General cancer rehab
The 3 most common cancers in males and females?
1. Male: prostate, lung, colon
2. Female: breast, lung, colon
Side effects of androgen deprivation treatments
Fatigue, decreased muscle mass and endurance
Definition of cancer related fatigue
Fatigue not alleviated by rest, persistent, distressing, not related to activity, interferes with function
Most common symptoms of CIPN
sensory: numbness and tingling
Most common bone related side effect of cancer treatment
osteoporosis
A term to describe increasing a patients strength and function in anticipation of an upcoming stressor
Prehabilitation
Common side effects of radiation treatment
Skin, fibrosis, nerve related, cardiopulmonary, osteoradionecrosis
Work up for cancer related fatigue
Rule out other causes: anemia, thyroid, sleep disturbance, depression/anxiety
Name of syndrome where neuropathy worsens after stopping chemotherapy
What is coasting
3 most common risk factors for osteoporosis in cancer
estrogen and androgen deprivation, steroids, chemotherapy
Common psychosocial concerns
Loss of income, job, identity, mental health, fear of return of cancer
Surgical side effects
Fibrosis, lymphedema, pain, post mastectomy pain syndrome
Patient reported outcome to assess fatigue
Brief fatigue inventory
Therapy interventions for neuropathy
Taping, desensitization, bracing, fall prevention, skin protection, balance and gait training, strengthening
3 most common sites for metastatic bone lesions
vertebrae, pelvis, ribs
Patient reported outcomes in cancer rehabilitation
1. FACT, PROMIS
Syndrome of musculoskeletal issues related to aromatase inhibitors
Aromatase inhibitor musculoskeletal syndrome (AIMSS): CTS, tendon tears, tendonopathy, arthritis, inflammatory arthritis
treatment of cancer related fatigue
Rest, pacing, exercise, stimulants
Common treatments for CIPN
gabapentin, duloxetine, Tibial nerve blocks, Qutenza, lidocaine infusions
Predictor of fracture risk in bone lesion
Mirels criteria
Score >9 suggests surgical fixation is needed
1 pt: UE< <⅓ bone diameter, sclerotic, mild pain
2 pt: LE, ⅓-⅔ diameter, mixed lytic/scelerotic, mod pain
3 pt: trochanteric, >2/3 , lytic, functional pain
The 5 components of the cancer care continuum
Prevention, detection, diagnosis, treatment, survivorship
How to distinguish radiation plexopathy from neoplastic plexopathy
upper vs lower trunk, pain, EMG findings
Proposed causes of cancer related fatigue
Multi modal treatments, cytokines, loss of muscle mass/inactivity, poor nutrition, chronic stress/loneliness, depression/anxiety, sleep issues, medication side effects, pain, genetics
Most common chemotherapy medications to cause neuropathy
taxanes, platinum based meds, protease inhibitors
3 most common cancers to metastasize to bone
Breast, Lung, prostate