C Change in bowel or bladder habits
A A sore that does not heal
U Unusual bleeding or discharge
T Thickening or lump in the breast or elsewhere
I Indigestion or difficulty in swallowing
O Obvious change in a wart or mole
N Nagging cough or hoarseness
DEFINITIONS
1.
2.
3.
4.
5.
6.
Neoplasm – “New Growth”; Applies to any
abnormal mass of tissue which exceeds the
growth of normal tissue, grows at the expense
of its host, and persists even after the stimulus
to grow is removed.
Tumor – Originally applied to the swelling
caused by inflammation but now refers only to
a new growth; characterized by progressive,
uncontrolled proliferation of cells; tumor may
be localized, invasive, benign or malignant.
Cancer – Layperson’s term for all malignant
neoplasm.
Metastasis – Occurs when cells break off from
a primary tumor site and travel to another
location via circulatory system.
Carcinoma – Malignant epithelial neoplasm
that invades surrounding tissue and
metastasizes to other body sites.
Sarcoma – A malignant neoplasm of soft
tissue; usually presents as painless swelling;
tumors are vascular and usually highly
invasive.
*Weight loss of more than 10# *Anorexia
*Undue fatigue
* Anemia
* Unexplained pain
* Weakness
Typical PT Guidelines
1. Optimize functional mobility
Includes strength, endurance, pain management,
independence with adaptive equipment, static and
dynamic balance, patient/caregiver education, orthotic
devices, and HEP
2. Maximize activity tolerance and endurance
3. Prevent joint contracture and skin breakdown
4. Prevent or reduce limb edema
5. Prevent post-op pulmonary complications
Major Tx Options:
Surgical removal of tumor
Radiation to destroy or shrink tumor
Chemotherapy
Biotherapy
Examples of types of Tx:
Curative Therapy
Intent to cure: Chemotherapy, surgery,
radiation, immunotherapy, hormonal
therapy.
Brachy Therapy
High doses of radiation directly into tumor.
Palliative Therapy
Tx’s that provide symptomatic relief w/o
intent to cure
Treatment Options
1. Functional training
2. Positioning
3. Therapeutic exercise (to tolerance)
4. Energy conservation techniques
5. Relaxation training
6. Therapeutic modalities
7. Assistive device/adaptive equipment training
8. Wheelchair and orthotic prescription
9. Pain management
10. Education Pt/family to tx protocols and Pt/family
awareness of risk of falling secondary to weakness
secondary weakness
General Guidelines for PT
5. If patient is on isolation precautions make
1. Know stage and grade of cancer
sure to sterilize all diagnostic and exercise
2. Patients may be on bed rest: Deep
equipment.
breathing exercises, position changes and bed
6. Watch placement of equipment on
exercise program.
patient’s sensitive skin.
3. Metastatic processes, especially to the bone
7. Emotional support for pt and family is
are at high risk for pathologic fracture. Take
helpful and appreciated.
care with manual chest PT techniques and
8. Timely communication with entire health
resistive exercises.
care team is essential for safe and effective
4. Pt/family education: safety management,
care.
energy conservation, postural awareness, and
9. Monitor lab values daily.
body mechanics.
5. If patient is on isolation precautions make
sure to sterilize all diagnostic and exercise
equipment.
6. Watch placement of equipment on patient’s
CONTRAINDICATIONS to PT
sensitive skin.
count < 50,000/uL
7. Emotional support for pt and family Platelet
is
Hemoglobin < 10g/dl
helpful and appreciated.
blood cell count < 300/uL
8. Timely communication with entireWhite
health
Absolute
care team is essential for safe and effective granulocytes < 2500/uL
care
9. Monitor lab values daily
PEARLS
*Schedule Tx when pt has peak energy; find their best time
of day
* Modify Tx as needed to accommodate for side effects of
Tx
*Conduct exercise at 40-65 of peak HR
*Chemobrain: The Fog
Confusion
Fatigue
Limited attention span
Short term memory
An unusual degree of difficulty w/concentration
Difficulty w/word finding
*Multi tasking and organization problems
* Monitor cardiac/respiratory systems and watch for signs
of dyspnea, sweating and pallor
Post Radiation
1. No PT while person has implanted
radioactive seeds
2. Massage and heating modalities
should be withheld for 1 year in an
irradiated area
3. Caution should be taken with skin
and underlying tissues in areas
irradiated by beam as they will be
fragile (blue markings in area)