Oncology

Question 1

What is cancer

Answer 1

• uncontrolled cell proliferation and spread of abnormal cells (malignant, neoplasms, tumor, carinoma)

Question 2

Dysplasia

Answer 2

• bad formation
• dysfunctional cells grow

Question 3

Metaplasia

Answer 3

• cells grow in the wrong place and grow out of control

Question 4

Hyperplasia

Answer 4

• increase in number of cells

Question 5

Tumor:
1. adenoma
2. adenocarcinoma
3. sarcome

Answer 5

1. non-cancerous
2. cancer develops in glandular epithelial cells
3. cancer develops in mesenchymal cells (muscle/bone etc)

Question 6

Incidence of cancers

Answer 6

• most common diagnosis = breast cancer/prostate cancer
• most commonly causing death = lung cancer

Question 7

Risk factors for cancer

Answer 7

• age
• previous cancer
• lifestyle
• viral exposure (Epstein-bar, H-pylori, herpes)
• unsafe sex
• urban air pollution
• smok
• tabaco
• alcohol
• obesity

Question 8

Patters of pain referral

Answer 8

• Somatic
• visceral
• neuropathic

Question 9

Somatic pain referrals
- C7-T5
- Shoulder
- L1-L2
- Hip joint
- pharynx
- TMJ:

Answer 9

lesion site to referral site

• C7-T5 = inter scapular area/posterior shoulder
• Shoulder = neck/upper back
• L1-L2 = SI joint/hip
• Hip joint = SI and knee
• pharynx = Ips. ear
• TMJ: head, neck and heart

Question 10

Visceral pain referrals:
- diagphragmatic
- heart
- urotherial tract
- pancreas/liver/spleen
- peritoneal/abdominal cavity

Answer 10

• diaphragmatic irritation = shoulder/lumbar spin
• heart: above diaphragm
• urotherial tract = back, inguinal region, anterior thigh and genitalia
• pancreas, liver, spleen, gallbladder = shoulder, mid thoracic, low back
• peritoneal or abdominal cavity = hip pain from abscess of poses or obturator muscles

Question 11

Neuropathic pain referral

Answer 11

• Nerve or plexus = anywhere in distribution of peripheral nerve
• nerver root = dermatome
• CNS: anywhere in region of body innervated b damaged structure

Question 12

Childhood cancers

Answer 12

• Most common malignancies = ALL, non-hodgkin lymphoma, and primary CNS tumors
• neuroblastoma is the most common extra cranial solid tumor in children(mass of cells established in one area)
• rhabdomyosarcoma is the most common soft tissue sarcoma and the seventh leading cause of cancer in children
• incidence peaks between 2-5 years and 15-19 years

Question 13

Prognosis for cancers

Answer 13

• varies
• about 65% of all people have 5 year survival rate
• a significantly lower survival rate in African American mean
• modified Barthel index can provide important predictions about the length of time until death

Question 14

Neoplasm ways to classifications and stage

Answer 14

• original cell type
• staging system
• the tumor, node, metatases system (TNM)
• variety of systems

Question 15

staging system for classifying and staging neoplasms

Answer 15

• specific for each type of cancer

Question 16

The tumor, node, metastases TNM system

Answer 16

• used most often for solid tumors
• adapted for other types of tumors
• tumor size: 0-4
• node - regional lymph node involvement: 0-4
• metastases - 0 (no) or 1(yes)

Question 17

• Variety of systems

in reguards to grading of cancers

Answer 17

• grading 1-4 is another way
• classifies the degree of malignancy and differentiation of malignant cells
• ann arbor staging for lymphomas - Hodgkins and non-hidgkin

Question 18

Original cell type classification of cancer cells

Answer 18

• look at table 9.1

Question 19

Staging and grading system (describe)

