Cancer

Question 1

4 Common Types of Cancers

Answer 1

1. Carcinoma:
   -from epithelial tissue (e.g. skin, stomach, breast, liver, kidney)
   -grow locally–>invad lymphatic–>Met
   -grow more quickly than sarcomas
2. Sarcoma:
   -from connective tissue, bone and muscle
   -grow+invade locally–>late Met
   -grow slowly but relentless
3. Lymphoma
   -from lymph node
   Hodgkin’s disease - painless, progressive enlargement of lymphoid tissue–>proliferation of lymph nodes in neck and axilla

Non-Hodgkin’s lymphoma - many types, some rapid growing and some slow growing

4. Leukemias and myeloma
   - Affect blood and blood-forming organs (bone marrow)

Question 2

Osteosarcoma

Answer 2

-Malignant bone-forming tumor
-X-ray: moth-eaten appearance
-limb salvage surgery/amputation

Question 3

Skin cancer

Answer 3

• Asymmetry
• Border (diffuse or non-distinct borders)
• Colour (bright, black or mixed)
• Diameter (>6mm)
• Evolving (changing)

Question 4

Stages of cancer

Answer 4

Stage 0 = cancer in situ

Stage 1 = cancer is small and has not extended into surrounding tissue

Stage 2-3 = cancer has extended into surrounding tissue

Stage 4 = cancer has spread to different organs

Question 5

Chemotherapy side effect

Answer 5

• fatigue
• pulmonary fibrosis
• cardiotoxicity
• myalgia
• peripheral neuropathy
• bone marrow depression

Cytotoxic precautions
–>contact precautions
- cytotoxic: excreted in urine
- can be absorbed through the skin
- in place for 48 hours after administration of the drugs

Question 6

Post-mastectomy consideration

Answer 6

1. Regain pain free ROM of shoulder
   –>early post op ex. in day 1!!
2. Prevention and reduction of edema (lymphedema)

PT Rx:
- light exercise–>more drainage
- Wrapping–>tightest in distal
- manual lymph drainage: CI: skin infection, active cancer, blood clots/CHF, area post radiation
-pneumatic compression
-compression garments

Question 7

Reduce the risk of developing Lymphedema

Answer 7

Protect arm/leg
- Shave with an electric razor
- avoid inserting needles and vaccinations in the affected limb

Rest arm or leg while recovering
- Avoid any strenuous activity
- no heavy lifting, intense exercise

Avoid heat on arm or leg
- No hot tubs or saunas
- No heat therapy to limb

Elevate arm/leg
- elevate the affected limb above heart level when possible

Avoid tight clothing
- Avoid anything that could constrict the limb (e.g. blood pressure cuff; tight band of clothing)

Keep limb clean
- Don’t go barefoot; wash hands