Untitled Quiz

Cancer Fundamentals

• Cancer is an umbrella term for over 300 different diseases.
• It's a dysregulation of cellular growth, leading to abnormal and damaging cell growth.
• This dysregulation often reflects changes in a cell's DNA and is often a genetic disorder (genetic or environmental).
• Cancer is the second leading cause of death in many countries.
• Cancer mortality rates have decreased since 1991.
• There are fears about the disease itself, treatment, treatment side effects, pain, suffering, disease recurrence, impotence, infertility, and mortality.
• Historically, cancer was viewed as an incurable disease.
• Improvements in diagnosis and medical care, though, have improved cancer patient outcomes.

Normal vs. Cancer Cells

• Normal cells have large cytoplasm, a single nucleus, a single nucleolus, and fine chromatin.
• Cancer cells have small cytoplasm, multiple nuclei, multiple and large nucleoli, and coarse chromatin.

Oncology Rehabilitation

• Rehabilitation is most effective when begun early; bed rest alone depletes strength by 3% daily.
• Oncology rehabilitation is a supportive health care program that addresses physical, mobility, and cognitive problems caused by cancer and its treatment.
• The patient adapts to disabilities and emotional/functional changes stemming from disease/treatment.
• Goals include helping survivors maintain activity, independence, and participation in family/community activities.
• These goals also include lessening cancer-related symptoms and adverse side effects, along with improving the quality of life.
• Physical therapy is integral to the cancer continuum.

Common Physical Problems After Cancer Treatment

• Pain
• Swelling and edema (fluid buildup)
• Decreased range of motion (ROM)
• Cording
• Strength loss
• Soft tissue restrictions
• Increased risk of infection
• Lymph/edema
• Vision loss
• Fatigue
• Bone loss (osteoporosis)
• Muscle loss
• Neuropathy
• Weight gain
• Postural changes
• Loss of normal function
• Cognitive changes (e.g., brain fog)

Cancer Continuum

• The cancer continuum outlines the various stages of cancer, from prevention to survivorship.
• It outlines the different stages of a disease, from the time of diagnosis to when the person survives or passes away.
• The continuum features prediognostic, diagnostic, and postdiagnostic periods.
• Physical therapy services fit into various periods of this continuum, which is broadly viewed as a patient's journey.

Essential Competencies for Physical Therapists

• Physical therapists need specialized training and certification in oncology to provide comprehensive care.
• Physical therapists need to be familiar with general cancer concepts, multiple body systems across the life span, cardiovascular and pulmonary systems, integumentary, musculoskeletal, and neurological systems.

Multidisciplinary Team

• Oncology rehabilitation is part of a multidisciplinary team that includes specialists in different fields of medicine.
• This includes primary care providers, oncologists, radiation oncologists, surgical oncologists, palliative care professionals, physician assistants, patient navigators, oncology social workers, and oncology nurses.

Post-Graduate Education

• Specialists in oncology certification is a crucial aspect of post-graduate education for physical therapists.
• Courses like ACSM-ACS Cancer Exercise Certification Course and Graduate Certificate in Oncology Rehabilitation from institutions like Oakland University are required (or highly recommended) for physical therapists in oncology practice.

Cancer Survivor

• A cancer survivor is anyone diagnosed with cancer who is still alive.
• Survivorship begins at diagnosis and continues throughout the life span, including during and after treatment.
• Family, friends, and caregivers are also impacted by the survivorship experience.

Long-Term Impact of a Cancer Diagnosis

• Chemotherapy and radiation treatments can lead to ongoing problems like frailty and premature aging.
• This experience can impact molecular integrity and physiologic capacity, which can increase the risk of age-related diseases.

Cancer Facts

• 77% of cancers are diagnosed at age 55 or older.
• Half of cancer patients are over 70 years of age.
• Early-onset cancers occur between ages 18 and 49; they're often outside of routine screenings.
• Early onset cancers include breast, colorectal, pancreatic, and renal cancers.
• Family history is a significant factor for early diagnosis.

Cancer Rates Among Younger Adults

• Cancer rates are rising among younger adults.
• Rates are often four times higher for those born after 1955, compared with individuals born in 1955.

Ancient History of Cancer

• Cancer was documented as a disease over 3500 years ago; historical treatments included cauterization.
• Early forms of treatment are on record from 1500 BC by Egyptian physicians.
• In the 500s BC, Hippocrates noted the distinctions between benign and malignant tumors and the belief that black bile was the primary cause of cancer.

Fossil Evidence of Cancer

• Evidence of cancer in fossils is available in archeological record (76 Million Year Old Dinosaurs)
• These discoveries show that cancer is not a modern disease.

Other Information

• Cancer is often accompanied by short-term (during/after treatment) and long-term effects.
• Short term effects, like neutropenia, Alopecia, & N&V, often resolve after treatment ends.
• Long-term effects, like peripheral neuropathy, cancer-related fatigue, osteoporosis, reproductive dysfunction, premature menopause, infertility, cardiac dysfunction, cognitive decline, increased risk of other cancers, and hearing loss can last after treatment.
• Late effects, like lymphedema, secondary cancer, cognitive changes, cardiovascular changes, reproductive dysfunction, and premature menopause/infertility, have a long-term impact.
• Demographic data helps predict how many cancer survivors might be expected to arise from cancer-related illness.
• Mechanisms of injury in cancer cases include mechanical/compressive tissue destruction/hormonal imbalances.
• Treatment and staging nomenclature have specific meanings, including Tumor Grade, Stages of tumors, TNM Staging, Grade 1, Grade 2, Grade 3, Grade 4, Gleason's Pattern, and others.
• Leukemias are cancers of the leukocytes or white blood cells; they are categorized by how quickly they develop—acute or chronic—and the type of blood cells affected (e.g., myelocytes, precursor cells for granulocytes).
• Lymphomas are blood cell cancers that develop from lymphocytes found in the lymphatic system. They are typically categorized by their clinical characteristics (indolent or aggressive).
• Multiple Myeloma is characterized by its development in plasma cells, affecting tissues like ribs, vertebrae, skull, pelvis, and femur. Signs include bone pain, fatigue, recurrent infections, and damage to the kidney/nervous system.
• There are specific tumor types like hepatocellular, adrenocortical carcinomas, melanoma, hairy cell leukemia, brain stem gliomas, ependymoma, mixed gliomas, astrocytoma, oligodendroglioma, subependymoma, and optic nerve gliomas.
• Cancer staging systems, like TNM, help describe tumor size (T), lymph node involvement (N), and metastasis (M) to classify its severity and guide treatment.