OTH: Cancer Flashcards
Etiology (5)
Environmental carcinogens Viral carcinogens Genetic Dietary Chronic stress
Early warning signs:
- Unusual ______/_______
- Lump, _______
- Sore that does not _____
- Change in _____/_____
- A cough that is _____, and ______
- Indigestion and dysphagia
- Change in size/appearance of ______
- Unexplained weight ____
- Bleeding/discharge
- Thickening
- Heal
- Bowel/bladder
- Hoarse and persistent
- Mole
- Loss
Tumor/neoplasm: abnormal growth of ____ ____ that is _______. Competes for vital blood supply and nutrients
New tissue
Nonfunctional
Benign tumor: localized, ___ growing, usually encapsulated. Noninvasive
Slow
Malignant tumor: INVASIVE, _____ growth. And usually mets.
Rapid
5 types of malignant tumors?
Carcinoma Sarcoma Lymphoma Leukemia Myeloma
This tumor originates in the EPITHELIAL tissue (skin, stomach, breast, rectum, colon).
Carcinoma
Carcinoma in situ is a ________ neoplasm that has not invaded basement membrane
Premalignant
The tumor originates in CT and mesodermal tissue (muscle, bone, fat)
Sarcoma
This tumor affects lymphatic system
Lymphoma
These tumors affect blood and blood forming organs
Leukemia
Myeloma
CA staging is based on what 3 factors?
Primary tumor (T) Regional lymph node involvement (N) And mets (M)
Stage 0 is what?
Carcinoma in situ
Stage 1 is what?
Tumor localized
2 cm or less
Not spread to (N)
Stage 2 is what?
Tumor locally advanced
2-5 cm
With or without (n) involvement
Stage 3 is what?
Tumor is locally more advanced Spread to (n)
Stage 4 is what?
Tumor has METS, or spread to other organs
Grade 1 (low grade): CA cells resemble \_\_\_\_\_ cells (well differentiated), \_\_\_ growing
Normal
Slow
Grade 2 (immediate grade): CA cells look more _____ (mod differentiated) and are growing _____ _____
Abn
Slightly faster
Grade 3 (high grade): CA cells are ____ (poorly differentiated)/ spread more _______
Abn
Aggressively
Grade 4 (high grade): CA cells are ____ (undifferentiated)
Abn
Cured means that there is no recurrence within __ years post-tx
5
Medical management includes what?
Surgery
Radiation
Chemo
Immunotherapy - interferons, interleukins, cytokines ; or stem cell transplant
Red Flag: Local and Systemic Effects:
Radiation:
Pain, fatigue, immunosuppression, FIBROSIS, BURNS, _______ wound healing, edema, _____ loss, CNS effects
Delayed
Hair
Red Flag: Local and Systemic Effects:
Chemo:
Fatigue, GI SYMPTOMS, anorexia, N/V/D, hemorrhage, bone _______ suppression, SKIN RASH, NEUROPATHIES, phlebitis, hair _____
Marrow
Loss
Red Flag: Local and Systemic Effects:
Immunotherapy:
Fatigue, weight ____, ___ like symptoms, N/V, anorexia, fluid _______
Loss
Flu
Retention
Red Flag: Local and Systemic Effects:
Hormonal therapy: GI SX’S, HTN, steroid induced DM, myopathy, weight _____, hot flash/sweating, altered _____ _____, impotence
Gain
Mental status
PT Exam: PAIN
CA pain syndrome - _______ symptoms may accompany moderate to severe pain
_____cardia, _____tension, _______pnea, N/V
Sympathetic
TACHYcardia
Htn
Tachypnea
PT Exam: Pain
Examine site ______ to tumor to look for mets
DISTAL
PT Exam: PAIN
________ pain due to surg, rad, chemo
Iatrogenic
PT Exam:
What is the most common symptom?
Cancer related fatigue
Adverse side effects of CA Tx:
Immunosuppressed pt: monitor VS, physical response to exercise, may see what changes in HR/BP?
