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== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed]) ==
== Introduction  ==
<div class="researchbox">
[[File:National-cancer-institute-0YBIMOqQzt0-unsplash.jpg|right|frameless]]
<rss>Feed goes here!!|charset=UTF-8|short|max=10</rss>  
Oncology is a  branch of medicine that specialises in the diagnosis and treatment of cancer. It includes
</div>  
* Medical oncology (the use of [[Chemotherapy Side Effects and Syndromes|chemotherapy]], [[immunotherapy]], [[Hormones|hormone]] therapy, and other drugs to treat cancer),
== References  ==
* [[Radiation Side Effects and Syndromes|Radiation]] oncology (the use of radiation therapy to treat cancer)
* Surgical oncology (the use of surgery and other procedures to treat cancer)<ref>NCI  [https://www.cancer.gov/publications/dictionaries/cancer-terms/def/oncology Cancer] Available from:https://www.cancer.gov/publications/dictionaries/cancer-terms/def/oncology (last accessed 29.8.2020)</ref>.
Cancer is the second leading cause of death globally
* Responsible for an estimated 9.6 million deaths in 2018. Globally, about 1 in 6 deaths is due to cancer.
* Approximately 70% of deaths from cancer occur in low- and middle-income countries.
* Around one third of deaths from cancer are due to the 5 leading behavioral and dietary risks: high [[Body Mass Index|body mass index]], low fruit and vegetable intake, lack of [[Physical Activity|physical activity]], tobacco use, and alcohol use<ref>WHO [https://www.who.int/news-room/fact-sheets/detail/cancer Cancer] Available from:https://www.who.int/news-room/fact-sheets/detail/cancer (last accessed29.8.2020)</ref>.
Physiotherapy are involved in care, management and rehabilitation of cancer patients from diagnosis to the [[Palliative Care Competence Framework for Physiotherapists|end of life]]. They:
* Conduct ongoing assessment of the needs of this patient group and their carers, in order to apply skilled interventions, which are vital for patients’ independence, functional capacity and quality of life.
* Are an essential member of the multi-disciplinary team, which is the key to successful rehabilitation and management of patients with cancer and [[Physiotherapy in Palliative Care|palliative]] care.
* The absence of physiotherapy intervention would be detrimental to patient care and the ability of the patient/family to cope with the effects of the disease or its treatment on their functional capacity and [[Quality of Life|quality of life]]<ref>The Role of Physiotherapy for People with Cancer - CSP Position Statement. The Chartered Society of Physiotherapy, July 2003. Available at http://www.csp.org.uk/uploads/documents/csp_statement_physioandcancer.pdf.  Retrieved 10/7/2010</ref>.
 
The following 5 minutes video is entitled "What causes cancer and how is it treated"<br>{{#ev:youtube|https://www.youtube.com/watch?v=SGaQ0WwZ_0I|width}}<ref>CTCA What is cancer Available from:https://www.youtube.com/watch?v=SGaQ0WwZ_0I (last accessed 29.8.2020)</ref>


References will automatically be added here, see [[Adding References|adding references tutorial]].  
== Pathophysiology  ==
[[File:National-cancer-institute-sIqWYiNLiJU-unsplash.jpg|right|frameless]]
Oncology is the branch of medicine that involves the prevention, diagnosis, treatment, and study of cancer. 
Cancer describes the abnormal growth of cells that results in a large mass known as a tumour. 
* Malignant tumours can spread into and invade surrounding tissues and in some cases the cells can break off and travel to other areas of the body, which is known as metatstasis. 
* Benign tumours do not invade surrounding tissues and do not continue to grow once they have been removed. 
* The regulation of cells is controlled by genetics and it takes changes to genes to create abnormal cancerous cells. 
* Genetic changes can be due to either the loss or gain of chromosomes through mitosis (the process of cell duplication) or due to mutations, changes in the nucleotide sequence  of genomic DNA.


