Osteopathic approach to the patient with cancer Flashcards
(38 cards)
What are the common neuromusculoskeletal manifestations of cancer?
- Musculoskeletal - back pain, joints, muscle, skin
- CNS - direct cerebral malignancy, indirect paraneoplastic
- Lymphatic system - lymphedema
- Peripheral nervous system - peripheral manifestations
- spinal cord compression
- Viscerosomatic-type response - TNF - enchanced cytolysis (tissue destruction), infection, tumor vascular damage, inflammatory responses (fever induction)
How would you appropriately present a cancer diagnosis to a patient?
- Ethical - tell the truth, offer optimism and reassurance
- Cure vs. Control of Disease
- Give opportunity to think and ask questions
- Treat the patient
When is OMT contraindicated in a cancer patient?
- area immediately surrounding cancer
- HVLA»_space; pathologic fracture of bone weakened by primary/metastic tumor
- lymphatic pumps/effleurage due to lymphogenous spread
When are OMT treatments indicated for use in a cancer patient?
- pain, somatic dysfunctions secondary to surgery, viscerosomatic reflexes
- prevent/treat complications d/t immobility
- atelectasis»_space; pneumonia or constipation
- lympedema
What is the second leading cause of death in the US?
cancer
What are the traditional allopathic approaches to cancer?
- surgery
- radiation therapy
- chemotherapy
How does renal cell cancer present?
- hematuria
- flank pain
-abdominal mass
(2-3% of all cancers)
What are the systemic manifestations of renal cell cancer?
- anemia or erythrocytosis
- FUO (fever of unknown origin)
- weight loss
- hypercalcemia
What are signs of renal cell cancer NMS metastasis?
- spine»_space; back pain
- soft tissue»_space; mass
- compression of spinal cord/nerve root»_space; peripheral neuropathic sxs
- direct metastasis»_space; CNS s/s
How is Renal cell cancer diagnosed?
- CT
- MRI
- IVP
- U/S
What are the treatments for renal cell cancer?
- surgery when localized
- radiation and chemotherapy - palliative
What is the most common cancer?
lung
- also most common cancer death
What percent of cancer deaths are tobacco products responsible for?
- 30% cancer deaths
- 80-85% of lung and laryngeal cancers
What are 4 types of lung cancer?
- small cell (oat cell) - aggressive
- squamous cell (epidermoid)
- adenocarcinoma
- large cell
In bronchogenic carcinoma, pain may present in what areas?
- neck
- axilla
- anterior lower ribs
- scapular region
- thoracic paraspinal muscle spasm
- paresthesia in upper extremity
What are some paraneoplastic syndromes?
- Cushing syndrome
- SIADH
- hpercalcemia (nonmetastic)
- subacute cerebellar degeneration
- demenia syndromes
- peripheral neuropathies
- polymiositis
- dermatomyositis
What symptoms would lead you to diagnose lung cancer?
- altered CNS function
- hypertropic pulmonary osteroarthropathy
- endocrine syndromes
- paraneoplastic syndromes
Formal diagnosis requires tissue confirmation obtained via?
- biopsy
- surgical resection
- sputum cytology
- brochial washings
What is the overall survival for lung cancer?
5 year survival is 30 - 80%
- small cell is negligible
What is multiple myeloma?
- neoplasm of B-lymphocytes of monoclonal origin
What does multiple myeloma look like on xray?
diffuse osteoporosis pattern may be seen
- lytic “punched out” lesion is absent
Where is the most frequent extramedullary sites for multiple myeloma?
- nasal sinuses
- nose
- nasopharynx
- tonsil
What percentage of patients complain of bone pain in multiple myeloma?
2/3
What is commonly seen in multiple myeloma?
- pathologic fractures common
- spinal cord and nerve root compression»_space; radicular pain
- hypercalcemia
- GI symptoms - nausea/vomiting/C + polyuria»_space;hypercalcemia
- progressive confusion
- drowsiness
- hyperviscosity syndrome
