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46 Cards in this Set

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  • Back
What percentage of deaths is cancer responsible for in the US every year?
22.7% of all deaths
What are all of the stages of cancer rehabilitative care?
What are some characteristics of cancer cells?
Lack of senescence (outlive normal cells and create new abnormal cells)

Loss of contact inhibition (cancer cells will continue to divide and reproduce when they approximate other cells)

Ability to divide w/out anchorage
What are some general risk factors that can be used when screening for cancer?
Age >65
Exposure to sunlight
Exposure to ionizing radiation
Chemicals/metal exposure
Family hx of cancer
Poor diet
Lack of physical activity
Being overweight
What does CAUTION stand for?
Change in bowel/bladder habits
A sore/bruise that doesn't heal
Unusual bleeding/discharge
Thickening or lump
Indigestion/hard to swallow
Obvious change in wart/mole
Nagging cough/hoarseness
What does TNM stand for?
T= tumor size

N= nodal involvement

M= metastatic disease
What are some considerations to keep in mind when developing a treatment plan for cancer patients?
Type and stage of cancer, QOL of patient and his/her goals, effectiveness of treatment, side effects of treatment, and financial ramifications.
What are the main goals when surgery is performed?
-Debulk tumor
-Diagnose tumor
-Remove pre-cancerous lesions
-Correct life-threatening conditions
What are some side effects of XRT?
Fatigue, dry, fragile, or reddened skin, damage to vital organs, xerostomia, osteoporosis, tissue fibrosis, lymphedema, muscle wasting, radiation pneumonitis, radiationi induced myelopathy, myelosuppresion, avascular necrosis, and sexual dysfunction.
What is chemotherapy?
A non-selective systemic treatment that effects rapidly dividing cells by disrupting DNA. Chemotherapy drugs are often used in combination and in cycles. The goals are to cure, slow progression of disease, shrink the tumor to ease surgical approach, and palliation.
What are some side effects of chemotherapy?
Myelosuppression, organ damage, pain, vomiting/diarrhea, electrolyte abnormalities, neuropathy, and sexual dysfuntion.
Define cancer related fatigue.
A condition in which a person with cancer experiences an overwhelming and sutained sense of exhaustion and has a decreased capacity for physical and mental work. It is not relieved by rest. Symptoms need to have been present every day or at least nearly every day for the same two week period in the last month.
What are some signs and symptoms of lung cancer?
Persistent cough, blood tinged sputum, unexplained weight loss, SOB, chest discomfort, wheezing, hoarseness, swelling of face or neck, loss of apetite, and fatigue.
Which type of lung cancer has a worse prognosis- small cell or non-small cell?
Small cell- no cure
What is leukemia?
A cancer that starts in blood-forming tissues such as the bone-marrow and causes large numbers of blood cells to be produced and enter the system. Can be acute, chronic, myelogneous, or lymphocytic.
What are the guidelines for exercise with changes in blood counts?
No exercise if Hg below 8, platelets below 20,000, and WBC count less then 5,000 and accompanied by fever.

Light exercise if Hg 8-10, platelets 20,000-50,000, and WBC count greater then 5,000.

Resistence exercise if platelets greater then 50,000.
What should be included in a cancer pain assessment?
Temporal factors, intensity, topography, quality, what makes it better/worse, and what is the patient using for pain relief.
What are breast cancer risk factors?
Family history
Menstruation before 12 yrs.
Nulliparous/1st child after 30
Activity/exercise levels
Where are breast cancer cells most likely to metastasize to?
What is a woman's chance of developing breast cancer?
1 in 8 or 13%
When is a mastectomy more appropriate then a lumpectomy?
When the tumor is greater then 4 cm, multifocal tumor, history of radiation, pregnant, small breast with a large tumor, and lumpectomy had positive margins.
What are the three types of mastectomy?
Radical (entire breast, nipple, skin, lymph nodes, pec minor and major are removed)

Simple (entire breast, nipple, and skin are removed)

Modified radical (entire breast, nipple, skin, lymph nodes, and the lining over the pecs are removed)
When would a SLNB be appropriate in a breast cancer patient?
Low risk for lymphatic involvement, younger patients, no previous axillary surgery, and no previous chemotherapy.
When can shoulder ROM be started post breast cancer surgery?
After the drains have been removed from the axilla.
What is a seroma?
A localized collection of serum that resembles a tumor and can accumulate following breast surgery. One of the most common complications of mastectomy.
What is the biology of metastasis?
Tumor cells grow at primary site --> Increase in vascularity --> Detatch into the circulatory system --> Grow at secondary sites
What areas are likely to present with bony metastasis?
Humerus (20%)
Ribs (25%)
Femur (25%)
Pelvis (40%)
Vertbebra (69%)
What are some red flags in cancer rehabiliation?
Sudden increase or change in pain symptoms, altered mental status, new palpable mass or lymph node, sudden onset of progressed lymphedema or quick exacerbation of lymphedema, bruising, and change in continence.
Define restorative rehabiliation.
The effort to restore the patient to a premorbid level of function when little or no long term impairment is anticipated.
Define supportive rehabilitation.
Attempts to maximize function when long-term impairment, disability, and handicap result from cancer or its treatment.
Define preventative rehabilitation.
Attempts to preculde or mitigate functional morbidity resulting from cancer or its treatment.
Define palliative rehabilitation.
Decreases dependence in mobility and self-care in associatoin with the provision of comfort and emotional support.
What do the different stages of cancer mean?
Stage 1- localized

Stage 2- some degree of regional spread

Stage 3- extensive regional spread

Stage 4- Spread throughout body; usually a terminal diagnosis
What are the four most common types of cancer that will metastasize to the brain?
What percentage of cancer patients experience malignant compromise of the spinal cord?

Back pain is the most common presenting sign/symptom.
What chemotherapy drugs can cause neurotoxicity?
Taxol, Taxotere, Vincristine, and Cis-platinum.
What chemotherapy drugs can cause nephrotoxicity?
What chemotherapy drugs can cause cardiotoxicity?
Adriamycin and Herceptin
What chemotherapy drugs can cause pulmonary toxicity?
What characteristics of cancer cells make them so lethal?
Immortality (uncontrolled replication with no cell death)

Angiogenesis (steals blood supply)

Invasion (total disregard for spatial control)
What is the seed and soil hypothesis?
Proposal that metastasis depends on cross talk between selected cancer cells (the seeds) and specific organ microenvironments (the soil). Organ preferential metastasis.
Is a tumor cell a programmed robot or the ultimate parasite?
Ultimate parasite- steals the organisms own blood supply and nutrients, receives growth factor from the organisms cells, and utilizes enzymes that degrade surrounding tissue to allow the tumor cells to spread.
Explain the concept of tumor dormancy.
Tumor cells are still present but are not actively proliferating (they are in a stable state).
Explain the concept of tumor heterogeneity.
Cancer cells are heterogenous and comprised of many different subpopulations. Very early in the cancer they diversify and develop different characteristics from each other. This is a hallmark of lethal cancer.
What is molecular signature?
The specific genetic make-up of the cancer cells. A goal is someday to be able to choose treatments based on the characteristics of the cancer cells.
What are some obstacles to cancer prevention?
Being able to identify high risk co-horts, accurate risk stratification, and non-toxic agents to use for treatment.