Module 5: Cancer 101 (Extended and Permanent Survivorship)

What are the 4 Major Distresses of Cancer Survivors?

• Anxiety

• Pain

• Falls

• Fatigue

Contributions to Cancer Related Pain:

• What are the 5 main Conditions Associated w Pain?

• Post Mastectomy Pain Syndrome

• Treatment Related Myalgias

• Bone Metastases

• Avascular Necrosis

• Multiple Myeloma

Contributions to Cancer Related Pain:

• What type of Cancer is Multiple Myeloma?

• Cancer characterized by bunch of lesions throughout bony structures

  • Esp Spine

Contributions to Cancer Related Pain:

• What are is the main Risk Factor for Cancer Related Pain?

  • Ex

• Exposure to Neurotoxic Chemotherapy

  • Vinca Alkaloids

  • Platinum Agents

  • Taxanes

Contributions to Cancer Related Pain:

• What does exposure to Vinca Alkaloids cause?

• Chemotherapy Induced Peripheral Neuropathy

Contributions to Cancer Related Pain: Prevalence

• 9-38% report anxiety and depression

• 37-99% of breast cancer survivors fear death or reoccurrence

• Social Isolation

• 49% of survivors report financial hardship

• 2 out of 3 survivors report cancer related fatigue

Chemotherapy Induced Peripheral Neuropathy:

• 6 Main S/S:

• N/T in Hands and Feet

• Painful Dysethesias

• Sensory Loss

• Poor Proprioception

• DTR’s

• Balance and Coordination

Chemotherapy Induced Peripheral Neuropathy:

• Main Risk Factor:

  • Ex:

• Exposure to Neurotoxic Chemotherapy

  • Vinca Alkaloids

  • Platinum Agents

  • Taxanes

Chemotherapy Induced Peripheral Neuropathy: Prevalence

• ___% first month after chemo

• ___% at 3 months

• ___% at 6 months

• 68%

• 60%

• 30%

Bone Health: NCCN Recommendations for Screening

• Who is recommended for screening?

  • Age: F v M

• What does screening include?

• All cancer pts who are at an increased risk for bone loss due to therapy and/or age

  • F: > 65

  • M: > 70

• Bone Mineral Density Testing

Bone Health: NCCN Recommendations for Screening

• Risk factors include what? (6)

• High dose/prolonged steroid use

• Sedentary lifestyle

• Advanced age

• Hypo estrogenic state

• Hypogonadism

• Oophorectomy or Orichectomy

Bone Health: Education:

• All pts should receive education on what 2 things?

• Current evidence on exercise to improve bone health in cancer pts is ____

• Does Aerobic Training improve Bone Density?

• Education:

  • Exercise

  • Vitamin D and Calcium Supplementation

• Inconsistent

• NO

Bone Health: Education

• What type of training is BEST?

• Ground reaction force should be above what?

• Frequency:

• Combine Moderate Vigorous Intensity Resistance AND High Impact Training

• 3-4x BW

• 30-60 min per day, 2-3x per week for 12 months

Pelvic Health:

• What may cause Urinary Incontinence cause in:

  • Males:

  • Females:

  • Both:

• M:

  • s/p Prostatectomy and/or bladder reconstruction

• F:

  • Gynecologic Cancer

  • Bladder Reconstruction

  • Hormonal Tx

• Both:

  • Lung, Hematologic, or Brain Cancer

Pelvic Health: Pelvic Pain

• Pain radiates where?

• What can disrupt Pelvic Anatomy?

• Hormonal Tx can cause what?

  • Some meds can induce what in:

    • M

    • F

• Pelvic Region

• Surgical disruption to pelvic anatomy

• Vaginal Atrophy

  • M: ED and Sterility

  • F: Menopause

Cancer Screening:

• What are CLEAR Warning Signs:

  • CAUTION

• Change in Bowel or Bladder Habits

• A Sore that Does NOT Heal

• Unusual Bleeding or Discharge

• Thickening or Lump in a Breast or Elsewhere

• Indigestion or Difficulty Swallowing

• Obvious Change in a Wart or Mole

• Nagging Cough or Hoarseness

Cancer Screening:

• What are 3 additional Cancer Warning Signs?

• Bone Pain

• Unexplained Weight Loss

• Night Pain

Cancer Screening:

• What are the 5 First signs of Leukemia?

• SOB

• Pallor

• Petechiae (Red dots all over the place)

• Bone Pain

• Fatigue

• What are the 3 Neutropenic Precautions?

• Wear face mask when doing any person exchanges and if you are unable to stay at least 6 feet apart from other people

• Use hand sanitizer containing at least 60% alcohol after any deposit, withdrawal, exchange, drive thru visit, ATM use

• Wash hands thoroughly when you arrive home or to your destination where a restroom is available

Outcome Measure Took Kit:

• What instrument is a good measurement for overall muscle strength and frailty for aging and oncology pts?

• Hand grip strength

• Hand held dynamometer