Lecture 18: Cancer Survivorship

Question 1

recommended weekly exercise for cancer survivors

Answer 1

• @ least 150 minutes of moderate-intensity activity or 75 minutes of vigourous-intensity activity or equivalent combo
• 2-3 strength training sessions

Question 2

life-style modifications for prevention of re-curring cancer

Answer 2

• nutrition
• exersize
• weight management (BMI: 20-25)
• limit alc consumption (1 drink/day for women or 2 per/day for men)
• vaccines

Question 3

5 recommended vaccines for cancer survivors + main idea

Answer 3

inactivated !!

• trivalent inactivated influenza (TIV)
• pneumococcal (PPSV-23/PCV-13)
• tetanus, diphtheria, pertussis (Tdap)
• human papillomavirus (HPV)
• COVID-19

Question 4

vaccines that aren’t recommended for cancer survivors + main idea

Answer 4

live vaccines

• polio and smallpox
• measles, mumps, rubella
• varicella
• varicela zoster

Question 5

how often after surviving cancer should you get a history and physical exam

Answer 5

• every 3-6 months for first 3 yrs after primary treatment
• every 6-12 months for yrs 4-5
• then annually

Question 6

for breast cancer what is the best surveillance for survivorship

Answer 6

• annual bilateral mammogram recommended
• in case of unilateral mastectomy: annual mammogram of opposite breast
• • preform monthly self exam on breast

Question 7

surveillance of pelvic exam for breast cancer

Answer 7

recommended that women on tamoxifen should have a gynecologic assessment every 12 months if uterus present

Question 8

interventions for lymphedema

Answer 8

• strength training
• weight loss
• lymphedema specialist
• compression stockings

Question 9

what assessment scale do you use for fatigue for cancer survivors

Answer 9

edmonton symptom assessment scale
0-10

score 1-3 = mild fatigue
score 4-6 = moderate fatigue
score 7-10 = severe fatigue

Question 10

is cancer-related fatigue the same as regular fatigue

Answer 10

no

Question 11

interventions for fatigue in survivorship

Answer 11

engage in 30 min of moderate-intense physical activity most days

Question 12

what is the scale used to screen survivors for distress

Answer 12

ESAS anxiety and depression scales

0=no anxiety/depression
10=worst anxiety/depression you can imagine

Question 13

interventions for menopausal sympts

Answer 13

• SSRIs and SNRIs
• caution when using these agents in conjunction w tamoxifen
• gabapentin and clonidine are other options for management of hot flushes
• consider routine exercise

Question 14

interventions for contraception in survivors

Answer 14

• hormonal contraceptive is not recommended
• barrier methods

Question 15

what should survivors who are at risk for osteoporosis do

Answer 15

should undergo a screening bone mineral density test (by DEXA scan) at baseline and every 1-2 yrs thereafter

+ if they are pre-menopausal and post-menopausal

Question 16

sexual functions of survivors

Answer 16

• should b asked regularly about their sexual function
• offer non-hormonal, water-based lubricants for vaginal dryness
• refer to psychoeducational therapy and sexual or marital counseling when appropriate