Oncology and Lymphedema

Question 1

What are the hallmarks of cancer?

Answer 1

1. Sustaining proliferative signaling, 2. Evading growth suppressors, 3. Resisting cell death, 4. Enabling replicative immortality, 5. Inducing angiogenesis, 6. Activating invasion and metastasis, 7. Genome instability and mutation, 8. Tumor-promoting inflammation.

Question 2

Define solid tumors and list their types.

Answer 2

Solid tumors are masses of tissue that can be benign or malignant. Types: Carcinoma, Sarcoma, Lymphoma.

Question 3

Define blood cancers and list their types.

Answer 3

Blood cancers do not form solid tumors and include Leukemia and Multiple Myeloma.

Question 4

What is carcinoma, and where does it originate?

Answer 4

Carcinoma originates in epithelial tissues such as skin, organ linings, and body cavities. It accounts for 85% of all cancers.

Question 5

What is sarcoma, and what tissues does it affect?

Answer 5

Sarcoma is cancer of connective tissues such as bone, fat, cartilage, and muscle. Examples: Osteosarcoma, Liposarcoma, Chondrosarcoma.

Question 6

What are lymphomas, and where are they found?

Answer 6

Lymphomas originate in lymphoid tissues like lymph nodes and spleen but can spread to bone marrow and other areas.

Question 7

What are the most common blood cancers?

Answer 7

Leukemia and Multiple Myeloma.

Question 8

What is the goal of radiation therapy?

Answer 8

To modify or kill cancerous cells by damaging their DNA through ionizing radiation.

Question 9

What are the side effects of radiation therapy?

Answer 9

Acute: Hair loss, skin redness, salivary gland changes, low sperm count. Late: Fibrosis, infertility, mutations, secondary cancers.

Question 10

Describe chemotherapy and its goals.

Answer 10

Chemotherapy uses drugs to kill or modify cancer cells at different life cycle stages. Goals: Cure, Control, Palliation.

Question 11

What are common side effects of chemotherapy?

Answer 11

Immunosuppression, nausea/vomiting, anemia, alopecia, fatigue, neuropathy, ‘chemo brain,’ and fertility problems.

Question 12

What is immunotherapy, and what are its types?

Answer 12

Immunotherapy uses living substances to boost the immune system against cancer. Types include monoclonal antibodies and CAR T-cell therapy.

Question 13

What are common metastatic pathways?

Answer 13

Blood pathways, lymph pathways, and fascial planes.

Question 14

What are the most common metastatic sites for breast cancer?

Answer 14

Bone, liver, brain, lymph nodes, and lungs.

Question 15

What are the treatment options for brain tumors?

Answer 15

Surgery, radiation therapy, and chemotherapy (less effective than other treatments).

Question 16

Describe the symptoms of brain tumors.

Answer 16

Headache, nausea, vomiting, seizures, hemiparesis, gait abnormalities, vision changes, and personality changes.

Question 17

What is the basic function of the lymphatic system?

Answer 17

To transport interstitial fluid, proteins, and lipids to the circulatory system and support immune functions.

Question 18

What is lymphatic load vs. transport capacity?

Answer 18

Lymphatic load is the fluid volume to be moved, while transport capacity is the system’s ability to carry fluid (10x normal load in a healthy system).

Question 19

What is lymphedema?

Answer 19

A condition where lymph fluid accumulates in interstitial spaces due to a damaged or overwhelmed lymphatic system.

Question 20

Differentiate between primary and secondary lymphedema.

Answer 20

Primary: Congenital/hereditary. Legs > Arms; Begins distally, unilateral presentation (somtimes bilateral)

Secondary: Result of damage, such as surgery or cancer treatments. Usually begins proximally, unilateral presentation

Question 21

What are the stages of lymphedema?

Answer 21

Stage 0: Subclinical/latent; no swelling.

Stage 1: Pitting edema, reversible with elevation, resolves while sleeping.

Stage 2: Non-pitting edema, irreversible fibrosis.

Stage 3: Severe swelling, skin changes (lymphostatic elephantiasis).

Question 22

What are the symptoms of lymphedema?

Answer 22

Heaviness, tightness, limited range of motion, aching, and recurrent infections.

Question 23

What is manual lymph drainage (MLD)?

Answer 23

A gentle massage technique to move lymph fluid under the skin, followed by compression therapy.

Question 24

When are short-stretch bandages used?

Answer 24

During acute or initial treatment of lymphedema for 23 hours/day over 2-6 weeks before transitioning to garments.

Question 25

What are the compression classes for garments?

Answer 25

Class I (20-30 mmHg): Stage 0-1 lymphedema, mild edema. Class II (30-40 mmHg): Stage 2-3 lymphedema, moderate-severe swelling.

Question 26

What systems are affected by lymphedema?

Answer 26

Musculoskeletal, neuromuscular, cardiovascular, integumentary, and quality of life.

Question 27

What is myelosuppression?

Answer 27

Decreased bone marrow activity leading to fewer RBCs, WBCs, and platelets.

Question 28

What is chemotherapy-induced peripheral neuropathy (CIPN)?

Answer 28

Nerve damage caused by chemotherapy, often affecting hands and feet.

Question 29

How does lymphedema affect quality of life?

Answer 29

Limits physical function, increases infection risk, and impacts emotional well-being due to visible swelling.

Question 30

What are precautions for neutropenia?

Answer 30

Handwashing, avoiding fresh flowers/animals, and maintaining protective isolation.

Question 31

What is the effect of corticosteroids in cancer treatment?

Answer 31

Reduces inflammation and improves appetite but can cause muscle weakness and other side effects.

Question 32

What causes cancer-related fatigue?

Answer 32

Multifactorial: Chemotherapy/radiation, sleep disturbances, malnutrition, and emotional distress.

Question 33

How does radiation fibrosis develop?

Answer 33

Progressive sclerosis of tissues due to radiation therapy, worsening for 1-5 years post-treatment.