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Complex Pt Management > Cancer Rehabilitation II > Flashcards

Cancer Rehabilitation II Flashcards

(51 cards)

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1
Q

What are the goals of chemotherapy?

A

Cure (remission)
Control (tumor size)
Palliation

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2
Q

What is chemotherapy?

A

Any drug used to treat disease

  • Systemic method of cancer treatment
  • Tailored to pt and tumor
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3
Q

What is the G0 phase in a cell cycle

A

Cells have not yet started to divide, (where most cells are)

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4
Q

What is the G1 phase in a cell cycle?

A

The cell starts making proteins and grows larger, new cells of normal size. last 18-30 hours

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5
Q

What is the S phase of the cell cycle?

A

DNA is copied, new cells formed have matching DNA strands

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6
Q

What is the G2 phase?

A

cell checks DNA and gets ready to start splitting into 2 cells
Last 2-10 hours

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7
Q

What is the M phase?

A

Mitosis - 30-60 minutes, cell splits into 2

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8
Q

What categories of chemo are cell cycle phase non specific?

A
  • Alkylating agents
  • Antitumor antibiotic
  • Platinum compounds
  • Mitotic inhibitors
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9
Q

What categories of chemo only affect S phase?

A

Antimetabolites

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10
Q

What categories of chemo only affect S and M phase?

A

Plant alkaloids

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11
Q

What categories of chemo only affect S and G2 phase?

A

Topoisomerase inhibitors

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12
Q

What is the goal of radiation therapy?

A

Curative or palliative

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13
Q

What are some methods of radiation therapy?

A
  • External beam radiation - teletherapy
  • Internal radiation - Brachytherapy
  • Systemic
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14
Q

Describe the radiation planning process w/ external beam?

A
  • Temp skin marks/tattos and positioning (make sure its the right spot)
    Treatment: 5-10 min
    Daily 5-6 weeks
    Measured in Grays (Gy)
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15
Q

Describe 40Gy dosage

A

Skin effects

  • hair loss occurs > 1 Gy
  • Dryness of glands
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16
Q

Describe 50Gy dosage

A

Bone effects

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17
Q

Describe 60Gy Dosage

A

Soft tissue effect

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18
Q

Describe 70Gy

A

Muscle and tendon effects

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19
Q

How is the Gy defined?

A

Irradiation absorbed by each kg of tissue expressed as Grays (Gy) - 2 Gy = 1J/kg of tissue

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20
Q

What is the purpose of Surgery for cancer?

A

physical removal of all or most of primary tumor, may involve removal of nearby lymph nodes that contain tumor mets

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21
Q

What is the purpose of External radiation?

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A

Radiation outside of body, beams focused on tumor

22
Q

What is the purpose of Internal radiation?

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A

Radiation source is inside body; capsules, seeds or needles of radioactive material placed in the tumor

23
Q

What is the purpose of systemic radiation?

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A

Selective tumor absorption of all radioactive material

24
Q

What is targeted therapy?