Answer 19

• stage 0 = carcinoma in situ (there/not invading)
• stage 1: early stage, cancer is usually localized to primary organ
• stage 2: increase risk of regional spread because of tumor size or grade
• stage 3: local cancer has spread regionally but may not be disseminated to distant regions
• stage 4: cancer has spread and disseminated to distant sites

Question 20

Metastases

Answer 20

• spread from primary site
• most common sites: lymph nodes, liver, lung, bone, and brain
• seed = cancer cell
• soil = host environment
• can aim treatment at either the seed or soil

Question 21

Pulmonary mets
- first symptoms

Answer 21

• most common of all metastatic tumors
• a dry, persistent cough is often the first symptom
• pleural invasion: pain or SOB

Question 22

Hepatic system mets
- common with
- symptoms

Answer 22

• primary metastatic site for tumors of the stomach, colorectal and pancreas
• symptoms: abdominal or right UQ pain, general malaise and fatigue anorexia, early satiety and weight loss and sometime low grade fever
• skewed blood work

Question 23

Skeletal system and cancers

Answer 23

• bone metastases: osteolytic/osteoblastic (affect breakdown or laying down)
• the axial Skelton is most commonly involved
• pain: deep, worsened by activity, esp. WBing
• pathological fxs: without MOI
• hypercalcemia

Question 24

Brain CNS mets/tumors

Answer 24

• life threatening and emotionally debilitating
• increase intracranial pressure, obstruct the normal flow of cerebrospinal fluid
• change mentation and contribute to cognitive impairments
• reduce sensory and motor function
• most common met = lung cancer

Question 25

Spinal cord tumors

Answer 25

- earliest neurological symptoms include: gradual onset of distal weakness and sensory changes, including numbness, paresthesias, and coldness - progressive central or radicular back pain often aggravated by recumbency, weight bearing, sneezing, coughing or valsalva maneuver - sitting often provides relief

Question 26

primary prevention of cancer

Answer 26

- preventing disease from starting - nutrigenomics - chemoprevention - cancer vaccines

Question 27

Secondary prevention of cancer

Answer 27

- screenings and check ups - early detection and prompt treatment - tends to better outcome sir caught early

Question 28

tertiary prevention for cancer

Answer 28

- prevent it from worsening - managing symptoms - limiting complications - preventing disability

Question 29

Diagnosis of cancer

Answer 29

- lab values: tumor markers - imaging: radiography, CT, MRI, endoscopy, isotope scan, mammography - biopsy

Question 30

Primary neoplastic treatment modalities

Answer 30

- local methods: remove it/surgery or radiation therapy - chemotherapy: primary = main treatment; neoadjuvant = before local methods; adjuvant = after local methods - immunotherapy

Question 31

PT role with cancer

Answer 31

- physical examination - determine patients goals - exercise program: can help regulate production of certain hormones that when unregulated can lead to tumor growth - energy conservation - emergencies - palliative care

Question 32

Exercise considerations with cancer patients

Answer 32

- fever - extreme or unusual tiredness/fatigue - unusual weakness - irregular heart beat, palpations or chest pain - sudden onset of dyspnea - leg pain or cramps - unusual joint pain - recent or new-onset back, neck o bone pain - unusual bruising, or bleeding - sudden onset of nausea during exercise - rapid weight gain or loss - diarrhea or vomiting - disorientation, confusion, dizziness, light-headedness - lured vision or visual disturbances - sin pallor or unusual skin rash

Question 33

oncologic emergencies

Answer 33

- superior vena cava syndrome - tumor lysis syndrome - cardiovascular effects - emergent spinal cord compression - severe thrombocytopenia

Question 34

Superior vena cave syndrome

Answer 34

- associated with small cell lung cancer and lymphoma - caused by mediastinal metastasis and central lung lesions - pressure on SVC causing jugular dissension and edema in head and neck

Question 35

Tumor lysis syndrome

Answer 35

- occurs often in myeloproliferative disorders - chemo causes destruction of massive number of cells quickly - acute renal failure