Sept. 12: Cancer Treatments

SLIDE 2:

Cancer medical interventions

  • Surgery, Radiation therapy, Chemotherapy, Targeted therapy, Immunotherapy or Biological Therapy, Stem Cell Transplantation

  • Hormone therapy- involves decreasing hormone lvls

  • Angiogenesis Inhibitor- focuses on inhibiting role blood vessels play in feeding cancer cells nutrients and 02

SLIDE 3:

Neoadjuvant therapy: (neo before)

  • first step treatment to shrink tumor before primary treatment status

    • chemo; radiation therapy; hormone therapy

  • primary tx is usually surgery

SLIDE 4:

Prehabilitation (PT first step):

  • after diagnosis and b4 medical intervention

  • helps to make you stronger and prepare for medical tx

SLIDE 4:

Adjuvant Therapy:

  • additional cancer treatments given after primary treatment to lower cancer recurrence risk

    • recurrence: new occurence of cancer that happened or appeared before

    • after surgery: radiation, chemo, immunotherapy, etc

SLIDE 7:

Resection/Excision:

  • tumor removal + surrounding healthy tissue (margin)

Cryosurgery:

  • liquid nitrogen spray or extremely cold probe to freeze and kill abnormal cells (bladder and prostate)

Electrocauterization:

  • high frequency electrical current to destroy/burn (rectal or colon)

Fulguration:

  • electrical current for destruction

Biopsy:

  • Excisional biopsy: small tumors + some normal tissue

  • Incisional Biopsy: diagnostic purpose

*****Don’t need to know hard definitions*****

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En bloc resection: surgical removal of entire tumpr w/o violating its capsule

  • resection of tumor encased by continuous margin of healthy tissue

SLIDE 12:

Mediastinum- membranous partition b/2 2 body cavities or 2 parts of an organ, especially that between lungs

SLIDE 15,16:

Radiation Therapy:

  • use of high-energy radiation to damage/kill cancer cells

Goal of Radiation therapy:

  • damage cancer cells while limiting harm to nearby healthy tissue

SLIDE 17:

When is radiation therapy used?

  • alone or in combo w/ other tx to TREAT ALMSOT EVERY TYPE OF SOLID TUMOR

  • Adjuvant radiation therapy focuses on area around oroginal cancer site

  • Prophylactic radiation therapy

    • preventative radiation therapy

  • Palliative radiation therapy

    • makes person more comfortable by killing something off

SLIDE 18:

External- most common-external beam

Internal- (brachytherapy)-implants placed directly into body near tumor

Systemic-radioactive materials (iodine) that are injected or taken orally (thyroid cancer)

Stereotactic (stereotaxic) radiosurgery uses large dose of radiation to destroy brain tumor (not actual surgery)

SLIDE 22:

Radiation Side Effects

  • Skin erythema and alopecia (HAIR LOSS) (often permanent)

  • pneumonitis (lung inflammation)

  • Xerostomia: dry mouth

  • Fatigue and mental fatigue

  • Neuropathy (numbness and tingling)

  • cardiomyopathy: heart muscle disease

SLIDE 24:

Chemotherapy

  • PURPOSE: damage DNA → apoptosis (self destruction)

  • Systemic: kills cancer cells regardless of location

SLIDE 25:

How is chemotherapy administered?

  • topical (skin cancer)

  • oral

  • injection (into vein or superficial tumor)

  • INTRAVENOUS- most commonly used- most efficient

  • intra-arterial (targeted administration)

  • Intra-peritoneal

    • peritoneum: membrane lines walls of abdominal (peritoneal) cavity and encloses abdominal organs

SLIDE 26:

Normal cells affected by chemotherapy

  • ALOPECIA (cells that grow hair)

  • ANEMIA, INCREASED RISK OF INFECTION, FATIGUE (cells in bone barrow— decreased red/wbc)

  • cells of skin/mouth — dry skin and oral sores, STOMATITIS (inflamed and sore mouth)

  • cells of gastrointestinal tract — NAUSEA, VOMITING, DIARRHEA

SLIDE 28,29,30:

Chemo Side effects: CIPN

Chemotherapy induced peripheral neuropathy

Consequences:

  • bilateral involvement

  • numbness, decreased proprioception (knowing where you are in space)

****anything SYSTEMIC (blood stream) goes everywhere so your problems are BILATERAL****

CHEMO SIDE EFFECTS: Neuropathic pain (neuralgia)

CHEMO SIDE EFFECTS: impaired vision

  • increases fall risk

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Targeted Therapy

  • uses drugs or other substances to precisely indentify and attack certain cancer cells

LESS LIKELY TO HARM NORMAL CELLS than CHEMOTHERAPY

SLIDE 34:

Keytruda:

  • used alone or w/ other drugs to treat many types of cancer

  • very expensive (Jimmy Carter was in Stage IV and overcame)

SLIDE 37:

Stem Cell Transplantation (Bone MARROW)

  • best way to get rid of cancer (from ur own or someone elses)

  • AUTOLOGOUS: marrow previosly saved from pt. is given back when needed

  • ALLOGENIC: marrow from a living donor other than patient

SLIDE 38:

CLINICAL TRIALS

  • Phase 1 (determining safe dose)

  • Phase 2 (efficacy of tx)

  • Phase 3 (DETERMINE WHETHER NEW TX IS ACTUALLY MORE EFFECTIVE THAN CURRENT TX)

SLIDE 40:

TAKE HOME MESSAGE:

  • cancer is not deadly

  • never say we suspect its cancer

    • PT’s can help save lives by finding cancer (we know how to screen, listen, palpate)

  • early detection is huge in increasing chances of living