Dyspnea, PALLOR, sweating, fatigue
Pt is easily fatigued with ____ exertion
Elevated
Minimal
Adverse side effects of CA Tx:
Muscle atrophy and weakness secondary to increased dose of ______ in chemo
Steroids
Adverse side effects of CA Tx:
ROM deficits due to increased dose of ____ around joints
Radiation
Adverse side effects of CA Tx:
Hematological disruptions:
WBC suppression (leukopenia)
Platelet suppression and ___ bleeding (thrombocytopenia)
RBC suppression (anemia) with decreased ______ capacity
Increased
Aerobic
PT Goals:
Edema control: elevated _____, _____ ROM
Massage
Post-op compression
Extremities
Active
Pt Goals:
TENS when?
Post op - for pain
Pt Goals: what kind of exercise?
Isometric
Light weight isotonic
Red Flag: Pts with significant bony metastasis, osteoporosis, or platelet <20,000, what activities should you do?
What may be restricted?
What is one at increased risk for?
AROM, ADL ONLY
WB may be restricted
Increased risk for vertebral compression and other fractures with mets. Light exercise only
Exercise contraindications/precautions:
Review ____ ____ prior to each tx session
Lab values
Exercise contraindications:
Can a patient exercise on the day of IV chemo?
NO
Exercise contraindications:
Can a patient exercise within 48 hours of chemo treatment?
YES
Not within 24 hours
Exercise contraindications:
Severe reaction to radiation?
NO exercise
Exercise contraindications:
Acute illness of febrile illness of > ____ degrees F
100 deg
Exercise contraindications:
Severe N/V/D within 24-36 hours
Dehydrated
Poor nutrition
NO
Exercise contraindications:
Unusual/extreme fatigue, muscle weakness, recent ____ pain
Bone
Exercise contraindications:
Chest pain, rapid/slow ___, increased ____, ____ swelling
HR
BP
Ankle
Exercise contraindications:
Severe dyspnea, pain on _____ _____, cough/wheeze
Deep breath
Exercise contraindications:
Dizzy/lightheaded, confusion, _____ vision, ataxia
Blurred
Patients with low platelets may experience what?
SOB, excess fatigue, angina, petechiae
If platelet less than 10,000, pt may have ____ ____
Spontaneous bleeding
Pts with neutropenia have an increased risk for what?
Infection
Pts with bony mets have an increased risk for pathological _____
What activities should be avoided?
Fx
NO MMT, resistance exercise, or high stress activities
Cancer specific emergencies: Sudden loss of \_\_\_\_ \_\_\_\_\_ \_\_\_\_ \_\_\_ compression Fever \_\_\_\_ syndrome
Limb function
Spinal cord
Superior vena cava
Post mastectomy:
Restore ____ ___ full ROM of shoulder
Prevent/decrease _______
Early post op exercise stressed as early as ______ __
Pain free
Edema
Day 1
Bone marrow transplant: prolonged hospitalization and inactivity. Average 30 days. Prolonged chemo/radiation = strict _____
Isolation
Exercise is CONTRA in patients with platelets less than _________
Caution with platelets ______-_______
20,000
20,000-50,000
Platelets: Normal?
150,000-450,000
Platelets: Some limitations at what value?
50,000 - 150,000
Platelets: Moderate exercise at what value?
30,000 - 50,000
Platelets: Light exericse at what value?
20,000 - 30,000
Platelets: ROM, ADL, GAIT ONLY at what value?
<20,000
WBC: Normal?
4800 - 10800
WBC:
Light/regular exercise at what value?
> 5000
WBC:
No exercise at what value?
<5000 with fever
WBC:
No exercise, and wear protective mask with what value?
<1000
Hgl: normal for female and male?
Female: 12-16
Male: 13-18
Hgl: regular exercise at what value?
> 10
Hgl: Light exercise with what value?
8-10
Hgl: No exercise with what value?
<8
Hct (% of RBC in blood): norm for male and female?
Female: 37-48
Male: 45-52
Hct: light/reg exercise at what value?
> 25%
Hct: no exercise at what value?
<25%
What physical agents are CONTRA?
Thermal agents, deep heating agents, diathermy, hydrotherapy
Not directly over tumor
Not over dysvascular tissue: tissue exposed to radiation
Not with pts with dec sensitivity to temp/pain
Not in areas of inc bleeding/hemorrhage
Not with acute injury, inflam, open wounds
CRYOTHERAPY is conta with pts that are insensitive to cold or have delayed _____ _____
Not over ____ ______
Wound healing
Dysvascular tissue
