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
PT strength training
- strength and stair training
- maintain larger muscle group of the legs
- most effective at preventing atrophy
26
PT close chain exercise
- Prevents shearing forces across joints
- allows for normal joint loading
- prevents vertebral compression fractures
27
PT avascular necrosis of femoral head
- exercise the surrounding joint muscles in non-weight bearing
- openchain exercise
28
Acute myeloid luekemia
- 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
Who is at risk for AML?
- 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
Signs and symptoms of AML
- low blood count
- fatigue
- dyspnea
- infection
- bleeding
31
physical exam of AML
- petechiae
- ecchymoses
- fever
- pallor
- confusion
- visual changes
- sternal tenderness
32
lymphoma
- 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
Hodgkin lymphoma
- 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
non-Hodgkin lymphoma
- 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
who is at risk of non-hodgkins lymphoma
- 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
signs and symptoms of non-Hodgkin lymphoma
- fever
- swollen lymph nodes
- severe itching
- excessive sweating
- unexplained weight loss
- fatigue
- abdominal discomfort
- shortness of breath
- chest pain or pressure
37
treatment of non-Hodgkin
- induction chemo
-radiation
immunotherapy
- central access catheter
- blood products
- lumbar punctures
- imaging studies
38
post surgical/radiation edema and fibrosis teatment
- gentle stretching
- good skin care
- botox injections can relieve pain and reduce muscle spasms
39
tx for chest and arm pain
- 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
tx for CIPN
- medications
- acupuncture
- reflexology
- e-stim
- balance
- exercise
41
tx for cancer related fatigue
```
- cognitive behavioral therapy
exercise
acupuncture
medications
reverse underlying medical condition: anemia, low vitamin D, pain, low thyroid, insomnia, depression/anxiety/distress
```
42
tx for mild cognitive impairment
- cognitive therapy
- organization and structures
- life management skills
- support groups
43
cancer prevention recommendations
- 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
thrombotic thrombocytopenic purpura
- 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
types of TTP
- 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
TTP symptoms
- fatigue
- fever
-bleeding
diarrhea
-chest apin
abdominal pain
-neurologic symptoms
-thrombocytopenia
