oncology

TNM

tumor, node, mestasis

stage I cancer

tumor limited to the tissue of origin; localized tumor growth

early stage cancer, overall have a good prognosis

stage II cancer

cancer involving more extensive disease as indicated by tumor size and/or cancer spread to nearby lymph nodes, but not to other parts of the body

stage III cancer

extensive local and regional spread

stage IV cancer

the cancer has invaded or metastasized to other organs of the body -- shift intervention to compensatory strategies and what is important to individual

grade 1 cancer

cancer cells that resemble normal cells and aren't growing rapidly

grade 2 cancer

don't look like normal cells and are growing faster than normal cells

grade 3 cancer

look abnormal and may grow/spread more aggressively

what is important in assessment preparation for cancer patients?

good hand hygiene!

remember your patient can be immuno-compromised

consider location of bony metastasis or tumors (mobilization, activity, transfers, sitting)

if someone's hemoglobin is low, what does this mean for treatment?

they're going to be very fatigued (less oxygen to the body)

neutropenic

no white blood cells, individual is very sick

what concern should you consider working with a patient with low platelets?

if they fall, could cause severe damage (bleed)

also consider therapeutic exercise, small tears to muscle could cause bleed

main goal of therapy/medical management

reduce pain

treatment has adverse effects on body and brain so emphasis on what is important to the client

how does surgery impact OT services?

knowing the reason for surgery can profoundly affect services and outcomes

diagnostic surgery

biopsy to determine the type, may remove some or all of suspicious tissue

staging surgery

determine size of tumor or where it has spread

tumor removal surgery

most common type

curative or primary

will also remove surrounding tissue

could just remove part that is causing pain

age, functional status, tumor size, location, all play a role in determining removal

can be combined with chemo and xrt

debulking surgery

remove part of the tumor

palliation surgery

relieve side effects, decrease pain, improve/restore function

reconstruction surgery

can occur during or after removal, ex: skin flap or breast reconstruction

prevention surgery

remove prior to risk of developing cancer