Oncology

Question 1

General signs and symptoms of cancer

Answer 1

CAUTION:
change in bowel/bladder routine
a sore that will not heal
unusual bleeding/discharge
thickening/lump develops
indigestion or difficulty swallowing
obvious change in wart/mole
nagging cough/hoarseness

Question 2

Cancers of epithelium

Answer 2

carcinoma
adenocarcinoma

Question 3

Connective tissue cancers

Answer 3

sarcoma
fibrosarcoma
liposarcoma
chondrosarcoma
osteosarcoma
hemangiosarcoma
leiomyosarcoma
rhabdomyosarcoma

Question 4

Nerve tissue cancers

Answer 4

astrocytoma
glioma
neurilemma sarcoma
neuroblastoma
retinoblastoma

Question 5

Hemotopoietic tissue cancers affect
examples

Answer 5

bone marrow and plasma cells
leukemia
myelodysplasia
myeloproliferative syndromes
multiple myeloma

Question 6

Musculoskeletal pain complaints in cancer patients

Answer 6

should not be taken lightly

Question 7

Bony pain complaints may relate to

Answer 7

primary site of malignancy or new matastasis
should be evaluated immediately as it could be indicative of spinal metastasis

Question 8

Soft tissue complaints may relate to

Answer 8

medication side effects or physiological changes in tissue

Question 9

What is used to classify tumors?

Answer 9

TNM

Question 10

TNM classification system

Answer 10

T-malignancy based on size and extent of primary tumor
N-lymph node involvement
M- presence of metastasis

Question 11

___ numbered stages are considered to have better overall prognosis.

Answer 11

lower

Question 12

National Cancer Institute Staging:
0
1
2
3
4

Answer 12

early malignancy that is only present in layer of cells which it began. Not all cancers have a stage 0.

malignancy limited to tissue of origin with no lymph node involvement or metastasis.

malignancy spreading into adjacent tissues; lymph nodes may show signs of micrometastases.

malignancy that has spread to adjacent tissue showing signs of fixation to deeper structures. Lymph node invovlement is high.

malignancy that has metastasized beyond primary site like to bone or another organ.

Question 13

Clinical staging vs pathologic staging

Answer 13

estimated extent of malignancy based on findings of physical exam, lab values, imaging and biopsy. Used in determining optimal course of treatment and establishes a baseline for ocmparison when assessing response.
vs.
staging based on pathology finding of tissue samples obtained during surgery.

Question 14

Pathologic stage can differ from clinical stage when…

Answer 14

surgery reveals cancer has spread more than expected in relation to clinical staging.
gives health care team more precise info to predict treatment response and prognosis.

Question 15

Most primary cancers outside the brain metastasize to

Answer 15

brain

Question 16

If breast cancer returns, it is usually within

Answer 16

2 years of initial diagnosis

Question 17

Usually signs and symptoms of bronchial carcinoma are

Answer 17

not present until disease is advanced

Question 18

Cervical cancer has a precancerous condition called

Answer 18

dysplasia and is easily treatable

Question 19

Primary cause of cervical cancer

Answer 19

HPV

Question 20

Colorectal cancer types that account for majority

Answer 20

adenocarcinoma and primary lymphoma

Question 21

There is ___ prognosis in lung cancer with expedited metastasis.

Answer 21

poor

Question 22

Exercise guidelines for patients undergoing cancer treatments:

Answer 22

always check physician orders with those with bone metastases to verify WB status and clearance to perform mobility.

monitor blood values daily: esp platelets and hematocrit

exercise should be in range of 40-65% peak HR, HRR, VO2max; def under anaerobic threshold.

RPE should not exceed 12

visits should be scheduled during time of day when patient is at peak energy levels

modify treatment to accommodate side effects of medical treatment

Question 23

____ disease is one of the most curable cancers.

Answer 23

Hodgkin

Question 24

___ cancer is a prominent type with extremely high mortality rate.

Answer 24

pancreatic

Question 25

____ is the most common type of prostate cancer. ____ cause of death in men. Prognosis is ____ with treatment.

Answer 25

adenocarcinoma second highest good

Question 26

_____ ____ carcinoma is a slow growing form of skin cancer that rarely metastasizes. Originates from epidermis and is most ___ form of skin cancer. Prognosis is ___.

Answer 26

basal cell common good

Question 27

Malignant melanoma peak incidence ___-___years old. Areas of metastases include

Answer 27

40-60 brain, lungs, liver, bone and skin

Question 28

Astrocytoma accounts for ___% of pediatric brain tumors. 2 types treatment

Answer 28

50 cerebellar supratentorial surgical resection offers 80-90% cure rate. Supratentorial also requires chemo/radiation.

