Oncology

Question 1

differentiate between cured and in remission

Answer 1

cured: no evidence of cancer and same life expectancy as those without cancer
remission: (partial or complete) no sxs in response to tx

Question 2

what is a benign tumor

Answer 2

harmless to host but puts pressure on systems

Question 3

what is a malignant tumor

Answer 3

aggressive and can lead to metastases

Question 4

what is a tumor derived from epithelial cells

Answer 4

carcinoma

Question 5

what is a tumor derived from muscle, bone, cartilage, fat, or connective tissue

Answer 5

sarcoma

Question 6

what is a lymphoma

Answer 6

cancer of bone marrow derived cells that affect the lymphatic system

Question 7

define myeloma

Answer 7

cancer involving the WBCs responsible for antibody production (B-cells)

Question 8

What are the T stages in TNM staging

Answer 8

primary tumor (T)

Tx: tumor cannot be evaluated
T0: no evidence of primary tumor
Tis: carcinoma in situ (early without spread to neighboring tissue
T1-4: size and extent of primary tumor

Question 9

What are the N stages in TNM staging

Answer 9

regional lymph nodes (N)

Nx: regional nodes cannot be evaluated
N0: no regional node involvement
N1-3: involvement (number and extent of spread)

Question 10

what are the M stages in TNM staging

Answer 10

distant metastases (M)

Mx: distant mets cannot be evaluated
M0: no distant mets
M1: distant mets

Question 11

what is a stage 1 tumor

Answer 11

tumor limited to the organ in which it developed

Question 12

what is a stage 2 tumor

Answer 12

local invasion of organ or adjacent tissue, perhaps first stage of lymph node development

Question 13

what is a stage 3 tumor

Answer 13

spread to the region surrounding the primary organ, high probability of metastatic disease

Question 14

what is a stage 4 tumor

Answer 14

metastatic

Question 15

T/F: metatstasis can occur up to 20 years after initial dx and medical intervention

Answer 15

True: metastasis can occur even despite medical intervention

Question 16

what are the three most common sites of cancer metastasis and why

Answer 16

lungs, bone, and liver due to extensive blood flow and venous/lymphatic drainage

Question 17

how do metastases to the brain affect patient presentation

Answer 17

change in mental status

Question 18

how do bone metastases affect patient presentation (2)

Answer 18

1. constant, intense night pain - deep

2. fractures occur with unlikely MOI (compression fx of the spine when sitting)

Question 19

how do metastases to the lungs affect patient presentation

Answer 19

pleural pain and dyspnea

Question 20

what is the most common site of mets?

Answer 20

lungs - first organ to filter malignant cells

Question 21

what is the goal of cancer treatment?

Answer 21

minimum necessary - destroy enough of the malignancy so that the body’s immune response can take over

Question 22

what are the five goals of surgery for cancer patients?

Answer 22

1. to diagnose cancer
2. to stage the disease
3. to treat it (remove tumors)
4. to reconstruct tissue
5. palliative care

Question 23

what are the three common themes of PT intervention following cancer surgery

Answer 23

1. early mobilization
2. maximize gas exchange
3. minimize deconditioning and risks associated with deconditioning

Question 24

what is chemotherapy

Answer 24

SYSTEMIC, NONSELECTIVE treatment designed to alter cell division, not directly destroy the tumor

Question 25

how do cytotoxic chemo drugs work?

Answer 25

they target actively reproducing cells whether they are normal or cancerous

Question 26

what are the two inherent problems with chemo?

Answer 26

1. it is unable to prevent recurrence of cancer | 2. cytotoxicity side effects

Question 27

what is a major side effect of chemo?

