Oncology

Question 1

What people are at risk of developing cancer?

Answer 1

The aging population and those with HIV

Question 2

What are warning signs of cancer?

Answer 2

1. Change in bowel and bladder habits
2. A sore that does not heal
3. Unusual bleeding or discharge
4. Thickening or lump in breast (or anywhere)
5. Indigestion or difficulty swallowing
6. Obvious change in wart/mole
7. Nagging cough or hoarseness

Question 3

What is a carcinoma?

Answer 3

It’s a cancer that arises from epithelial tissue of the skin or lining of internal organs

Question 4

How does a carcinoma metasize?

Answer 4

Through the lymphatic system(blood and lymphatic nodes)

Question 5

What is a sarcoma?

Answer 5

A sarcoma is a ‘fleshy’ tumor derived from the mesoderm, accounting for 10% of all cancers and is very rare.

Question 6

What types of tissues can sarcomas be derived from?

Answer 6

Sarcomas can be derived from connective tissues such as muscle, bone, or cartilage.

Question 7

What are examples of sarcomas?

Answer 7

Examples of sarcomas include osteosarcoma (cancellous bone), liposarcoma (fat tissue), chondrosarcoma (cartilage), and leiomyosarcoma (smooth uterine muscle).

Question 8

How do sarcomas metastasize?

Answer 8

Sarcomas metastasize through the venous system.

Question 9

What is lymphoma?

Answer 9

A group of blood cell tumours that develop from lymphocytes (a type of white blood cell).

Question 10

Where does lymphoma originate?

Answer 10

It originates in lymph nodes, spleen, and intestinal lining.

Question 11

Is lymphoma malignant or benign?

Answer 11

Lymphoma is always malignant.

Question 12

What are general signs and symptoms of lymphoma?

Answer 12

Fever, night sweat, weight loss, itching skin, anorexia, fatigue, respiratory dyspnea.

Question 13

What is Hodgkin lymphoma (HL)?

Answer 13

A type of lymphoma characterized by specific risk factors and demographics.

Risk factors include Epstein-Barr virus and family history. Peak age is 15–39 years, with a second peak at 50–60 years. It has a 75–90% survival rate and a 20% recurrence rate. Gender ratio is 5:1 (male:female).

Question 14

What is Stage I of HL and NHL?

Answer 14

Localized disease contained within a lymph node.

Question 15

What is Stage II of HL and NHL?

Answer 15

Presence of lymphoma in two or more lymph nodes on the same side of the diaphragm.

Question 16

What is Stage III of HL and NHL?

Answer 16

Spread of the lymphoma to both sides of the diaphragm.

Question 17

What is Stage IV of HL and NHL?

Answer 17

Diffuse; tissue outside a lymph node involved, e.g. bone marrow.

Question 18

What is leukemia?

Answer 18

A malignant progressive disease in which the bone marrow and other blood-forming organs produce increased numbers of immature or abnormal leucocytes, suppressing the production of normal blood cells.

Question 19

What are the signs and symptoms of leukemia?

Answer 19

Feeling sick, fever, night sweats, fatigue, nausea, unintentional weight loss, easy bruising, pale skin, an enlarged spleen or liver, frequent infection, anemia, which may cause dyspnea and pallor.

Question 20

What is acute leukemia?

Answer 20

The most common form of leukemia in children, characterized by a rapid increase in the number of immature blood cells.

Question 21

What is chronic leukemia?

Answer 21

A type of leukemia where the bone marrow is unable to produce healthy blood cells, leading to an excessive build-up of relatively mature, but still abnormal, white blood cells.

Typically takes months or years to progress and mostly occurs in older people.

Question 22

What is the treatment requirement for acute leukemia?

Answer 22

Immediate treatment is required.

Question 23

What is lymphocytic leukemia?

Answer 23

Lymphocytic leukemia involves a specific subtype of lymphocyte, the B-cell, which is an infection-fighting immune system cell.

Question 24

What is myelogenous leukemia?

Answer 24

Myelogenous leukemia originates in a type of marrow cell that normally goes on to form red blood cells, some other types of white cells, and platelets.

Question 25

What is the purpose of grading in the TNM system?

Answer 25

Grading establishes the degree of malignancy and how differentiated the cells are based on histology examination.

Question 26

What does Grade 1 indicate in tumor grading?

Answer 26

Grade 1 indicates well differentiated tumors that closely resemble normal parent tissue.

Question 27

What does Grade 2 indicate in tumor grading?

Answer 27

Grade 2 indicates moderately differentiated tumors with considerable resemblance to parent cells, but with visible abnormalities.

Question 28

What does Grade 3 indicate in tumor grading?

Answer 28

Grade 3 indicates poorly differentiated tumors that show very little resemblance to normal parent tissue, with evident abnormalities.

Question 29

What does Grade 4 indicate in tumor grading?

Answer 29

Grade 4 indicates undifferentiated carcinoma, which bears no significant resemblance to parent cells and shows no visible formation of glands or ducts.

