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S2 PTA 104 disease > Oncology/cancer > Flashcards

Oncology/cancer Flashcards

1
Q

Cancer

A

Uncontrolled cell proliferation

  • abnormal cells
  • malignant/malignancy neoplasm, tumor, carcinomas
  • 5% genetic
  • most common: lung, breast, colorectal
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2
Q

Typical cells

A

Uniform size, shape and structure

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3
Q

Differentiation

A

Normal cells change to form specific tissue and physiologic function

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4
Q

Dysplasia

A

Disorganization of cells, varies, van reverse or progress

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5
Q

Hyperplasia

A

Increased # of cells in tissue = mass

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6
Q

Tumors

A

Abnormal growths, new tissue without purpose = neoplasms

  • benign or malignant
  • primary: local cells
  • secondary: metastasized from other tissue (in predictable pattern)
  • carcinoma in situ: pre-invasive, premalignant, epithelial from glándula/squamos cells
  • anaplastic: undifferentiated, no sign of parent tissue
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7
Q

Neoplasm

A

Classified by cell or tissue type, origin, differentiation site, benign, malignant

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8
Q

Benign

A

Moles, ganglion, fibromas, lipomas

  • small to 3-4 inches
  • usually painless
  • does not spread
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9
Q

Eptithial type

A

Protect, excrete, absorb

  • carcinoma
  • adenocarcinomas - glandular
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10
Q

Connective tissue type

A

Connective tissue, muscle, bone, cartilage, fat

- sarcomas

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11
Q

Nerves type

A

Brain, spinal cord, nerves

- astrocytoma

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12
Q

Lymphoid type

A

Spleen and lymph nodes

- lymphoma

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13
Q

Hematopoietic

A

Bone marrow

- leukemia

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14
Q

Staging

A

Extent of disease - rate of growth - prognosis - comparisons

  1. In situ (remained in place, has not spread)
  2. Local
  3. Tumor size
  4. Spread
  5. Distant sites
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15
Q

TMN pic

A

Tumor, nodes, mestatases

Chart

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16
Q

Grading

A

Degree of malignancy (1-4)

  1. More closely resembles the tissue of origin
  2. Poorly differentiated cells, more likely to metastasize early
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17
Q

Epidemiology

A
  • geographic/environment
  • lifestyle
  • 2nd leading cause of death in US
  • nutrition, smoking, lack of exercise, ozone destruction
  • men: prostate, lung, colon
  • women: breast, lung, colon
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18
Q

Etiology

A
  • genetic: theory of oncogenes
  • environmental/exogenous
  • multi-factorial: viral, chemical, hormones, ETOH
19
Q

Risk factors

A

Age - lifestyle

- modifiable: tobacco, ETOH, obesity, inactivity, diet/nutrition, unsafe sex, pollution (air, smoke, fuels)

20
Q

Metastases

A
  • primary tumor cell breaks away, travels via blood and or lymph to organ capillaries
  • common sites: nodes, liver, lung, bone, brain
  • influences: aging, immune suppression, hormonal, pregnancy, stress
  • occur 3-5 years up to 15-20 years
21
Q

Related to PT?

A
  • contras to modalities
  • confusion (brain mets) or pain unrelieved with rest (bone mets)
  • err on side of caution!
  • thoracic pain is RED FLAG
  • ask dont assume
22
Q

Questions for pt

A
  • pain worse at night
  • pain not relieved with rest
  • is pain constant, rather than intermittent
  • night sweats
  • unexplained weight loss >10lbs in few months?
  • decreased memory
  • thoracic pain
  • family hx
23
Q

S&S

A
  • frequently asymptomatic
  • N/V, retching, anorexia, unplanned weight loss
  • pain (most common)
  • depression
  • fatigue
  • mole, non healing wound
24
Q

Pain

A

Somatic
Visceral
Neuropathic

25
Q

Fatigue

A
  • common after radiation and chemo
  • ask pts about fatigue and changes in sleep pattern
  • emotional changes: depression and anxiety
26
Q

Medical management

A
  • prevention: early detection, state of the art services, research
  • diagnosis: tissue biopsy, tumor markers
  • treatment: curative or palliative
27
Q

Prevention

A
  1. Screening, eliminate risks
  2. Early detection, prompt treatment
  3. Managin symptoms, limit complications, prevent associated disability
28
Q

Categories of medical treatment

A
  • complementary and alternative medicine
  • radiation
  • chemotherapy
  • biotherapy
  • hormonal
29
Q

