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PT Across the LIFESPAN > PHYSICAL THERAPY IN ONCOLOGY > Flashcards

PHYSICAL THERAPY IN ONCOLOGY Flashcards

1
Q

carcinoma affects…

A

soft tissue

a cancer arising in the epithelial tissue of the skin or of the lining of the internal organs.

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2
Q

Sarcoma affects…

A

Connective tissue and bone:

Sarcoma is an uncommon group of cancers which arise in the bones, and connective tissue such as fat and muscle

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3
Q

Leukemia affects….

A

hematopoietic cells:

a malignant progressive disease in which the bone marrow and other blood-forming organs produce increased numbers of immature or abnormal leukocyte (WBC)

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4
Q

Lymphoma affects…

A

Lymphoma is the name for a group of blood cancers that develop in the lymphatic system

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5
Q
A

TNM staging

Tumor, Node, Metastasis

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6
Q

SIGNS AND SYMPTOMS:

A
  • Pallor
  • Easy bruising
  • Pain that wakes from sleeping
  • Lymphadenopathy
  • Fatigue
  • Unintentional weight loss
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7
Q

Peripheral blood smear

A

A blood smear is a blood test used to look for abnormalities in blood cells

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8
Q

During this week, anti-emetics are given, typically feel reasonably well

A

Chemo week

drug that is effective against vomiting and nausea

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9
Q

During this week, chemo is taking effect, mouth sores, nausea, low counts/energy. Will be admitted if febrile

A

Neutropenic week

abnormally low level of neutrophils (WBC)

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10
Q

Oncology mediports:

restrictions?

A
  • Subcutaneus, venous access
  • No restrictions
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11
Q

after removal of oncology mediport

A

avoid excessive stretch and weight bearing for 2 weeks

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12
Q
A

oncology mediports

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13
Q

Vinka-alkaloids

A
  • Chemothrapy agents
  • Vincristine
  • Vinblastine
  • Vinorelibine
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14
Q

____________ are used in chemotherapy for cancer. They are a class of cell cycle–specific cytotoxic drugs that work by inhibiting the ability of cancer cells to divide: Acting upon tubulin, they prevent it from forming into microtubules, a necessary component for cellular division.

A

Vinca alkaloids

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15
Q

Vinca-Alkaloids side effects

A

Peripheral neuropathy:

  • Long nerves in the body: finger flexors and dorsiflexors
  • Diminished reflexes
  • Muscle cramping
  • Pain/hypersensitivity
  • Paralysis

“Patient may not tell doctors about side effects”

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16
Q

The anthracyclines are among the most effective anticancer treatments ever developed and are effective against more types of cancer than any other class of chemotherapeutic agents. Their main adverse effect is _________, which considerably limits their usefulness

A

cardiotoxicity:

Cardiomyopathy and CHF

Monitor HR closely, asymptomatic

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17
Q

Anthracycline antibiotics examples:

A
  • Doxorubicin
  • Danorubicin
  • Epirubicin
  • Idarubicin
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18
Q

Since cancer cells, in general, proliferate faster and with less error-correcting than healthy cells, cancer cells are more sensitive to DNA damage—such as being alkylated. _________ agents are used to treat several cancers. However, they are also toxic to normal cells (cytotoxic), particularly cells that divide frequently, such as those in the gastrointestinal tract, bone marrow, testicles and ovaries, which can cause loss of fertility. Most of the ___________ agents are also carcinogenic.

A

Alkylating

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19
Q

Side effects of Alkylating agents (Busalfan)

A
  • Pulmonary Fibrosis
    • Low O2 Sat
    • Do not use supplemental oxygen (makes pulmonari fibrosis worse)
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20
Q

Busulfan is used for:

A
  • Preparing the body for a hematopoietic stem cell transplant in combination with another medicine (cyclophosphamide) in patients with chronic myelogenous leukemia.
  • It may also be used for other conditions as determined by your doctor.
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21
Q

Platinum Based chemothrapy agents:

A
  • Cisplatin
  • Carboplatin
  • Nedaplatin
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22
Q

Side effects of Platinum-Based chemothrapy agents

(Cisplatin Carboplatin Nedaplatin)

A

Hearing Loss, Vestibular Involvement

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23
Q

The main dose-limiting side effect of cancer treatment with platinum compounds is

A

neurotoxicity

which causes peripheral neuropathies including polyneuropathy

hearing loss, vestibular involvement

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24
Q

peripheral neuropathies during chemotherapy treatment include:

A
  • Loss of Achilles tendon reflex
  • Sensory impairments
  • Numbness
  • Parasthesia
  • Weakness/muscle atrophy
  • Loss of fine motor skills
  • Gait disturbance with tripping and falls
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25
Q

peripheral neuropathies during chemotherapy treatment develop at which phase of the tx?

A

any phase of treatment

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26
Q

progression of peripheral neuropathy

(SE from chemotherapy)

A
  1. Cramping
  2. Pain
  3. Weakness
  4. Numbness
  5. Paralysis
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27
Q

what is referred as the “chemo brain”

A
  • Mental “cloudiness”
  • Typically rapid onset
  • Can be short term or long term
  • Exact cause is unknown
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28
Q

During “chemo brain” period, mental “cloudiness” can include the following impairments:

A
  • Lapses in memory
  • “spacing out” and difficulty concentrating
  • Multitasking becomes difficult
  • Increased processing time
  • Word recall
29
Q

Distressing persistent, subjective sense of physical, emotional and/or cognitive tiredness or exhaustion related to cancer or cancer treatment that is not proportional to recent activity and interferes with usual functioning.

