Oncology Flashcards
differentiate between cured and in remission
cured: no evidence of cancer and same life expectancy as those without cancer
remission: (partial or complete) no sxs in response to tx
what is a benign tumor
harmless to host but puts pressure on systems
what is a malignant tumor
aggressive and can lead to metastases
what is a tumor derived from epithelial cells
carcinoma
what is a tumor derived from muscle, bone, cartilage, fat, or connective tissue
sarcoma
what is a lymphoma
cancer of bone marrow derived cells that affect the lymphatic system
define myeloma
cancer involving the WBCs responsible for antibody production (B-cells)
What are the T stages in TNM staging
primary tumor (T)
Tx: tumor cannot be evaluated
T0: no evidence of primary tumor
Tis: carcinoma in situ (early without spread to neighboring tissue
T1-4: size and extent of primary tumor
What are the N stages in TNM staging
regional lymph nodes (N)
Nx: regional nodes cannot be evaluated
N0: no regional node involvement
N1-3: involvement (number and extent of spread)
what are the M stages in TNM staging
distant metastases (M)
Mx: distant mets cannot be evaluated
M0: no distant mets
M1: distant mets
what is a stage 1 tumor
tumor limited to the organ in which it developed
what is a stage 2 tumor
local invasion of organ or adjacent tissue, perhaps first stage of lymph node development
what is a stage 3 tumor
spread to the region surrounding the primary organ, high probability of metastatic disease
what is a stage 4 tumor
metastatic
T/F: metatstasis can occur up to 20 years after initial dx and medical intervention
True: metastasis can occur even despite medical intervention
what are the three most common sites of cancer metastasis and why
lungs, bone, and liver due to extensive blood flow and venous/lymphatic drainage
how do metastases to the brain affect patient presentation
change in mental status
how do bone metastases affect patient presentation (2)
- constant, intense night pain - deep
2. fractures occur with unlikely MOI (compression fx of the spine when sitting)
how do metastases to the lungs affect patient presentation
pleural pain and dyspnea
what is the most common site of mets?
lungs - first organ to filter malignant cells
what is the goal of cancer treatment?
minimum necessary - destroy enough of the malignancy so that the body’s immune response can take over
what are the five goals of surgery for cancer patients?
- to diagnose cancer
- to stage the disease
- to treat it (remove tumors)
- to reconstruct tissue
- palliative care
what are the three common themes of PT intervention following cancer surgery
- early mobilization
- maximize gas exchange
- minimize deconditioning and risks associated with deconditioning
what is chemotherapy
SYSTEMIC, NONSELECTIVE treatment designed to alter cell division, not directly destroy the tumor
how do cytotoxic chemo drugs work?
they target actively reproducing cells whether they are normal or cancerous
what are the two inherent problems with chemo?
- it is unable to prevent recurrence of cancer
2. cytotoxicity side effects
what is a major side effect of chemo?
myelosuppresion: leukopenia, anemia, thrombocytopenia
what are four major motor symptoms of chemo-related peripheral neuropathy
- leg heaviness
- anterior tib weakness (tripping)
- difficulty holding/manipulating objects
- shaky handwriting
what are the four major sensory symptoms of chemo-related peripheral neuropathy
- pins and needles
- cold extremitiy
- burning sensation
- sharp, shooting pain
what are the three major autonomic symptoms of chemo-related peripheral neuropathy
- orthostasis
- flushing
- tachycardia
what are PT implications for patients undergoing chemo
- modify activity based on symptom intensity
- aerobic training to prevent endurance loss and mediate cancer-related fatigue
- chemo precautions
what is radiation therapy
non-selective, localized treatment designed to focally destroy/damage cancerous cells
what types of energy are used for radiation therapy
x-ray, gamma ray, alpha and beta particles
how does radiation therapy work
radiation affects the nucleic acids of DNA, RNA, and vital enzymes leading to chromosomal aberrations and cell death
What are characteristics of cells that are most radiosensitive
- cells that regularly divide with high O2 content
- G2 and mitosis phase
- blood, intestine, ovaries, testes
what kinds of cells are radioresistant
bone, muscle, nerve, endocrine
how long do physiologic effects of radiation last?
microcellular changes can occur mainly up to 1 year after treatment
acute: 1-6 months
subacute: 6-12 months
chronic: 1 year
which radiation sites are most susceptible to immunocompromise
long bones, ilieum, and sternum
how can the skin change following radiation? (4)
- it can become fragile
- it can become erythmatous
- it can become fibrotic
- it can create adhesions
what happens GI/GU following radiation
vomiting/diarrhea
what is the most common area of AVN following radiation?
hip
what is radiation myelitis
demyelination, necrosis, and loss of blood flow due to damaged blood vessels along the spinal column
what are symptoms of radiation myelitis
sensory dysfunction and motor weakness
what are major PT implications for patients undergoing radiation (4)
- monitor for neuropathy
- prevent contractures
- manage edema
- no thermal modalities
what is hormonal therapy
drugs that interfere with hormone production OR removal of the hormone producing glands
what are the three general types of bone marrow/stem cell transplant
- autologous
- allogenic
- syngeneic
what happens prior to a bone marrow/stem cell transplant and why do we care
high dose chemo and or total body irradiation - be aware of side effects and isolation precautions
what are some alternative and complementary therapies to cancer treatment
- meditation/mindfullness/yog
- peppermint tea for nausea
- acupuncture for pain
- prayer or tai chi
what are the CAUTION early warning signs for cancer
- change in bowel bladder
- a sore that doesnt heal in 6 wks
- unusual bleeding/discharge
- thickening lump
- indigestion
- obvious wart/mole change
- nagging cough/hoarseness
what is cachexia
wasting phenomenon due to illness
what are the four goals of cancer rehab
- prevention
- restoration
- support
- palliative care
is exercise safe for cancer patients
absolutely, in the context of their characteristics
what is unique about cancer related fatigue
not relieved by rest and is the most common symptom of treatment
how does aerobic exercise improve sxs in cancer patients
reduces fatigue, nausea, anxiety, and depression
improves self-esteem, physical activity, and weight control
what is aerobic exercise protocol for cancer patients
large muscle, moderate intensity (40-60% HRM), 3-5x/wk 20-60 min/session
what does the research say about exercise Rx in cancer patients
less fatigue in persons who perform aerobics at least every other day for 10 min