<references />
== Causes ==
[[File:Smoking-1026556 960 720-2.jpg|right|frameless]]
There are several causes of cancer, the most common being genetic mutations due to environmental and lifestyle factors, which account for between 90-95% of cases.  The remaining are due to inherited genetics<ref>Anand P, Kunnumakara AB, Sundaram C, Harikumar KB, Tharakan ST, Lai OS, Sung B, Aggarwal BB. Cancer is a preventable disease that requires major lifestyle changes. Pharmaceutical research. 2008 Sep 1;25(9):2097-116.</ref>.  There are many known environmental factors that increase the risk of developing cancer:
* '''Carcinogens''': There are many known carcinogens with the most obvious one being tobacco.
* Tobacco: Each year tobacco is responsible for than 7 million deaths worldwide, more than 6 million of those can be attributed to direct tobacco use, but there are approximately 890,000 that are the result of second-hand tobacco smoke<ref>World Health Organization. Tobacco [Internet]. Geneva: World Health Organization; March 2018 [cited 21 May 2019]. Available from: https://www.who.int/news-room/fact-sheets/detail/tobacco</ref>.  Recent decreases in the numbers of people smoking has led to a decrease, in many countries, of cancer deaths related to [[Lung Cancer|lung cancer]]  1990.<ref>Islami F, Torre LA, Jemal A. Global trends of lung cancer mortality and smoking prevalence. Translational lung cancer research. 2015 Aug;4(4):327.</ref>
* '''Radiation''': Radiation has long been known to be carcinogenic.  Initially studies focused on incidents that involve large amounts of radiation and it was evident that large doses of radiation were at a higher risk of developing cancer.<ref>Ron, E. (1998). ''Ionizing Radiation and Cancer Risk: Evidence from Epidemiology. Radiation Research, 150(5)''</ref>  It is now known that even low doses of radiation emitted by an X-ray machine can put a person at risk, especially if exposure starts young and is repeated often.<ref>Kleinerman RA. Cancer risks following diagnostic and therapeutic radiation exposure in children. Pediatric radiology. 2006 Sep 1;36(2):121-5.</ref>
* '''Pollution''': Air pollution has been identified as a contributing risk factor for developing cancer and also for lowering the rates of a positive prognosis <ref>Vineis, P., & Husgafvel-Pursiainen, K. (2005). ''Air pollution and cancer: biomarker studies in human populations †. Carcinogenesis, 26(11), 1846–1855.''doi:10.1093/carcin/bgi216 </ref>


Physiotherapy is an autonomous profession concerned with the care, management and rehabilitation of<br>patients. These principles apply to the management of patients with cancer through all care and<br>rehabilitation programmes from diagnosis to the end of life.&nbsp; Physiotherapists conduct ongoing assessment of the needs of this patient group and their carers, in order to apply skilled interventions, which are vital for patients’ independence, functional capacity and quality of life.&nbsp; The role of the physiotherapist, as an essential member of the multi-disciplinary team is key to the successful rehabilitation and management of patients with cancer and palliative care needs. The absence of physiotherapy intervention would be detrimental to patient care and the ability of the patient/family to cope with the effects of the disease or its treatment on their functional capacity and quality of life<ref>The Role of Physiotherapy for People with Cancer - CSP Position Statement. The Chartered Society of Physiotherapy, July 2003. Available at http://www.csp.org.uk/uploads/documents/csp_statement_physioandcancer.pdf.  Retrieved 10/7/2010</ref>.<br>
* '''[[Nutrition|Diet]], [[Therapeutic Exercise|Exercise]] and [[Obesity]]''': Obesity has been recognised as a contributing factor, in relation, to cancer; both in terms of risk and mortality.<ref>Ligibel JA, Alfano CM, Courneya KS, Demark-Wahnefried W, Burger RA, Chlebowski RT, Fabian CJ, Gucalp A, Hershman DL, Hudson MM, Jones LW. American Society of Clinical Oncology position statement on obesity and cancer. Journal of clinical oncology. 2014 Nov 1;32(31):3568.</ref>  As well as controlling obesity diet an exercise also have role to play in preventing and managing cancer. The World Health Organisation estimated a 20% to 40% decrease in the risk of developing [[Breast Cancer|breast cancer]] amongst physically active women.<ref>Bianchini F, Kaaks R, Vainio H. Weight control and physical activity in cancer prevention. Obes Rev. 2002; 3:5-8.</ref> And in another study, published in 2008, a group of 2987 women participated in a study, via questionnaire, that showed physical activity was associated with an improved prognosis.<ref>Holmes MD, Chen WY, Feskanich D, Kroenke CH, Colditz GA. Physical activity and survival after breast cancer diagnosis. Jama. 2005 May 25;293(20):2479-86.</ref> As much as [[Physical Activity|physical activity]] can have a positive effect on preventing and improving prognosis, lack of physical activity can be detrimental


== Physiology  ==
* '''[[Infectious Disease|Infections]]''': It has long been recognised that infections are a cause of cancer and in 2002 it was estimated that approximately 18% of of malignant cancers could be attributed to an infection.<ref>Parkin DM. The global health burden of infection-associated cancers in the year 2002. Int J Cancer 2006;118:3030–44</ref>


