Oncology and PT implications Flashcards

1
Q

What is cancer

A
  • malignant neoplasm
  • tumor
  • can be named by cells of origin: lipoma, osteoma, neuroma, myeloma
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2
Q

what is a carcinoma

A
  • a tumor that is not necessarily cancer
  • arise from epithelial cells
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3
Q

sacromas

A

develop from connective tissue

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4
Q

lymphomas

A

originate in lymphoid tissue

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5
Q

leukemias

A
  • cancer from hematologic system
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6
Q

What is the most prevalent cancer

A

breast cancer

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7
Q

what cancer causes the most deaths worldwide

A

lung cancer

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8
Q

incidence of cancer

A
  • most commonly diagnosed: lung, breast/prostate, colorectal
  • estimated 1 in 3 people will have cancer in their lifetime
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9
Q

what are some modifiable risk factors for cancer

A
  • tobacco use
  • environment
  • diet
  • physical activity
  • sexually transmitted disease/infections
  • alcohol/drug use
  • occupation/military work
  • ionizing radiaition
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10
Q

what are non-modifiable risk factors

A
  • age
  • ethnicity
  • family history and genetics
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11
Q

What is paraneoplastic syndrome

A
  • cancer cells take on new roles of other cells
  • resemble primary disorders of endocrine, metabolic, hematologic, cutaneous, neurological, neuromuscular
  • unknown cause
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12
Q

what are potential causes of paraneoplastic syndrome

A
  • inflammation due to tumor growth
  • autoantibodies
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13
Q

examples of paraneoplastic syndrome

A
  • cushings syndrome: small cell lung cancer
  • lambert-eaton syndrome: SCLC
  • raynaud’s plasma cell
  • polymyalgia-lymphoma
  • necrotizing vasculitis-lymphoma
  • palmar fasciitis- ovarian cancer
  • ALS, myasthenia gravis
  • polymyositis, dermatomyositis
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14
Q

What is stiff-person syndrome

A
  • rare paraneoplastic syndrome
  • precursor to lung or breast cancer
  • can also be genetic or autoimmune disorder
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15
Q
A
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16
Q

symptoms of

stiff person syndrome

A
  • sudden painful spasms in hips or back
  • can progress to abdomen, arms, face
  • affects walking, adls, mental health
17
Q

Other examples of paraneoplasmic syndrome: non-specific

A
  • anorexia (Related to TNF: cachexin which supresses hunger)
  • fatigue
  • fever (related to pyrogen production)
18
Q

What is cancer related fatigue

A
  • persistent tiredness or exhaustion
  • may no be related to course of disease
  • common ith chemotherapy, radiation, biological modifiers, bone marrow transplant
  • may be related to higher levels of inflammatory markers, TNF
  • lower cortisol levels
  • anemia
19
Q

Oncologic pain

A
  • signs of cancner or related to cancer treatment
20
Q

Biologic causes of oncologic pain

A
  • bone destruction
  • visceral or circulatory obstruction
  • nerve compression
  • tissue or skin distension
  • inflammation, infection, necrosis
21
Q

Pain management - PT

A
  • functional activities
  • exercise
  • relation
  • massage/manual therapy
  • E-stim
  • ice
  • biofeedback
  • complementary/alternative interventions
22
Q

Chemo-induced peripheral neuropathy PT exercises

A
  • ther ex during chemo reduces risk
  • aerobic exercise
  • HIIT
23
Q

Meds for chemo-induced peripheral neuropathy

A
  • miragabalin: gabapentinoid, long half-life, binds to Ca+ channels
  • PEA: endogenous bioactive lipid, modulates inflammation
  • clonidine: used for ADD, reduces allodynia
24
Q

Breast-cancer related lymphedema

prevention and intervention

A
  • monitoring
  • compression garments: KT tape
  • MLD, CDT massage
  • resistance and aerobic exercise
  • low level laser therapy
  • acupuncture, yoga
25
Multiple myeloma | PT interventions to reduce..
- fatigue - muscule wasting - sleep disruption - improve QOL
26
multiple myeloma | considerations for exercise and mobilization
- hemoglobin - bone marrow cancer could affect - platelets - neutropenia: common side effects of chemo causing severe immunocompromised - bony lesions
27
Hospice
end of life or near end of life within 6 months
28
palliative care
serious condition that may require hospice
29
What does hospice and palliative care both focus on
- focuse on management of pain and other symptoms - can occur with hospice - can occur with rehab
30
What are the goals of hospice/palliative care
- maximize Quality of life - prevent secondary conditions - rehab in reverse (goasl for maintaince/training caregiver) - hospice services are bundled: patient gets personnel as needed, PT for pain/mobility, interdisciplinary team
31
Pain management - medical for hospice/palliative care
- as needed - around the clock - patient controlled analgesia - may need a pain pump
32
prevention of cancer: primary
- risk factor assessment - early detection - follow the ten commandments
33
Tertiary prevention of cancer
- radiation, chemo - complmentary and alternative medicine - surgery - biotherapy, antiangiogenic therapy
34
35
What is biotherapy
- immunotherapy, immune based therapy - uses biological response modifiers (interferons, IL-2 cytokines) - bone marrow or stem cell transplants - monoclonal antibiodies
36
What are monoclonal antibodies
- rituximab (rituxan): lymphoma, leukemia - trastuzumab (herceptin): breast cancer, stomach cancer - alemtuzumab (campath-1H): chronic lymphocytic leurkemia - cetuximab (erbitux): bowel cancer - Bevacizumab (Avastin) | mab=monoclonal antibodies
37
What is antiangiogenic therapy
- stops growth of blood vessels - uses antiangiogenesis factors: endostatin, angiostatin, calpastatin - cuts of blood supply to tumor - stops pathologic angiogenesis - may need to mutliple inhibitors due to redundancy | not as effective if cancer has spread
38
what is hormonal therapy
- used if cancer is affected by a specific hormone - tamoxifen: anti-estrogen - leurprolide: inhibits testosterone - goserelin: inhibits gonagotropins in pituitary => decreases testosterone