Question 29

Leukemia sxs Over ___% patients with ALL achieve remission and ___-___% patients with AML achieve remission.

Answer 29

anemia, leukocyte count greater than 500,000 mm and thrombocytopenia 90% 70-80%

Question 30

Neuroblastomas are found in

Answer 30

sympathetic nervous system adrenal glands or paraspinal ganglia most common malignant tumor in children

Question 31

Prognosis is best for children diagnosed with neuroblastoma in first ___. They can

Answer 31

year of life spontaneously regress in rare cases

Question 32

Osteogenic sarcoma occurs at Most common form of ____ in _____. peak ages it occurs ____-___. Treatment____. What is not effective against it?

Answer 32

epiphyses of long bones most common form of bone cancer in children peak ages 10-20 treatment is amputation radiation is not effective with this type of tumor

Question 33

Wilms' tumor is an most cases are diagnosed between what ages? 5 year cure rate

Answer 33

embryonal nephroblastoma found in the kidney 1-4 75%

Question 34

Chemo can alter blood counts:

Answer 34

anemia, thrombocytopenia, neutropenia all part of CBC

Question 35

Patients who are anemic are advised to

Answer 35

change positions slowly, rest frequently, allow a full nights sleep

Question 36

Thrombocytopenia refers to

Answer 36

low platelet levels bruise easily

Question 37

Neutropenia causes those with it to

Answer 37

develop serious infections

Question 38

Biotherapy

Answer 38

utilizes various agents and/or techniques to change relationship between malignancy and its host. acts to strengthen patient's biological response to malignant cells

Question 39

Antiangiogenic therapy

Answer 39

focuses on use of thalidomide and its suppression of blood supply formation. It has had initial success in treatment of multiple myeloma.

Question 40

Strenuous activity should be initially ____ following implantation of radioactive seeds in brachytherapy. Communication with radiation oncologist is imperative because further...

Answer 40

avoided contraindications or precautions may be advised depending on individual case.

Question 41

Brachytherapy

Answer 41

treatment especially with prostate cancer of radioactive implantations

Question 42

Skin tattoos are used to guide beam alignment for radiation. PTs must be cautious and ___ interventions that would alter these. Examples of these treatments:

Answer 42

defer taping , soft tissue or myofascial mobilizations

Question 43

Irradiated skin requires

Answer 43

special care

Question 44

___ and ___ are contraindicated over irradiated areas for a minimum of 12 months.

Answer 44

massage and heat

Question 45

Certain chemo agents may cause patients to have a level of toxicity that requires...

Answer 45

staff and visitors to take additional precautions before making physical contact

Question 46

Pt vomiting during therapy should be

Answer 46

reported to nurse/physician especially if they are taking antiemetic medication

Question 47

Palliative oncology treatment includes

Answer 47

radiation, chemo, PT, chiro, acupuncture ,alternative and homeopathic medicines, relaxation, biofeedback, pharmacological intervention and hospice.

Question 48

Palliative care can be implemented

Answer 48

any time in the disease process

Question 49

Alkylating agents do what? Implications for PT with them?

Answer 49

bind to DNA to prevent replication extreme fatigue, GI issues, cancer pain, and blood disorders

Question 50

Most ___ and ____ modalities are contraindicated for use over active malignancy but not necessarily for use elsewhere on body.

Answer 50

heat electrotherapeutic

Question 51

Why are heat and electrotherapeutic modalities contraindicated?

Answer 51

potential for facilitating growth of malignant mass or hematogenous spread. With physician guidance, these can be overlooked in lieu of palliative goals for terminally ill patients.

Question 52

Biologic response modifier agents

Answer 52

enhance body's own ability to respond to neoplastic growth. They are not cytotoxic but facilitate patients immune response to destroy malignant tissues.

Question 53

Heavy metal compounds to treat cancer include

Answer 53

platinum coordination complexes act as alkylating agents

Question 54

Hormones are used as

Answer 54

adjunct therapy along with other forms of treatment specific to malingnancy

Question 55

Plant alkaloid agents target

Answer 55

replication process prior to and during mitosis to inhibit cell division

Question 56

differentiated cells

Answer 56

cells that have matured from a less specific to a more specific cell type

Question 57

dysplasia

Answer 57

abnormal development of cells or tissue that is often an early sign of neoplasia

Question 58

hyperplasia

Answer 58

increase in cell number that may be normal or abnormal depending on additional characteristics.

Question 59

Malignant neoplasm

Answer 59

abnormal uncontrolled cell growth that invades and destroys adjacent tissues and may metastasize to other sites and systems of the body

Question 60

Metaplasia

Answer 60

change in a cell from one type to another that may be normal or abnormal

Question 61

Neoadjuvant

Answer 61

chemo or radiation given prior to surgical oncology intervention