Oncology: Common Symptoms And Side Effects And Their PT Management Flashcards
What proportion of pts with cancer have pain at diagnosis? During active treatment? With advanced disease?
1/4 at diagnosis
1/3 during active treatment
3/4 with advanced disease
What are the various things that can contribute to cancer pain?
NS, endocrine, immune, systemic integration responses
Pressure, nerve infiltration, bone pain, and ischemic pain from the tumor
Surgery, chemo, radiation
Emotional response to diagnosis, emotional response to pain, though patterns surrounding pain
How does the NS contribute to cancer pain?
Peripheral and central sensitization
How does the endocrine system contribute to cancer pain?
The tumor changes hormonal regulation and hormones are released in response to pain
How does the immune system contribute to cancer pain?
Increased presence of inflammatory chemicals
What things are involved in PT management of cancer pain?
Education
Massage
Manual therapy
Movt
Mind-body care
Rarely electrophysical modalities
What is involved in education for cancer pain management?
Pain neuroscience education
Motivational interviewing
Goals and functional despite pain
Meds and medical treatment (timing meds with PT)
Massage is most helpful for what purpose in cancer pain management?
Stress reduction and relaxation as ms tension can feed into pain
T/f: there are many contradictions and precautions for manual therapy in treatment of cancer pain
True
What is the goal of manual therapy for management of cancer pain?
Improved kinesthetic sense and cortical mapping
NOT tissue change
T/f: skilled touch in manual therapy can be helpful for hypersensitivity and allodynia in cancer pain
True
What is involved in movement to manage cancer pain?
Graded motor imagery
Progressive loading
Aerobic activity
What is involved in mind body care for management of cancer pain?
Mindfulness integration
Breathing techniques
T/f: electrophysical modalities are generally contraindicated in cancer pts
True
Why are electrophysical modalities generally contraindicated for cancer pts?
Bc of concerns for tumor growth
How long should we avoid using electrophysical modalities in pts with a hx of cancer?
At least 5 years post remission
What are the 2 exceptions to the rule that electrophysical modalities are contraindicated in cancer pts?
Using low level laser for breast cancer associated lymphedema
Using modalities in palliative/hospice care where the benefits of pain control outweighs the risk for disease progression
What is cancer related fatigue?
Distressing, persistent sense of physical/emotional/cognitive fatigue not proportional to recent activity that significantly interferes with functioning
What is a sign of emotional fatigue?
Not talking to family and friends
What is a sign of cognitive fatigue?
Not being able to focus on a tv show or book
What is the prevalence of cancer related fatigue (CRF)?
> 90% of pts with cancer at some point during disease/treatment have CRF
What is the pathology behind CRF?
Unknown but multifactorial
What factors contribute to CRF?
Cancer directed therapies
Tumor growth
Unrelieved pain
Anemia
Meds
Deconditioning
Depression
Sleep disturbance
T/f: a screening of CRF should be included in the assessment of all pts with cancer
True