Cancer Flashcards
S2Q4
CANCER:
trends - death, disable, age
central goal of rehab (2)
rehab goals (4)
- death: 2nd
- self report disable: 13th
- age: >65y
- central goal of rehab: Ax Rx
rehab goals
- restorative: impairment
- preventive: deconditioning
- supportive: functional indep via AD
- palliative: irreversible changes
CANCER
rehab when, effect duration
tx x rehab
cancer vs. non (2), factors (4)
- rehab: before or during chemo tx
- tx has no adverse effect on rehab
- rehab effect: lasts 3m p d/c
cancer vs. non-cancer
- same functional gain from rehab
- CA > NCA for return to acute care
- factors for return: inc creatinine, dec albumin, use of feeding tube & catheter
CANCER: Karnofsky Scale
mild - 1.1.2
mod - 2.2.2
severe 0 3.2.4.3
mild
- 100: no complains
- 90: minor sx
- 80: normal activity with effort, some sx
mod
- can’t work, can home & self care; various assist
- 70: can’t normal activity, can personal care
- 60: occasional assist, can most intimate personal
- 50: considerable assist, medical care
severe
- 40: disabled; special care; 50% bed
- 30: severely disabled; admission is indicated
- 20: very sick; admission is necessary; active care; bed
- 10: moribound; coma/barely; rapid
- 0: death
CANCER
initial dx (2)
surveillance (2) + specific
recurrence (1)
temporization (2)
palliation (3)
initial dx
- acute morbidities
- address physical impairment
surveillance
- delayed cancer tx toxicities (cardiotoxicity)
- promote reentry
recurrence
- early stage impairments
temporization
- control sx
- address disability
palliation
- preserve function, community, education
CANCER
most common (3)
5y survival top 2
prostate cancer - age and therefore, prognosis
- most common: breast, colorectal, prostate
- 5y survival: prostate > breast
prostate cancer
- develop in geriatrics = mostly die d/t age not complications
- very good prognosis
CANCER: Precautions
hematologic - 1=1, d/t
metastatic - contraindication (2) + d/t
compression of spine - level=plegia
fluid - where (4), lead to
HEMATOLOGIC PROFILE
- lower hemoglobin = lower exercise capacity
- radiation affects bone marrow
METASTATIC BONE DISEASE
- pathologic fx
- don’t lifting or intense activity
COMPRESSION OF SPINE
- thoracic = paraplegic
FLUID IN PLEURA, PERICARDIUM, ABDOMEN, RETROPERITONEUM
- lead to can’t move cardiovascular organs around
CANCER: Precautions
CNS - who (2)
3 electrolye - d/t (2), sx (4)
OH, HR, fever
CNS DEPRESSION OR COMA
- in bedbound or palliative
HYPER/HYPOKALEMIA, HYPO/HYPERCALCEMIA, HYPONATREMIA
- d/t kidney damage (can’t excrete), cancer tx
- sx: behavioral, delirium, seizure, headache
OH
HR >110bpm, FEVER >101
- don’t rehab
CANCER: Precautions
first line of rx
crescendo
breakthrough
morphine - for (2)
exercise - parameters, when effect (2), best aerobic
thrombocytopenic - (3G)
- first line of rx: non-opioid analgesic
- crescendo: inc pain
- breakthrough: inc pain despite pain meds; give drugs
morphine
- regulated opioid
- for intense pain, prevent bedridden
exercise
- 30 mins mod 5x/wk, 45-60 mins for adult, 60 mins for kids
- aerobic endurance effect: 3x/wk 15w
- strengthening effect: 2x/wk 21w
- cycle ergometry: preferred aerobics
thrombocytopenic
- 30-50k platelets: unrestricted
- 10-20k: aerobics
- < 10k: no active therapy
CANCER: Precautions
bone marrow rehab - positions (3), extra tx
- supine or sitting, head elevated
- standing: brief
- deep breathing exercise
CANCER: Bone Metastasis
trends (2), associated cancer (5), osteoclastic activity (4)
survival, Mx (2)
types (2)
pain - most what, factors (2), where (2)
other sx (2)
exams - (1.2.1)
- most problematic for clinicians
- 3rd most common systemic metastasis
- associated: breast, lung, prostate, kidney, thyroid
- osteoclastic activity: lymphoma, multiple myeloma, thyroid, renal
- survival: 21-33m
- Mx: protection bracing (fx), neutral spine technique
- osteolytic: broken
- osteoclastic: bigger/denser
pain
- most insidious, persistent, worse at rest, dgaf about activity
- thoracic spine, femoral shaft
other sx: weight loss, neuro
exams
- triple phase bone: most
- MRI: local pain, neuro
- PET: lesion
CANCER: Fatigue
d/t, patho if, rest, severity (3), OMT
factors - (7.7)
- d/t cancer tx
- pathologic if persistent
- dgaf about rest
- severity: 1-3 (mild), 4-6 (mod), 7-10 (severe)
- OMT: FACIT (higher = better QOL)
most common factors
- pain, emotion, sleep disturbance, nutrition, anemia, deconditioning, comorbities
- cytokine release: d/t chemical build up in body
- adrenal insufficiency
- styroid myopathy, cachexia
- hypothyroidism, hypogonadism
- altered oxidative capacity: inc VO2max & CV endurance, dec max O uptake, abnormal ST & T waves
CANCER: Complications
metastatic brain - trend, associated (5), where, sx (4), lepto sx (3)
METASTATIC BRAIN
- most catastrophic neuro
- associated: lung, breast, colorectal, multiple myeloma, genitourinary
- cerebrum >
- sx: headache seizure mental hemiparesis
- ax: MRI
leptomeningeal
- back pain, radiculopathy, CN
CANCER: Complications
radiation (2)
lymphedema - associated (4), sx (4), tx (1.3)
malnutrition - albumin, BW
RADIATION ACUTE
- mucositis: dry or inflamed mucous
- xerostomia: dry mouth
LYMPHEDEMA
- asso: breast, myeloma, gyne, lymphoma
- sx: painless, colorless swelling, loss of contour, heavy; elephantisis
- tx: compexion; skin care, mob, stretch
MALNUTRITION
- serum albumin: <3
- lose 10% of pre-illness BW
CANCER: Complications
sex - d/t, men women (2.1)
breast - condition, condition 2 d/t + trend, tx (3)
prostate - sx (2), patho (2), death
SEX
- d/t tx
- testosterone & sperm; menopause
BREAST CANCER
- most common for women
- post-surgical pain syndrome
- tx: cutaneous desen, sof tissue mob, thermal c caution
- shoulder dysfunction: d/t surgery; most common long term morbidity
PROSTATE CANCER
- most common for men
- bone meta, androgen
- death d/t deprivation
- sx: incontinence, impotence
CANCER: Complications
head & neck - d/t (3), sx
hema - sx (2)
lung - sx (2)
GI - trend (2), tx
sarcoma of bone tissue - 3, prognosis, tx (1.2)
HEAD AND NECK CANCER
- squamous cell, alcohol, tobacco
- sx: diff swallow
HEMATOLOGIC
- lead to fatigue & neuropathic pain
LUNG CANCER
- apical/pancoast
- lead to fatigue & decon
GI MALIGNANCY
- 2nd death, M=F
- tx: surgery
SARCOMA OF BONE & TISSUE
- osteo chondro ewing
- tx: amputation —> chemo, radiation
- prog: good ewing if amp
