MSM Test 3 – Flashcards
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Primary tumor
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cells that are local to the structure
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Secondary Tumor
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result of metastasized caner cells from the primary site
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Dysplasia
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Abnormal/ Disorganization of cells
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Hyperplasia
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Enlarged tumor
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Differentiation
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Does this look like the cells they started as? -if they mutate and no longer look like original cells-> BAD (anaplastic or undifferentiated= cancer)
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Benign
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-Non-invasive -Non metastatic -OMA
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Malignant
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-invasive -Metastatic (*carcinoma, sarcoma*)
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What do carcinomas originate from?
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epithelial cells
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What do sarcomas originate from?
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connective tissue
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What do lymphomas originate from?
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lymphoid tissue
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What do Leukemias originate from?
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hematologic cells
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Signs and symptoms of Prostate cancer that affect PT
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continual pain in lower back, ribs, pelvis, and thighs
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Signs and symptoms of colon/ rectal cancer that affect PT
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-abdominal, pelvic, back or sacral pain -pain that radiates down lower extremities
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Paraneoplastic Syndrome
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Produce signs and symptoms that aren't direct effects of the tumor or its metastases *can be first sign* -Cancer arthritis -neurologic changes -anorexia -malaise -diarrhea -weight loss -fever
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S/S of metastases: integumentary
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-skin lesion that doesn't heal -palpable changes in nail bed -bleeding, discharge, tenderness
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Osteoblastic Tumors
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-skeletal related events sequelae: pain and pathological fractures
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Osteolytic Tumors
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-skeletal related events sequelae: severe pain, pathological fractures, life threatening hypercalcemia, spinal cord compression
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What % cortical bone loss results in no WB?
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*40%*
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S/S of metastases: Musculoskeletal
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-deep localized bone pain -pathologic fracture -idiopathic proximal muscle weakness -decreased tolerance of WB -soft tissue swelling -back or rib pain
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S/S of metastases: Neurologic
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-headaches with nausea and vomiting -irritability -confusion -seizure -changes in bowel and bladder -change in DTR, clonus, or babinski -vision changes -change in mental status -balance/coordination problems -numbness and tingling
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S/S of metastases: Pulmonary
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-pleural pain -dyspnea -new onset of wheezing -productive cough -bloody cough
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S/S of metastases: Hepatic
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-abdominal pain and tenderness -jaundice -ascites -peripheral edema -right shoulder pain -general malaise -bilateral carpal tunnel syndrome
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Adjuvant therapy
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treatment give after the primary cancer treatment is completed to improve the change of a cure
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Neoadjuvant Therapy
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given before the primary therapy- both to kill any cancer cells and contribute to the effectiveness of the primary therapy
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Combined Modality Therapy
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More than one therapy in treating a patient, such as a combination of radiation therapy and chemotherapy
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Radiation Indications
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-Cure -Control (shrink tumor/ minimize spreading) -Palliative (decrease S/S, shrink tumor) -Prophylactic (make sure all cancer is gone in an area)
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Internal Radiation
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-very intense -less damage to healthy cells -hospitalized -*Indicated for breast, prostate, thyroid, head and neck cancers*
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External Beam Radiation
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-Minimal dose (fractionated) -Outpatient -Delivered in form of electromagnetic waves
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Radiation Side Effects
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-Skin erythema or irritation *observe skin while exercising* -Muscle weakness -Fatigue -Connective tissue fibrosis -Effects on bone (osteoporosis/ fractures) -*lymphedema* -weight loss -infection -sterility (prostate cancer)
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Acute Tissue Tolerance with Radiation
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while undergoing treatment-> erythema
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Intermediate Tissue Tolerance with Radiation
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up to 6 months-> fibrotic tissue changes
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Chronic Tissue Tolerance with Radiation
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6 months to 2 years-> -vascular changes -fibrotic changes continue resulting in limitations in ROM or chest expansion (irreversible) -effect on pigment producing cells -tensile strength compromised
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Chemotherapy
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treatment on *widespread* metastatic disease
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Alkylating Agents (Chemotherapy)
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Treat slow grouping cancers Side Effects: -blood cell count-> CHECK HGB/ HCT/ PLATELETS -Myalgia -balance issues-> FALL RISK
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Antitumor Antibiotics (Chemotherapy)
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used a lot in children Side Effects: -cardiotoxicity -Congestive heart failure -Lung toxicity
