Oncology Flashcards
1
Q
what is a rare disease?
A
- any disease, disorder, illness or condition affecting fewer than 200,000 people in the US is considered rare.
2
Q
what is cancer?
A
- group of diseases characterized by the uncontrolled growth and spread of abnormal cells.
- if the spread of abnormal cells is not controlled, can result in death
3
Q
benign
A
- localized
- slow growing
- encapsulated
- not invasive
4
Q
malignant
A
- invasive rapidly growing
- usually encapsulated in the early stages
5
Q
survivor
A
- anyone who is living with active cancer or having had a diagnosis of cancer
6
Q
chemo brain
A
- a colloquial term for difficulties with concentration and memory that may follow the administration of some forms of chemo
7
Q
epidemiology of cancer
A
- 2nd most common cause of death in the US: Prostate , breast, lung, colon
8
Q
cancer survival rate
A
- 5 year survival rate for all cancer is 69%
- 5+ years, survival rate returns to near their non-cancer peers
9
Q
comorbidities
A
- most survivors have more than 1 comorbidity
- chemo toxicities: muscle atrophy, paralysis, chemo brain
- late effects of radiation therapies
- adverse sequela of surgical interventions
10
Q
risk factors for cancer
A
- tabacco use
- sun exposure
- obesity/ food/ fitness
- HPV and cervical cancer
- emvironmental carcinogens
- genetics
11
Q
roles of PT in oncology
A
- Bone health
- Pre-hab
- pelvic floor
- orthopedic
- CIPN
- Steroid induced myopathy
12
Q
Pre-hab for oncology patients is….
A
- physical and psychological assessments prior to the onset of acute cancer treatment
- baseline level of function-enables therapist to repeat and identify change
- pre-existing functional impairments
- provides targeted interventions to improve functional status prior to cancer treatment
13
Q
steroid induced myopathy
A
-muscle weakness and atrophy caused by high doses of glucocorticoids
14
Q
myopathy
A
- a nonspecific muscle weakness secondary to an identifiable disease or condition
15
Q
glucocorticoid alters protein metabolism
A
- decrease muscle protein anabolism
- they limit amino acid transport into muscles.
- they inhibit the stimulatory action of insulin, insulin-like growth factor- 1 and amino acids. these factors play key roles in protein synthesis by governing the initial step of mRNA translation.
- can cause muscle atrophy by inhibiting myogenesis
16
Q
increased muscle protein catabolism
A
- the main effects is to induce muscle protein catabolism
- myofibrillar proteins are degraded
- -actin and myosin are dissociated
17
Q
glucocorticoid
A
- common man made steroids used in cancer treatment
- typically prescribed for a short duration of time, a few days to a few weeks.
- bone marrow and stem cell transplant patients are required to take steroids for a longer duration
18
Q
use of steroids in cancer treatment
A
- treat cancer itself in tandem with chemo
- reduce inflammation
- reduce immune response such as after a transplant
- to help relieve sickness secondary to chemo
- to help boost appetite
19
Q
Type I
A
- slow twitch
- muscles appear red
- the redness is the result of high amounts of myoglobin and a high capillary content
- myoglobin and capillary content in red muscles contributes to the greater oxidative capacity
- -rich in mitochondria, lipids, and oxidative enzymes
20
Q
Type II
A
- fast twitch
- larger fibers
- rich in phosphorylase and glycogen
- poor in mitochondria and oxidative enzymes
- steroids affect Type IIB muscle fibers no effect Type I. type IIB are less active than type I = more atrophy rate
21
Q
-acute steroid induce myopathy
A
- occurs most often in the intensive care unit
- rapidly progressive weakness of the proximal and distal muscle groups
-rapid onset of weakness and wasting, also referred to as acute illness myopathy, is the result of multiple factors:
22
Q
chronic steroid induced myopathy
A
- muscle weakness develops insidiously
- progresses slowly
- usually painless or mildly painful
- weakness is primarily proximal: pelvic girdle muscles more severely involved than arms, cranial nerves innervated muscles and sphincters are spared
- rarely distal muscles affected
- muscle atrophy that regresses only after a matter of weeks or months
- patients who received steroids for less than 4 weeks rarely develop steroid myopathy
23
Q
psychological considerations after steroids
A
- irritability, euphoria, nervousness
- serious depression and psychosis
- insomnia is often a complaint
- when intense changes are observed a physician should be notified
24
Q
PT aerobic exercise
A
- training along with proper nutrition
- most patients receiving glucocorticoids are often too sick to exercise
- those who are able to exercise cannot do so to the intensity required to prevent myopathy
- 150 min aerobic moderate
- 75 min high intensity
25
Q
PT strength training
A
- strength and stair training
- maintain larger muscle group of the legs
- most effective at preventing atrophy
26
Q
PT close chain exercise
A
- Prevents shearing forces across joints
- allows for normal joint loading
- prevents vertebral compression fractures
27
Q
PT avascular necrosis of femoral head
A
- exercise the surrounding joint muscles in non-weight bearing
- openchain exercise
28
Q
Acute myeloid luekemia
A
- group of heterogeneous hematopoietic stem cell disorders whch are characterized by incomplete maturation of blood cells and reduced production of other normal hematopoietic cells
29
Q
Who is at risk for AML?