Answer 27

myelosuppresion: leukopenia, anemia, thrombocytopenia

Question 28

what are four major motor symptoms of chemo-related peripheral neuropathy

Answer 28

1. leg heaviness 2. anterior tib weakness (tripping) 3. difficulty holding/manipulating objects 4. shaky handwriting

Question 29

what are the four major sensory symptoms of chemo-related peripheral neuropathy

Answer 29

1. pins and needles 2. cold extremitiy 3. burning sensation 4. sharp, shooting pain

Question 30

what are the three major autonomic symptoms of chemo-related peripheral neuropathy

Answer 30

1. orthostasis 2. flushing 3. tachycardia

Question 31

what are PT implications for patients undergoing chemo

Answer 31

1. modify activity based on symptom intensity 2. aerobic training to prevent endurance loss and mediate cancer-related fatigue 3. chemo precautions

Question 32

what is radiation therapy

Answer 32

non-selective, localized treatment designed to focally destroy/damage cancerous cells

Question 33

what types of energy are used for radiation therapy

Answer 33

x-ray, gamma ray, alpha and beta particles

Question 34

how does radiation therapy work

Answer 34

radiation affects the nucleic acids of DNA, RNA, and vital enzymes leading to chromosomal aberrations and cell death

Question 35

What are characteristics of cells that are most radiosensitive

Answer 35

1. cells that regularly divide with high O2 content 2. G2 and mitosis phase 3. blood, intestine, ovaries, testes

Question 36

what kinds of cells are radioresistant

Answer 36

bone, muscle, nerve, endocrine

Question 37

how long do physiologic effects of radiation last?

Answer 37

microcellular changes can occur mainly up to 1 year after treatment acute: 1-6 months subacute: 6-12 months chronic: 1 year

Question 38

which radiation sites are most susceptible to immunocompromise

Answer 38

long bones, ilieum, and sternum

Question 39

how can the skin change following radiation? (4)

Answer 39

1. it can become fragile 2. it can become erythmatous 3. it can become fibrotic 4. it can create adhesions

Question 40

what happens GI/GU following radiation

Answer 40

vomiting/diarrhea

Question 41

what is the most common area of AVN following radiation?

Answer 41

hip

Question 42

what is radiation myelitis

Answer 42

demyelination, necrosis, and loss of blood flow due to damaged blood vessels along the spinal column

Question 43

what are symptoms of radiation myelitis

Answer 43

sensory dysfunction and motor weakness

Question 44

what are major PT implications for patients undergoing radiation (4)

Answer 44

1. monitor for neuropathy 2. prevent contractures 3. manage edema 4. no thermal modalities

Question 45

what is hormonal therapy

Answer 45

drugs that interfere with hormone production OR removal of the hormone producing glands

Question 46

what are the three general types of bone marrow/stem cell transplant

Answer 46

1. autologous 2. allogenic 3. syngeneic

Question 47

what happens prior to a bone marrow/stem cell transplant and why do we care

Answer 47

high dose chemo and or total body irradiation - be aware of side effects and isolation precautions

Question 48

what are some alternative and complementary therapies to cancer treatment

Answer 48

1. meditation/mindfullness/yog 2. peppermint tea for nausea 3. acupuncture for pain 4. prayer or tai chi

Question 49

what are the CAUTION early warning signs for cancer

Answer 49

1. change in bowel bladder 2. a sore that doesnt heal in 6 wks 3. unusual bleeding/discharge 4. thickening lump 5. indigestion 6. obvious wart/mole change 7. nagging cough/hoarseness

Question 50

what is cachexia

Answer 50

wasting phenomenon due to illness

Question 51

what are the four goals of cancer rehab

Answer 51

1. prevention 2. restoration 3. support 4. palliative care

Question 52

is exercise safe for cancer patients

Answer 52

absolutely, in the context of their characteristics

Question 53

what is unique about cancer related fatigue

Answer 53

not relieved by rest and is the most common symptom of treatment

Question 54

how does aerobic exercise improve sxs in cancer patients

Answer 54

reduces fatigue, nausea, anxiety, and depression improves self-esteem, physical activity, and weight control

Question 55

what is aerobic exercise protocol for cancer patients

Answer 55

large muscle, moderate intensity (40-60% HRM), 3-5x/wk 20-60 min/session

Question 56

what does the research say about exercise Rx in cancer patients

Answer 56

less fatigue in persons who perform aerobics at least every other day for 10 min