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A

Individualized therapies that target the underlying pathophysiology

25
What are MSK side effects of cancer treatments?
- OP (WB activities) - Change in body comp (cachexia or obesity) - PA, nutrition - Arthralgia (weight loss, AD, Thermo, Electro) - Decreased muscle strength (Progressive resistance, Ec, aquatic)
26
What are neuro side effects of cancer?
- cognitive changes (meditation, training) | - Peripheral neuropathy (Acupuncture, AD, aerobic/resistive ex)
27
What are cardiopulmonary side effects of cancer?
- L ventricular dysfunction (Cardiac rehab)
28
What are the integumentary side effects of cancer?
- Alopecia - Tissue fibrosis - Tissue necrosis - Hyperpigmentation - Lymphedma
29
What populations have the higher symptom burder?
- Women - Lung cancer patients - Person's with lower income levels - Persons receiving palliative or hospice care - 1 in 2 reported pain or SOB
30
What are the local effects of tumors?
- Pain (absent until late stages (3-4) - Obstruction (tumor compresses) - Tissue necrosis and ulceration (may lead to bleeding or infection around the tumor)
31
What are systemic effects of tumors?
- Cachexia (loss of body weight and muscle mass - increased demands from tumor cells) - Anemia (blood loss at tumor site - nutritional deficits) - Infections - occur frequently as host resistance declines - Severe fatigue - Bleeding - Paraneoplastic syndrome - tumor cells secrete subances that cause neurological dysfunctions
32
What is general exercise clearance for cancer?
- Evaluate for comorbidities - Exercise testing not required for walking, flexibility and weight training - If needed follow ACSM testing and contraindications - Evaluate for lymphedema risk
33
What is the preventative goal of PT?
Before the development of disability | Lessen severity or shorten duration
34
What is the restorative goal of PT?
- return to former status is expected w/o handicap or residual disease - return to gainful occupation
35
What is the goal of supportive PT?
- ongoing disease is controlled or slowly progressing | - maintain degree of function through training and care
36
What is the goal of palliative PT?
- Increasing disability is expected from disease | - Prevent or reduce complications
37
What are the most common side effects of cancer?
- Pain & fatigue = top 2 - Anemia - Hair loss and integumentary issues - Gastrointestinal problems - Pain - Emotional distress
38
How does physical activity affect anemia?
Aerobic exercise can increase total hemoglobin and reduce red cell mass
39
What do you consider in exercise with GI patients?
- Overdosing can inhibit gastric emptying, decrease GI absorption, or cause GI symptoms (including bleeding) - Know patients baseline
40
What are the general exercise guidelines for older adults ?
- 150 minutes a week moderate intensity aerobic exercise - 10 minute duration bouts - balance/fall prevention 3 times/week - Muscle strengthening 2 or more days a week - Start with low weights and reps - Assess exercise program weekly - avoid over training
41
What is the FITT-VP principle
- Frequency: up to 5x/wk - aerobic, 2-3 non consecutive -resistance - Intensity: 1-3 sets (8-16 reps) Progress second - Time: Progress first - Type: ACSM
42
Describe how O2 is measured with exercise?
- know pt's baseline - norm = 95-100% - <90% = hypoxemia (temp due to exercise, can transition to hypoxia)
43
What are the national standards for the Commission on Cacner?
- - Psychological distress screening - Patient navigation process - Survivorship care plan
44
What is condition/region specific the best assessment?
- assesses characteristic or activities most relevant to the condition or intervention - measures spectrum of health concepts including physical, social, and emotional - Characteristics of both generic health status and condition specific
45
What is the prospective surveillance models?
- Baseline assessments - regular screenings (3-6 months for first 3 years, 6-12 months for next 2 years, annually thereafter) - early ID and treatment side effects - Multidisciplinary approach - Model has been recommended
46
Side effects of Methotrexate?
- fever, chills, swollen lymph glands, night sweats, weight loss - Vomiting, white patches or sores inside your moth or on lips, - diarrhea, cough w/ mucus, stabbing chest pain, wheezing, feeling shortness of breath - Kidney problems - Live problems - Nerve problems - Signs of tumor breakdown (confusion, tiredness, numbness or tingling, muscle cramps, muscle weakness, vomiting, diarrhea, fast or slow HR)
47
Side effects of 5FU antimetabolite
30% - Diarrhea - nausea and possible occasional vomiting - mouth sores - poor appetite - watery eyes, sensitivity to light - taste changes, metallic taste in mouth during infusion - discoloration along vein - Low blood counts
48
Describe the dosage of radiation therapy and its effects?
- 40gy = Skin, hair loss w/ <1 Gy, dryness of glands - 50gy = bone effects - 60gy= soft tissue effects - 70gy= muscle and tendon effects
49
What are the 5 most common side effects and screening
1. Fatigue (shortness of breath) - figure 8 walk test, stanford fatigue scale, 2. Anemia - hemoglobin and hematocrit 3. Hairloss or integumentary issues (symptom inventory tools) 4. Gastrointestinal problems (symptom inventory tools) 5. Pain (VAS, pain drawing, numerical pain scale)
50
What is a possible intervention for anemia?
aerobic exercise to increase RBC production and hemoglobin
51
What is a possible intervention for neuropathy?
aerobic exercise, therapeutic agents, balance

Complex Pt Management (12 decks)

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