A
- AML is most common in older people >65 yr old
- slightly higher incidence in males
- slightly higher incidence in populations of European descent
- exposure to ionizing radiation
- chemicals known to cause DNS damage
- predisposing conditions: myelodysplastic processes or other chronic bone marrow stem cell disorders
30
Q
Signs and symptoms of AML
A
- low blood count
- fatigue
- dyspnea
- infection
- bleeding
31
Q
physical exam of AML
A
- petechiae
- ecchymoses
- fever
- pallor
- confusion
- visual changes
- sternal tenderness
32
Q
lymphoma
A
- umbrella term describing dozens of cancers that begin in the immune system. lymphoma are the most common type of blood cancer, and are broadly categorized as Hodgkin or non-hodgkins.
33
Q
Hodgkin lymphoma
A
- occurs when white blood cells called B-lymphocytes become abnormal and begin growing and dividing so fast that normal cells in the immune system cannot keep up.
-
34
Q
non-Hodgkin lymphoma
A
- occurs when either rB or T cell lymphocytes become abnormal. in most cases it is the B cells that are defective.
- nonhodgkin lymphomas are categorized based on a spectrum of how they behave in the body
35
Q
who is at risk of non-hodgkins lymphoma
A
- underlying immune system conditions
- older individuals
- males are more likely to be diagnosed than females
- exposure to chemo and radiation
- previous infections
- exposure to chemicals
- obesity
36
Q
signs and symptoms of non-Hodgkin lymphoma
A
- fever
- swollen lymph nodes
- severe itching
- excessive sweating
- unexplained weight loss
- fatigue
- abdominal discomfort
- shortness of breath
- chest pain or pressure
37
Q
treatment of non-Hodgkin
A
- induction chemo
-radiation
immunotherapy - central access catheter
- blood products
- lumbar punctures
- imaging studies
38
Q
post surgical/radiation edema and fibrosis teatment
A
- gentle stretching
- good skin care
- botox injections can relieve pain and reduce muscle spasms
39
Q
tx for chest and arm pain
A
- myofascial release
- stetching of arm, chest, back , rib cage
- posture , core, ergonomics
- massage
- strengthening of shoulder blades and back muscles
- physician referral?: acupuncture, injections, muscle relaxants, pain medictaions
40
Q
tx for CIPN
A
- medications
- acupuncture
- reflexology
- e-stim
- balance
- exercise
41
Q
tx for cancer related fatigue
A
- cognitive behavioral therapy exercise acupuncture medications reverse underlying medical condition: anemia, low vitamin D, pain, low thyroid, insomnia, depression/anxiety/distress
42
Q
tx for mild cognitive impairment
A
- cognitive therapy
- organization and structures
- life management skills
- support groups
43
Q
cancer prevention recommendations
A
- be a healthy weight
- physically active
eat a rich diet in whole grains veggies, fruit, and beans
-limit consumption of fast foods and other processed
-limit consumption of red and processed meat
44
Q
thrombotic thrombocytopenic purpura
A
- rare blood disorder that is considered a true medical emergency.
- TTP is diagnosed at a rate of 3-4 in 1 million people per year
- potentially fatal complications can result from internal blood clottin, with damage to critical organs such as the brain and heart
45
Q
types of TTP
A
- hereditary: inherited deficiency or abnormality of the ADAMTS
- immune -mediated TTP: 99% have no defined cause. in all cases, there is a decreased levels of the ADAMTS 12 enzyme as a result of antibodies attacking the enzyme
46
Q
TTP symptoms
A
- fatigue
- fever
-bleeding
diarrhea
-chest apin
abdominal pain
-neurologic symptoms
-thrombocytopenia