A

CANCER RELATED FATIGUE (CRF)

30
Q

__________ biopsy is a surgical procedure used to determine if cancer has spread beyond a primary tumor into your lymphatic system. Sentinel node biopsy is used most commonly in evaluating breast cancer and melanoma.

A

Sentinel node

31
Q

Breast cancer tx considerations

A
  • Metastases to bone and brain
  • Axillary lymph node dissection
  • Flexion restrictions
  • Cording/Axillary Web Syndrome
32
Q

Gynecologic Cancers treatment considerations

A

Retroperitoneal Lymph Node Dissection (RPLND) often performed

33
Q

Trismus refers to

A

reduced opening of the jaws caused by spasm of the muscles of mastication, or may generally refer to all causes of limited mouth opening

34
Q

Head and Neck cancer tx considerations

A
  • Restrictions in neck ROM post-op
  • Trismus
35
Q

lung cancer metastasizes to

A

bone and brain

36
Q

lung cancer tx considerations

A
  • Pulmonary health
  • Oxygen saturation levels
  • Positioning
37
Q

Leukemia & Lymphoma high risk of

A

Avascular Necrosis

38
Q

How do pediatric cancer affect development?

A
  • Developmental delays
    • Parent education is extremely important
39
Q

Primary Bone Tumors Metastasizes to

A

lung

40
Q

primary bone tumors peaks at

A

growth spurts

41
Q

Brain Tumors tx considerations:

A
  • May be inoperable
  • Level of function changes very quickly
  • Ommaya reservoir
  • Steroids and anti-convulsant
42
Q

Most men die ______ prostate cancer, not from it

A

with​

43
Q

Colorectal, Pancreatic & Gastrointestinal tx considerations

A
  • Large scale surgeries needed,
  • early mobilization is key
44
Q

the “big 3” in cancer treatment

A
  • chemotherapy
  • surgery
  • radiation
45
Q

General chemotherapy side effects include

A
  • Nausea
  • Mucositis (“mouth sores”)
  • Low blood counts:
    • Neutropenia (abnormally low level of neutrophils, WBC)
46
Q

radiation therapy can be given up to

A

10 years after treatment

47
Q

radiation side effects

A
  • FIBROSIS:
    • Skin: lack of glands and follicles, sensation, pliability
    • Organs
48
Q

Hematopoietic stem cells are replaced with new ones from a donor

A

“BONE MARROW TRANSPLANT

49
Q

sources of stem cell transplant:

A
  1. Peripheral Blood
  2. Cord Blood
  3. Bone Marrow
50
Q
A

Cushingoid Symptoms

51
Q

syngenic

A

genetically matched twin

52
Q

Systems effected in a transplanted immune system

A
  • Skin
  • Liver
  • Gut
53
Q

a collection of signs and symptoms due to prolonged exposure to cortisol

A

Cushing’s syndrome

54
Q

steroids used for cancer treatment prevent increased…

A

intra-cranial pressure

55
Q

Bone Pain

A
  • Platelets and HgB are produced in the bone marrow
  • Activity has no effect
  • No risk of fracture or damage
56
Q

When to proceed to PT treatment session:

A
  • Lower extremity DVT with IVC filter
  • Platelets > 20, HgB > 8
  • Bone pain from increasing counts
  • Hydration prior to or following chemotherapy
57
Q

When to modify to PT treatment session:

A
  1. Platelets 10-20, HgB 7-8 with special orders
  2. Symptomatic
  3. External VP shunt
58
Q

delay or hold PT session?

  • Active chemotherapy infusion
  • Active blood or platelet transfusion
  • A-Line in place
A

delay

59
Q

delay or hold PT session if…?

  • Following radiation
  • Following dialysis
  • DVT (without IVC filter)
  • PEG-asparaginase
A

hold

come back in a few days

60
Q

Pretreatmnet of patients with cancer:

A
  • Strengthening and conditioning
  • Education on potential treatment related activity and participation limitations
61
Q

cancer cells division progression

A
62
Q

METASTASES

A
  • Cancer cells travel to a remote area via
    • Blood vessels
    • Lymph vessels
63
Q

Axillary web syndrome (AWS), also known as cording, sometimes develops as a side effect of

A

sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND). Both procedures involve removing just a few (SLNB) or many (ALND) of the axillary, or underarm, lymph nodes. Most people with breast cancer need to have at least one of these surgeries. Scar tissue from surgery to the chest area to remove the cancer itself also can contribute to cording .

64
Q

An Ommaya reservoir is an

A

intraventricular catheter system that can be used for the aspiration of cerebrospinal fluid or for the delivery of drugs (e.g. chemotherapy) into the cerebrospinal fluid. It consists of a catheter in one lateral ventricle attached to a reservoir implanted under the scalp.

65
Q

Cancer pain management:

A
  • Pt education:
    • Life style change: nutrition & sleep cycle
    • Activity management: no aggressive exercise or activity when pain is severe
  • Physical exercise: strenghthening, endurance, stretching
  • Mind-body therapy: yoga, relaxation therapy
  • Passive interventions: massage, TENS, hydrotherapy, myofascial release
66
Q

cancer PT treatment during active care phase

A

Address specific impairments, episodes of care inpatient and outpatient

67
Q

cancer PT treatment during palliation phase

A
  • Focus on patient/family goals.
  • Improve quality of life.
  • Maximize functional skills.
  • Durable medical equipment needs
68
Q

cancer PT treatment during Post care/ Maintenence phase

A
  • Address specific impairments and conditioning.
  • Return to activity and participation based on patient’s goals.

PT Across the LIFESPAN (13 decks)

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