elsewhere I-indigestion or difficulty swallowing O-obvious changes in wart or mole N-nagging cough/hoarsness ```

Question 36

Diagnostics

Answer 36

- Biopsy, endoscopy (invasive) | - CT, MRI (radiologic/noninvasive)

Question 37

Types of Treatment

Answer 37

- Surgery - Radiation - Chemotherapy - Biotherapy - Immunotherapy - Hormonal therapy

Question 38

Medical Management of Cancer Tx

Answer 38

- Medications other than chemo - Alternative care - Hospice

Question 39

PT management of cancer treatment

Answer 39

- positioning - relaxation techniques - biofeedback - manual therapy

Question 40

Goals of Intervention

Answer 40

- cure the cancer - control the cancer - palliative care

Question 41

Progression of Cancer

Answer 41

- complete remission/response - partial response - no response - survival

Question 42

Complete Remission/Response

Answer 42

-disappearance of clinically evident disease

Question 43

Partial Response

Answer 43

-more than 50% reduction in tumor size

Question 44

No Response

Answer 44

-no response to treatment

Question 45

Survival=

Answer 45

time from diagnosis to death

Question 46

Prognosis affected by:

Answer 46

- type, stage, grade of cancer - type/effectiveness of therapy - pt's general health status - age

Question 47

Winningham Precautions: | Platelets

Answer 47

<50,000/ml

Question 48

Winningham Precautions: | Hb

Answer 48

<10g/ml

Question 49

Winningham Precautions: | Absolute Granulocytes

Answer 49

<500/ml

Question 50

Winningham Precautions

Answer 50

-precautions to aerobic exercise in chemotherapy patients

Question 51

Winningham Precautions: | WBC

Answer 51

< 3,000/ml ; 10,000 with fever (no exercise)

Question 52

Side effects of Chemo

Answer 52

``` fatigue, GI, anxiety/depression, hepatotoxicity, hemorrhage, bone marrow suppression, anemia, infection, neutropenia, thrombocytopenia, muscle weakness, decreased bone density, rash, neuropathies, hair loss, sterilization, sexual dysfunction, weight loss/gain ```

Question 53

Side Effects of Radiation

Answer 53

``` fatigue, radiation sickness, immunosuppression, decreased platelets/WBC, infection, fibrosis, burns, mucositis, diarrhea, edema, hair loss, ulceration, CNS/PNS effects, Malignancy ```

Question 54

Symptoms of Metastasis: Lung

Answer 54

-cough, pleural pain, SOB

Question 55

Symptoms of Metastasis: Liver

Answer 55

-abdominal pain, RUQ pain, malaise, fatigue, anorexia, weight loss, fever

Question 56

Symptoms of Metastasis: Bone

Answer 56

-deep pain worsening with activity, pathologic fractures

Question 57

Symptoms of Metastasis: Brain

Answer 57

-cognitive impairment, headache, reduced sensory/motor function

Question 58

Symptoms of Metastasis: Lymphnodes

Answer 58

-lymphedema