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Cancer Staging
- 0 = carcinoma in situ
- 1 = localized, < 2 cm, no spreading to lymph nodes
- 2 = locally advanced, 2-5 cm, with or without lymph node involvement
- 3 = locally more advanced, spread to lymph nodes
- 4 = mets
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Effects of Radiation
- Pain
- Radiation sickness
- Fibrosis
- Delayed wound healing
- Hair loss
- Fatigue
- Immunosuppression
- Burns
- Edema
- CNS effects (demyelination, radiation encephalopathy)
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Effects of Chemotherapy
- Fatigue
- Bone marrow suppression (anemia, leukopenia, thrombocytopenia)
- Neuropathies
- Hair loss
- GI sx (diarrhea, ulcers, hemorrhage, anorexia, nausea, vomiting)
- Skin rashes
- Phlebitis
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Effects of Immunotherapy
- Fatigue
- Weight loss
- Fever
- Chills
- Nausea
- Vomiting
- Anorexia
- Fluid retention
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Effects of Hormonal Therapy
- GI symptoms
- HTN
- Hot flashes/sweating
- Impotence
- Steroid-induced diabetes and neuropathy
- Weight gain
- AMS
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Cancer: PT Goals, Outcomes, and Treatment
- Isometrics and lightweight isotonics safe for most patients with cancer
- Pts with significant bony mets, osteoporosis, low platelet count (<20,000) → AROM, ADL exercise only (WB may be restricted)
- Low-mod intensities (40-60% O2/HRR), 11-13/20 RPE, 3-5 days/week, 20-60 min/session
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Cancer: Exercise Contraindications
- Day of IV chemo or within 24 hours of treatment
- Severe reaction to radiation therapy
- Acute infection/febrile illness
- Severe nausea/vomiting/diarrhea within 24-36 hours
- Dizziness, lightheadedness, disorientation, confusion, blurred vision, ataxia
- Unusual/extreme fatigue, muscle weakness, recent bone pain
- Chest pain, rapid/slow HR, elevated BP, swelling of ankles
- Severe dyspnea, pain on deep breath, coughing/wheezing
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Low Platelets: Symptoms
- SOB
- Excessive fatigue
- Possible angina
- May develop petechiae, purport, ecchymosis, hematuria, anemia, hematochezia
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Post-Mastectomy: PT Intervention
- Restore painfree and full ROM of shoulder
- Prevent/reduce edema
- Stress early stop exercise
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Post Bone Marrow Transplant
- Prolonged hospitalization and inactivity (~30 days)
- Prolonged chemo/radiation
- Strict isolation
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