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ACUTE CARE MODULE 2 > Oncology > Flashcards

Oncology Flashcards

1
Q

differentiate between cured and in remission

A

cured: no evidence of cancer and same life expectancy as those without cancer
remission: (partial or complete) no sxs in response to tx

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2
Q

what is a benign tumor

A

harmless to host but puts pressure on systems

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3
Q

what is a malignant tumor

A

aggressive and can lead to metastases

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4
Q

what is a tumor derived from epithelial cells

A

carcinoma

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5
Q

what is a tumor derived from muscle, bone, cartilage, fat, or connective tissue

A

sarcoma

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6
Q

what is a lymphoma

A

cancer of bone marrow derived cells that affect the lymphatic system

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7
Q

define myeloma

A

cancer involving the WBCs responsible for antibody production (B-cells)

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8
Q

What are the T stages in TNM staging

A

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

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9
Q

What are the N stages in TNM staging

A

regional lymph nodes (N)

Nx: regional nodes cannot be evaluated
N0: no regional node involvement
N1-3: involvement (number and extent of spread)

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10
Q

what are the M stages in TNM staging

A

distant metastases (M)

Mx: distant mets cannot be evaluated
M0: no distant mets
M1: distant mets

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11
Q

what is a stage 1 tumor

A

tumor limited to the organ in which it developed

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12
Q

what is a stage 2 tumor

A

local invasion of organ or adjacent tissue, perhaps first stage of lymph node development

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13
Q

what is a stage 3 tumor

A

spread to the region surrounding the primary organ, high probability of metastatic disease

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14
Q

what is a stage 4 tumor

A

metastatic

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15
Q

T/F: metatstasis can occur up to 20 years after initial dx and medical intervention

A

True: metastasis can occur even despite medical intervention

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16
Q

what are the three most common sites of cancer metastasis and why

A

lungs, bone, and liver due to extensive blood flow and venous/lymphatic drainage

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17
Q

how do metastases to the brain affect patient presentation

A

change in mental status

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18
Q

how do bone metastases affect patient presentation (2)

A
  1. constant, intense night pain - deep

2. fractures occur with unlikely MOI (compression fx of the spine when sitting)

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19
Q

how do metastases to the lungs affect patient presentation

A

pleural pain and dyspnea

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20
Q

what is the most common site of mets?

A

lungs - first organ to filter malignant cells

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21
Q

what is the goal of cancer treatment?

A

minimum necessary - destroy enough of the malignancy so that the body’s immune response can take over

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22
Q

what are the five goals of surgery for cancer patients?

A
  1. to diagnose cancer
  2. to stage the disease
  3. to treat it (remove tumors)
  4. to reconstruct tissue
  5. palliative care
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23
Q

what are the three common themes of PT intervention following cancer surgery

A
  1. early mobilization
  2. maximize gas exchange
  3. minimize deconditioning and risks associated with deconditioning
24
Q

what is chemotherapy

A

SYSTEMIC, NONSELECTIVE treatment designed to alter cell division, not directly destroy the tumor

25
Q

how do cytotoxic chemo drugs work?

A

they target actively reproducing cells whether they are normal or cancerous

26
Q

what are the two inherent problems with chemo?

A
  1. it is unable to prevent recurrence of cancer

2. cytotoxicity side effects

27
Q

what is a major side effect of chemo?

A

myelosuppresion: leukopenia, anemia, thrombocytopenia

28
Q

what are four major motor symptoms of chemo-related peripheral neuropathy

A
  1. leg heaviness
  2. anterior tib weakness (tripping)
  3. difficulty holding/manipulating objects
  4. shaky handwriting
29
Q

what are the four major sensory symptoms of chemo-related peripheral neuropathy

A
  1. pins and needles
  2. cold extremitiy
  3. burning sensation
  4. sharp, shooting pain
30
Q

what are the three major autonomic symptoms of chemo-related peripheral neuropathy

A
  1. orthostasis
  2. flushing
  3. tachycardia
31
Q

what are PT implications for patients undergoing chemo

A
  1. modify activity based on symptom intensity
  2. aerobic training to prevent endurance loss and mediate cancer-related fatigue
  3. chemo precautions
32
Q

what is radiation therapy

A

non-selective, localized treatment designed to focally destroy/damage cancerous cells

33
Q

what types of energy are used for radiation therapy

A

x-ray, gamma ray, alpha and beta particles

34
Q

how does radiation therapy work

A

radiation affects the nucleic acids of DNA, RNA, and vital enzymes leading to chromosomal aberrations and cell death

35
Q

What are characteristics of cells that are most radiosensitive

A
  1. cells that regularly divide with high O2 content
  2. G2 and mitosis phase
  3. blood, intestine, ovaries, testes
36
Q

what kinds of cells are radioresistant

A

bone, muscle, nerve, endocrine

37
Q

how long do physiologic effects of radiation last?

A

microcellular changes can occur mainly up to 1 year after treatment

acute: 1-6 months
subacute: 6-12 months
chronic: 1 year

38
Q

which radiation sites are most susceptible to immunocompromise

A

long bones, ilieum, and sternum

39
Q

how can the skin change following radiation? (4)

A
  1. it can become fragile
  2. it can become erythmatous
  3. it can become fibrotic
  4. it can create adhesions
40
Q

what happens GI/GU following radiation

A

vomiting/diarrhea

41
Q

what is the most common area of AVN following radiation?

A

hip

42
Q

what is radiation myelitis

A

demyelination, necrosis, and loss of blood flow due to damaged blood vessels along the spinal column

43
Q

what are symptoms of radiation myelitis

A

sensory dysfunction and motor weakness

44
Q

what are major PT implications for patients undergoing radiation (4)

A
  1. monitor for neuropathy
  2. prevent contractures
  3. manage edema
  4. no thermal modalities
45
Q

what is hormonal therapy

A

drugs that interfere with hormone production OR removal of the hormone producing glands

46
Q

what are the three general types of bone marrow/stem cell transplant

A
  1. autologous
  2. allogenic
  3. syngeneic
47
Q

what happens prior to a bone marrow/stem cell transplant and why do we care

A

high dose chemo and or total body irradiation - be aware of side effects and isolation precautions

48
Q

what are some alternative and complementary therapies to cancer treatment

A
  1. meditation/mindfullness/yog
  2. peppermint tea for nausea
  3. acupuncture for pain
  4. prayer or tai chi
49
Q

what are the CAUTION early warning signs for cancer

A
  1. change in bowel bladder
  2. a sore that doesnt heal in 6 wks
  3. unusual bleeding/discharge
  4. thickening lump
  5. indigestion
  6. obvious wart/mole change
  7. nagging cough/hoarseness
50
Q

what is cachexia

A

wasting phenomenon due to illness

51
Q

what are the four goals of cancer rehab

A
  1. prevention
  2. restoration
  3. support
  4. palliative care
52
Q

is exercise safe for cancer patients

A

absolutely, in the context of their characteristics

53
Q

what is unique about cancer related fatigue

A

not relieved by rest and is the most common symptom of treatment

54
Q

how does aerobic exercise improve sxs in cancer patients

A

reduces fatigue, nausea, anxiety, and depression

improves self-esteem, physical activity, and weight control

55
Q

what is aerobic exercise protocol for cancer patients

A

large muscle, moderate intensity (40-60% HRM), 3-5x/wk 20-60 min/session

56
Q

what does the research say about exercise Rx in cancer patients

A

less fatigue in persons who perform aerobics at least every other day for 10 min

ACUTE CARE MODULE 2 (9 decks)

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