Question 30

What does STAGING refer to in clinical terms?

Answer 30

Clinical extent of disease; defined by number of tissue layers involved.

Question 31

What does 'T' represent in staging?

Answer 31

T = tumor.

Question 32

What is T1 in staging?

Answer 32

T1 = in situ; no penetration; <2cm.

Question 33

What is T2 in staging?

Answer 33

T2 = Beyond membrane; >2cm <5cm.

Question 34

What is T3 in staging?

Answer 34

T3 = Through layers; >5cm.

Question 35

What is T4 in staging?

Answer 35

T4 = Into surrounding structures.

Question 36

What does NO indicate in lymph node involvement?

Answer 36

NO = No evidence of node involvement.

Question 37

What do N1-3 represent in lymph node involvement?

Answer 37

N1-3 = increments of node involvement.

Question 38

What does N4 indicate in lymph node involvement?

Answer 38

N4 = both sides of the body involved.

Question 39

What does Mx indicate in metastasis testing?

Answer 39

Mx = not tested for metastasis

Question 40

What does MO indicate in metastasis testing?

Answer 40

MO = No evidence of metastasis

Question 41

What does M1 indicate in metastasis testing?

Answer 41

M1 = distant metastasis

Question 42

What is the therapist's role in cancer management regarding lymphoedema?

Answer 42

Manual lymph drainage, ROM exercises, aerobic exercises, and lymphatic bandaging.

Question 43

How can cardio-respiratory problems be addressed in cancer management?

Answer 43

Through aerobic and strength training to combat cancer-related fatigue during and after medical treatments.

Question 44

What is a method for pain management in cancer patients?

Answer 44

Therapeutic massage.

Question 45

What is important for addressing deconditioning in cancer patients?

Answer 45

Rebuilding endurance and cardiovascular function, which can be challenging but should always be done.

Question 46

What are common genito-urinary complications in cancer patients?

Answer 46

Incontinence and sexual dysfunction.

Question 47

How can pelvic floor exercises help cancer patients?

Answer 47

They can play an integral part in managing incontinence and sexual dysfunction.

Question 48

What is vital for maintaining health?

Answer 48

Maintaining ambulation is vital. A regular exercise programme should be encouraged.

Question 49

What should be avoided when using stairs?

Answer 49

Try to avoid stairs without handrails.

Question 50

What should be used on uneven surfaces?

Answer 50

Use an appropriate assistive device.

Question 51

What is important when standing and turning to a chair?

Answer 51

Take small steps and lift your feet. Avoid twisting with your feet planted.

Question 52

How should one roll in bed?

Answer 52

Log roll only.

Question 53

What should be used for toilet transfers?

Answer 53

Use a raised toilet seat.

Question 54

What is myelosuppression?

Answer 54

Myelosuppression refers to bone marrow depression, which results in decreased production of all blood components.

Question 55

Why is it important to obtain a full blood count before rehabilitation sessions?

Answer 55

It is important to obtain a full blood count (WBC, platelets, HcT or Hgb) before each rehabilitation session because vigorous resistive exercise may be contraindicated if blood counts are low.

Question 56

What is thrombocytopenia?

Answer 56

Thrombocytopenia is a condition characterized by a low platelet count.

Question 57

What is the normal platelet count range?

Answer 57

The normal platelet count range is 200,000 - 500,000/mm³. ## Footnote At this level, resistive exercises can be done.

Question 58

What exercises can be done with a platelet count between 30,000 and 50,000/mm³?

Answer 58

Only active exercises can be done due to the risk of internal hemorrhage, but normal ambulation activities can be continued.

Question 59

What exercises are recommended for a platelet count less than 30,000/mm³?

Answer 59

Gentle exercises at bedside are recommended.

Question 60

What should be done with a platelet count less than 20,000/mm³?

Answer 60

Minimal exercises are allowed, but always consult with a nurse or doctor before activity with platelets this low.

Question 61

What is Leukopenia?

Answer 61

A low white blood count

Question 62

What is the normal white blood count?

Answer 62

5000-10 000mm³

Question 63

What is the precaution when dealing with a leukopenic patient?

Answer 63

Patient should limit contact with others and also be strict with hygiene and they are susceptible to infections

Question 64

What is the caution post radiation?

Answer 64

Not apply heat or cold over radiated areas and not massaging with oils or lotions But allowing pt to set their own goals and monitoring their vital signs and scheduling treatments 12hrs before radiation

Question 65

What does Cardiac toxicity lead to?

Answer 65

Chronic heart failure

Question 66

When treating a patient with Cardac toxicity what should you look out for?

Answer 66

Monitor for SOB Pulse rate increasing with change in activity Chest pain Diaphresis Vital signs frequently

Question 67

What are the complications that develop with Fibrosis?

Answer 67

Hard oedema and fibrotic tissue which limits ROM So swelling and redness is what to look out for at the IV site

Question 68

So what would the management be for someone with fibrosis?

Answer 68

Splinting and ROM exercises to prevent contractures