Cancer Class 3 - Medical Protocols & Massage Therapy - Surgery

Question 1

The most effective treatment option is to ______ localized cancer. It may include chemo and/or radiation pre/post-surgery.

Answer 1

Remove

Question 2

______________ surgery is not really a cancer surgery. It improves the __________/function of an area impacted by cancer.

Answer 2

Reconstructive
Appearance

Question 3

__________ surgery involves physically removing and examining a sample of cells called a ______.

Answer 3

Diagnostic
Biopsy

Question 4

T/F - Diagnostic surgery is looking for metaplasia.

Answer 4

False - Diagnostic surgery is looking for ANAPLASIA.

Question 5

____________ surgery is commonly referred to as preventative surgery, where no cancer cells are present yet.

Answer 5

Prophylactic

Question 6

If there is increased an risk of breast cancer, a __________ can be performed as a ____________ surgery.

Answer 6

Mastectomy
Prophylactic

Question 7

__________ surgery is for patients that are terminally ill and it improves their quality of life.

Answer 7

Palliation

Question 8

__________ surgery is used to reduce the tumour load if there are multiple tumors present. They would remove the biggest ones and follow-up with ____________, in hopes that the immune system can deal with the smaller ones.

Answer 8

Debulking
Chemotherapy

Question 9

When there is no presence of cancer cells in the periphery of the tissue sample.

Answer 9

Clear Margins

Question 10

Some post-surgical ______________/precautions for a patient with any recent surgical procedure (__-__ weeks ago) include:
- Trauma to the body (e.g. physical, mental, emotional)
- Consider hygiene (e.g. incision from surgery)
- Be careful with traction and PROM
- Positioning

Answer 10

Considerations
1-2 Weeks

Question 11

The expected presentation of post-surgical tissue (1-2 weeks ago) is _____.

Answer 11

S.H.A.R.P. (Swelling, Heat, Altered Function, Redness, Pain)

Question 12

T/F - Massage therapists can begin onsite treatment to a post-surgical incision after 4-6 weeks.

Answer 12

False - Massage therapists can begin onsite treatment to a post-surgical incision ASAP.

Question 13

The following are absolute general _________________ to treating a patient post-surgery:
- Fever
- Septicemia
- Patient unwillingness
- Unstable vital signs
- Certain drugs

Answer 13

Contraindications

Question 14

The following are aspects of good ____ resolution:
- Aesthetically pleasing
- No pain
- Flexibility and proper collagen alignment following functional lines of stress and movement patterns
- Sufficient perfusion and drainage
- Normal sensation
- No nerve compression

Answer 14

Scar

Question 15

Our role as massage therapists when beginning on-site work post-surgery for the general population is to promote good ____ tissue and help the patient with ____________ levels.

Answer 15

Scar Tissue
Dissociation Levels

Question 16

From 24-48 hours post-surgery, a seal or _____ will develop as a barrier against germs. We want to use the __ inch avoidance rule, as this is a local contraindication for massage.

Answer 16

Crust
4 inch

Question 17

For the first 5 days post-surgery, there will be formation of ___________ tissue, which is very delicate, sensitive and cannot withstand ________.

Answer 17

Granulation
Pressure

Question 18

T/F - Formation of granulation tissue is not a local contraindication for massage.

Answer 18

False - Formation of granulation tissue IS a local contraindication for massage.

Question 19

From __ to ___ days post-surgery, the sutures or stitches are removed.

Answer 19

5-10 days

Question 20

From 7-10 days, there is light _______________ (aka. proliferation) if “clean healing” is happening. This means there is adequate _________ and absence of infection.

Answer 20

Collagenization
Perfusion

Question 21

T/F - Ideally we would want to begin our scar work techniques at the 2 week post-surgery mark.

Answer 21

True

Question 22

From __ to __ weeks, there is heavy collagenization (aka. consolidation/___________).

Answer 22

4-6 weeks
Remodelling

Question 23

T/F - For cancer patients, it is much harder to follow a typical time frame when it comes to massage therapy post-surgery.