Types of skin cancer

A
  1. Benign: keratosis or nevi (moles)
  2. Premalignant
  3. Malignant
    - basal cell: most common, slow growth, usually head and neck
    - squamous cell: 95% cure w/ early detection
    - malignant melanoma: rarest and most deadly
30
Q

Prevention and early detection of skin cancer

A
  • avoid sun exposure between 10-4
  • use sunscreen
  • WHO recommends no one <18 yo use tanning beds
  • have skin inspected for nodules, red patches, brown or black moles
31
Q

Warning signs of skin cancer

A
  • a sore that does not heal
  • a change in the shape, size, color, or texture of a leasion, esp an expanding, irregular circumference or surface
  • new moles or odd shaped lesions that develop
  • a skin lesion that bleeds repeatedly, oozes fluid, or itches
32
Q

ABCDE

A

Asymmetry: lopsided
Border: irregular or indistinct in shape
Color: unevenly colored with a mixture of shades
Diameter: 1/4”+
Evolution: recent changes

33
Q

Basal cell

A

Most common form of skin cancer in US

  • men 2x > women, fair skinned
  • malignant, slow growing, rarely metastasizes
  • on sun expose areas
  • originates in epidermis
  • x-ray exposure and immunosuppression
  • S&S: painless and any color, sunken center, bleeeds, non-healing, nodular
  • Tx: biopsy, surgical removal, ointment
34
Q

Squamous cell carcinoma

A

2nd most common skin cancer

  • 50+ yo men 3x > women
  • sun/ UV exposure, chewing tobacco or smoking, burned/scar tissue, carcinogen exposure, actinic keratosis, fair skinned, HPV, immunosuppression, hx of chemo, chronic inflammation, HIV/AIDS
  • S&S: non-healing irregular shape, thickened rough crust, trunk and head, change in leasion
  • 95% detection curable
  • Tx: excision, cream, injection
35
Q

Malignant melanoma

A

Invasive af

  • 4-5% CA, 75% deaths
  • childhood overexposure to sun, fair skinned, family history, multiple moles
  • nodules spread rapidly
  • S&S: mixed, flat/raised, irregular shape, dark varied color, itching, >6mm, bleeding, sudden appearance
  • PT need observation for early detection
36
Q

Skin cancer tax

A
  • surgery (Moh’s for clean margin)
  • electrodessication (basal and squamos)
  • radiation therapy (melanoma)
  • cryosurgery
  • systemic immunotherapy
37
Q

Physical therapy

A
  • prevention, restoration, support, palliative
  • functional deficits (weak, inflexible, falls, breathing, lymphedema, psychosocial)
  • goal: maximizing funciton, improve quality of life
  • breast CA pts often need shoulder rehab
38
Q

Precautions

A
  • Blood, vitals, infection, bleeding, arrhymias
  • dilated neck veins, facial/arm lymphedema
  • tumor lysis syndrome (TLS): muscle weakness and cramping, arrhythmia, decrease BP, tachycardia 6-72 hrs post chemo
  • spinal cord compression (back pain, weakness, gait changes)
  • thrombocytopenia (low platelets and high risk of bleeding)
  • severe anemia relates to fatigue
  • neutropenic precautions (risk for infection)
39
Q

Physical agents

A

Heat modalities
US
Estim
Laser

40
Q

Palliative care

A
  • improve QOL
  • prevent symptoms and side effects to terminally I’ll
  • decrease suffering, physical and psychological, support spiritual and emotional
  • maintenance of independence, dignity
  • pain manement (positioning and breathing)
  • endurance, energy conservation, home modifications
  • after curative treamtin is no longer an option
41
Q

General benefits of exercise

A
  • macrophages
  • natural killer cells
  • lymphokine-activated killer cells
  • neutrophils
  • regulating cytokines
42
Q

Exercise for prevention

A
  • physical activity: energy expenditure, movement
  • exercise- intensity, duration, frequency designed for fitness
  • increase HR/RR lasting 30 min 5x/wk
  • survivors 30-60 min moderate-vigorous 5x/wk
43
Q

Exercises with chemo or radiation

A
  • platelets < 50,000
  • hemoglobin <10g/dL
  • no exercise writhing 2 hrs of treatment
  • moderate aerobic
  • balance, strength, coordination
  • 6 minute walk test
  • 15-30 min, 3-5 days/wk, 60-80% max HR
  • high reps, low weight
  • <11-15 RPE
  • > 60 min increased fatigue reported
  • ROM, gentle resistance, interval
  • high energy periods

S2 PTA 104 disease (15 decks)

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