Cancer Flashcards
(23 cards)
Cancer:
Define and Early Warning Signs
cancer is a broad group of diseases characterized by rapidly proliferating anaplastic cells - 2nd leading cause of death in the US
- Early warning signs
- usual bleeding or discharge
- a lump or thickening of any area
- a sore that does not heal
- change in bowel/bladder habits
- hoarseness or persistent cough
- indegestion or difficulty swallowing
- change in size/appearance of mole
- unexplained weight loss
Types of Cancer:
Carcinoma
Sarcoma
Lymphoma
Leukemias and Myelomas
- Carcinoma
- malignant tumor originating in epithelial tissues - skin, stomach, colon, breast, rectum, etc. in situ = has not invaded basement membrane
- Sarcoma
- a malignant tumor originating in connective tissue and mesodermal tissues - muscle, bone, fat
- Lymphoma
- affects lymphatic system - Hodgkin’s, lymphatic leukemia
- Leukemias and Myelomas
- affecting the blood - unrestrained growth of leukocytes and blood forming orgrans (bone marrow)
Cancer Staging
0
1
2
3
4
- 0 = carcinoma in situ
- 1 = tumor is localized, = 2cm, has not spread to lymph
- 2 = locally advanced, 2-5 cm, w or w/o lymph
- 3 = locally more advanced; spread to lymph, designated 2 or 3 based on type
- 4 =tumor has metastisized, spread to other organs
Cancer Grades
- Grade 1 = low grade, cancer cells resemble normal cells (well differentiated) and are slow growing
- Grade 2 = intermediate, cancer cells look more abnormal (mod diff) and are growing slightly faster
- Grade 3 = high grade, cancer cells more abnormal (poor dif); grow and spread more agressively
- Grade 4 = high grade, cancer cells are abnormal and undifferentiated
Cancer Red Flags w/ Treatment Strategies
Radiation
Chemo
Immunotherapy
Hormonal Therapy
- Radiation
- pain and fatigue
- radiation sickness
- immunosuppression
- fibrosis
- burns
- delayed wound healing
- edema
- hair loss
- CNS effects
- radiation encephalopathy, demyelenation
- Chemo
- fatigue
- gastrointestinal symptoms**
- bone marrow suppression
- fatigue
- skin rashes
- neuropathies**
- phlebitis
- hair loss
- Immunotherapy
- fatigue
- weight loss
- flu like symptoms
- fever - chills
- nausea
- vommiting
- anorexia
- fluid retention
- Hormonal Therapy
- gastrointestinal symptoms
- HTN
- steroid induced diabetes and myopathy
- weight gain
- hot flashes
- sweating
- altered mental status
- impotence
Physical Therapy Exam Cancer Patients
- Pain
- p! at site distal to tumor - metastasis
- nerve/root compression
- ischemic response
- sympathetic signs
- Cancer related fatigue CRF
Physical Therapy Goals Outcomes and Interventions
- identify and support pt family
- positioning
- edema control
- pain control
- maintain or correct ROM and strength
- Improve aerobic capacity
- assess fatigue 12 hrs later
- teach energy conservation
- remember precautions/contra = check labs before each treatment!!
Specific Considerations for Exercise:
Post Mastectomy
Post - Bone Marrow Transplant
- Post Mastectomy
- focus on restoring pain-free full ROM of shoulder, prevention/reduction of edema, restoration of function
- early post op exercise is stressed - sometimes day 1
- Post - Bone Marrow Transplant
- average 30 day hospital stay
- prolonged chemo, radiation, strict isolation
- focus on restoration of funx, and effects of deconditioning
- exercise contraindicated in pts w/ PLT < 20k and use caution 20-50K
Red Flags: Radiation Tx
- pain and fatigue
- radiation sickness
- immunosuppression
- fibrosis
- burns
- delayed wound healing
- edema
- hair loss
- CNS effects
- radiation encephalopathy, demyelenation
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Red Flags: Chemotherapy Tx
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- fatigue
- gastrointestinal symptoms**
- bone marrow suppression
- fatigue
- skin rashes
- neuropathies**
- phlebitis
- hair loss
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Red Flags: Immunotherapy Tx
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- fatigue
- weight loss
- flu like symptoms
- fever - chills
- nausea
- vommiting
- anorexia
- fluid retention
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Red Flags: Hormonal Therapy
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- gastrointestinal symptoms
- HTN
- steroid induced diabetes and myopathy
- weight gain
- hot flashes
- sweating
- altered mental status
- impotence
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Adverse Signs of Cancer Tx: w/ Immunosuppressed patient
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- Monitor vital signs
- Physiological responses to exercise
- May see elevated HR and BP
- Dyspnea
- Pallor
- Sweating
- Fatigue w/ minimal exertion
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Adverse Signs of Cancer Tx: Muscle Atrophy and Weakness
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Secondary to high doses of steriods
Disuses
Tumor compresssion/invasion
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Adverse Signs of Cancer Tx: ROM deficits
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Esp w/ high dose radiation around joints
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Adverse Signs of Cancer Tx: Hematologic Disruptions
- <!--StartFragment-->WBC supression (leukopenia) = increased infection risk
- Platelet suppresion (thrombocytopenia) = increased bleeding
- RBC suppression (anemia) = diminished aerobic capacity
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Red Flags: Cancer Patients: Pathological Fractures
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lung, breast, prostate, thyroid, and lymph met to bone
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Red Flags: Cancer Patients: Paraneoplastic Syndrome
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s/s at a site distant from tumor or met sites, from ectopic hormone production by tumor cells or metabolic abnormalities from secretion of tumor-vasoconstrictive products
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Red Flags: Cancer Patients: Cushing Syndrome
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small cell lung cancer
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Red Flags: Cancer Patients: Neurological Syndromes
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Cerebellar degeneration
Peripheral neuropathy
Myasthenia gravis
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Red Flags: Cancer Patients: Cancer stimulation of antibody production
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- Anorexia
- Malaise
- Diarrheas
- Weight loss
- Fever
- Progressive muscle weakness (type II atrophy)
- Diminished DTRs
- Myositis
- Joint pain
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Red Flags: Tx Methods in Patients w. significant bone metastasis
- Platelets < 20k
- AROM, ADL only
- WB may be restricted
- Provide appropriate ambulatory aids, orthoses
- High risk of vertebral compression and other fractures w. metastatic disease. Use light exercise only
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Red Flags: Use of Modalities in Cancer Patients
- <!--StartFragment-->Thermal Agents, Cryotherapy, Hydrotherapy
- Do not use directly over tumor
- Do not use over dysvascular tissue
- Decreased sensation to pressure or pain
- Delayed wound healing
- Increased bleeding or hemorrhage or open wounds
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