Answer 23

True

Question 24

Some adverse __________ for cancer patients that would delay/absolutely contraindicate onsite manual work include:
- Acute inflammation (SHARP signs)
- Immunocompromised patients (presence of infection)
- Potential thrombosis (DVT)
- Oozing/lack of closure at surgical site (low WBC counts)
- Poor perfusion (less blood cells to promote healing)
- Actue sharp pain (aka. cancer pain, paradoxical pain)
- Skin is too fragile (modify techniques)

Answer 24

Indicators

Question 25

There will be _________ immune function in the first week post-surgery. The concern for massage will depend on if clear _______ where achieved or not.

Answer 25

Decreased Margins

Question 26

T/F - If clear margins were achieved, it means that they managed to successfully take out the cancer. This is not a high level of concern for massage.

Answer 26

True

Question 27

T/F - If clear margins were not achieved, there is still a high level of cancer cells. However, this is not a definite concern for massage and we don't need to check-in with a professional prior to treating.

Answer 27

False - If clear margins were not achieved, there is still a high level of cancer cells. THIS IS a definite concern for massage and we NEED TO check-in with a professional prior to treating.

Question 28

There may be more fluctuations in ____________ and tissue status, depending on their cancer journey.

Answer 28

Inflammation

Question 29

T/F - Cancer patients are at a lower risk for infection, but if they do contract something they will have more difficulty fighting it.

Answer 29

False - Cancer patients are at a HIGHER risk for infection, AND if they do contract something they will have more difficulty fighting it.

Question 30

Cancer patients can have an increased or decreased risk of ___________ problems, depending on the type of cancer they have and if their drug cocktail affects their ability to clot.

Answer 30

Coagulation

Question 31

There may be slower or poorer quality of _______ for cancer patients.

Answer 31

Healing

Question 32

____________ may be a factor for cancer patients, especially if they aren't feeling well due to cancer toxicity and side effects of chemotherapy.

Answer 32

Malnutrition

Question 33

T/F - Chemotherapy and radiation can delay, completely stop or even reverse healing of scar tissue for cancer patients.

Answer 33

True

Question 34

_______ can be extensive and cause decreased function/vulnerability of multiple structures.

Answer 34

Surgery

Question 35

T/F - Extra structures, such as lymph nodes or part of the esophagus, can be removed during surgery to ensure clear margins are achieved.

Answer 35

True

Question 36

Involves a horizontal incision and short cut in the axillary area. They are placed at the end of an extensive surgery to prevent hematoma and decrease congestion.

Answer 36

Drains

Question 37

______ are tunnelled under the skin to the surgical site and are kept in place with a stitch. _____ will fill with fluid and are then emptied, along with the tubes being flushed with ______.

Answer 37

Drains Bulbs Saline

Question 38

T/F - Drains are kept in for 1 week, or when there is less than 2-3 tbsp of fluid collected in a day.

Answer 38

False - Drains are kept in for 2-3 WEEKS, or when there is less than 2-3 tbsp of fluid collected in a day.

Question 39

T/F - Patients won't typically complain about the small drain incisions compared to the large surgical incision.

Answer 39

False - Patients WILL typically complain MORE about the small drain incisions compared to the large surgical incision.

Question 40

It is important to be aware that post-surgical _____ can create disablement, disfigurement and have an emotional impact on the cancer patient.

Answer 40

Scars

Question 41

Some issues related to _____ for cancer patients include: - Decreased ROM - Increased pain - Potential nerve entrapment - Poor perfusion - Secondary issues (e.g. compression syndromes)

Answer 41

Scars

Question 42

A type of surgery related to intestinal cancer in which a hole is created in the abdominal wall (stoma) that allows waste to leave the body.

Answer 42

Ostomy

Question 43

Some major concerns for RMTs related to _____ bags include: - Don't lay patient on bag - Raise bag above level of body - Be aware of infection - Ensure proper communication during turning - Check-in about emptying bag before treatment

Answer 43

Stoma