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Antimetabolites (Chemotherapy)
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Starves cancer cells Side effects: -confusion -vision -muscle weakness -osteoporosis-> hypercalcemia
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Taxanes/ Plant Alkaloids (chemotherapy)
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halt the cancer cells from dividing Side Effects: -*Cancer induced peripheral neuropathy* -Dizziness -Weakness -Visual problems
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Biotherapy
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treatment to stimulate or restore the ability of the immune system to fight cancer, infection, and other diseases
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Biotherapy Side Effects
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-cardiovascular changes -Flu-like symptoms -Loss of appetite -GI Symptoms -rash with dry itching skin -fluid retention -CNS-> numbness/ tingling, forgetful/ confused
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Bone Marrow or Stem Cell Transplant
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Method for reducing people from bone marrow destruction while allowing high doses of chemo and radiation (autologous > allogenic)
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Bone Marrow Transplant Side Effects
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-infection -fatigue -malaise -CNS symptoms -Graft vs host disease
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Graft Versus Host Disease (GVHD)
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Associated with allogenic transplant -loss of end ROM in multiple joints -develop bronchiolitis obliterans -significant weight loss
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Colony- Stimulating Factors (CSFs)
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supports the person with low blood counts due to chemo, acts as a hematopoietic growth factor and helps bone marrow recover
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Monoclonal Antibodies
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lab engineered copies of proteins used to help stimulate the immune system with chemo
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Hormonal Therapy
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blocks or prevents cancer cells form being exposed to hormones that cause them to grow
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Aromatase Inhibitor (Hormonal Therapy)
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wrist and hand pain with aromatase inhibitor associated musculoskeletal syndrome
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Oncologic Emergencies
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-Spinal Cord Compression -Pathologic fracture -Superior Vena Cava Syndrome -Increased Inter cranial pressure -Pericardial effusion/ cardiac tamponade -Pleural Effusion -Tumor Lysis Syndrome -Uretal/ Intestinal obstruction -Hemarthorosis -Hypercalcemia
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What should PTs focus on with hypercalcemia?
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WB activities
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How long after Chemo/ radiation should you perform exercise?
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2 hours!
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Radiation Erythema
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can exercise if only erythema but *no exercise if blistering until skin is healed*
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DASH
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Disabilites of Arm, Shoulder, and Hand -shown to be reliable in those with breast cancer (fibrosis, neuropathy)
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What intervention should be used for pts at risk for pathologic fracture (multiple myeloma or metastasis)?
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Non weight bearing activities -high repetition, low weight circuit
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Axillary Web Syndrome
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-Coring is common -associated with the risk of lymphedema -Treatment= gentle stretching and myofascial release -causes pain and limitation in shoulder flex/ab, elbow, and hand
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Aerobic Exercise for patients with cancer
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-individualized exercise programs -begin at low progress to moderate (50-70% HR max; 3-5 METS) -Borg scale 9-11 then 11-13 -Walking programs -journaling -education to maintain activity level -interval training can be beneficial
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Breast Reconstruction with Lat complications
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-decreased ROM -cannot pull/push/ heavy lifting for 6 weeks -functional activities with low weight
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Breast Reconstruction with Rectus Abdominus complications
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-careful with transfers
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Risk Reduction Program for Breast Cancer
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-Reduce post op swelling -ROM of glenohumeral scapula complex -reduce scare tissue formation -hand and arm care to minimize risk of infection -education on s/s of infection
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Lymphedema assessment
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>2 cm at any of the 4 measurement points -c/o heaviness, tightness, swelling
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Impairments with Prostate cancer
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- spinal metastasis= back pain -LE lymphedema -incontinence -cancer related fatigue
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Impairments with Head and Neck Cancer
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-Limitation in ROM in neck and shoulder -decreased strength -decreased endurance/ fatigue -impaired sensation/ skin
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Constant's Shoulder Test
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valid and reliable in pts with head and neck cancer
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3 main symptoms of leukemia
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-anemia -infection -bleeding tendencies
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Multiple Myeloma
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WB activities (due to hypercalcemia) no torsional activities
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5 Main symptoms of AIDS
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-profound fatigue -frequent recurrent infections -diarrhea -Kaposi's sarcoma -altered neurologic function
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Clinical Manifestations of AIDS
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-persistent generalized adenopathy -weight loss, fatigue, night sweats, fevers -Opportunistic infections -Involvement of central, peripheral, and autonomic nervous systems -Neuromuscular diseases -chronic diarrhea, fever, malnutrition -pelvic inflammatory disease -polymyositis
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Stage 1 exercise training for HIV/ AIDS
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no limitations to exercise
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Stage 2/3 exercise training for HIV/ AIDS
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-60-80% HR max -RPE 14 - at least 20 mins (constant or interval) -3x/ week -CD4 count 100-1000