* '''[[Stress and Health|Stress]]''': There is evidence that stress has a detrimental effect on the immune response and may be a contributing factor to the initiation and in some cases progression of cancer.<ref>Reiche, E. M. V., Nunes, S. O. V., & Morimoto, H. K. (2004). ''Stress, depression, the immune system, and cancer. The Lancet Oncology, 5(10), 617–625.'' doi:10.1016/s1470-2045(04)01597-9</ref>
== Conditions  ==
== Conditions  ==
 
[[File:Stomach cancer patient.png|right|frameless]]
[http://www.physio-pedia.com/Acute_Lymphoblastic_Leukemia Acute Lymphoblastic Leukemia]<br>[http://www.physio-pedia.com/Breast_Cancer Breast Cancer]<br>[http://www.physio-pedia.com/Chemotherapy_Side_Effects_%26_Syndromes Chemotherapy Side Effects &amp; Syndromes ]<br>[http://www.physio-pedia.com/Chondroblastoma Chondroblastoma]<br>[http://www.physio-pedia.com/Colorectal_Cancer Colorectal Cancer]<br>[http://www.physio-pedia.com/Ewing%27s_Sarcoma Ewing's Sarcoma]<br>[http://www.physio-pedia.com/Gastric_Cancer Gastric Cancer]<br>[http://www.physio-pedia.com/Giant_Cell_Tumor Giant Cell Tumor]<br>[http://www.physio-pedia.com/Glioblastoma_Multiforme Glioblastoma Multiforme]<br>[http://www.physio-pedia.com/Glioblastoma_Multiforme Hodgkin's Lymphoma]<br>[http://www.physio-pedia.com/Multiple_Myeloma Multiple Myeloma]<br>[http://www.physio-pedia.com/Neuroblastoma Neuroblastoma]<br>[http://www.physio-pedia.com/Non_Hodgkin_Lymphoma Non Hodgkin Lymphoma]<br>[http://www.physio-pedia.com/Osteochondroma Osteochondroma]<br>[http://www.physio-pedia.com/Osteoid_Osteoma Osteoid Osteoma]<br>[http://www.physio-pedia.com/Osteosarcoma Osteosarcoma]<br>[http://www.physio-pedia.com/Pancreatic_Cancer Pancreatic Cancer]<br>[http://www.physio-pedia.com/Radiation_Side_Effects_and_Syndromes Radiation Side Effects and Syndromes]<br>[http://www.physio-pedia.com/Renal_Cancer Renal Cancer ]<br>[http://www.physio-pedia.com/Testicular_Cancer Testicular Cancer ]<br><br>
There are many types of cancer, see below:
 
*[[Acute Lymphoblastic Leukemia|Acute Lymphoblastic Leukemia]]
*[[Acute Myeloid Leukemia|Acute Myeloid Leukemia]]
*[[Brain Tumors]]
*[[Breast Cancer|Breast Cancer]]
*[[Cervical Cancer|Cervical Cancer]]  
*[[Chondroblastoma|Chondroblastoma]]
*[[Colorectal Cancer|Colorectal Cancer]]
*[[Ewing's Sarcoma|Ewing's Sarcoma]]
*[[Gastric Cancer|Gastric Cancer]]
*[[Giant Cell Tumor|Giant Cell Tumor]]
*[[Glioblastoma Multiforme|Glioblastoma Multiforme]]
*[[Hodgkin's Lymphoma]]
*[http://www.physio-pedia.com/Malignant_Melanoma Malignant Melanoma]
*[[Multiple Myeloma|Multiple Myeloma]]  
*[[Neuroblastoma]]
*[[File:Breast Cancer Metastases Diagram1 .jpg|right|frameless]][[Non Hodgkin Lymphoma|Non Hodgkin Lymphoma]]
*[[Osteoblastoma|Osteoblastoma]]
*[[Osteochondroma]]
*[[Osteoid Osteoma]]
*[[Osteosarcoma]]
*[[Pancreatic Cancer|Pancreatic Cancer]]
*[http://www.physio-pedia.com/Paraneoplastic_Syndrome Paraneoplastic Syndrome]  
*[[Renal Cancer]]
*[[Skeletal Metastases|Skeletal Metastases]]
*[[Testicular Cancer|Testicular Cancer]]
*[[Thyroid Cancer|Thyroid Cancer]]
== Examination  ==
== Examination  ==
*[[Oncology Examination]]
== Interventions  ==
*[[Oncology Medical Management|Medical Management]]
*[[Oncology Physiotherapy Management|Physiotherapy Management]]
*[[Radiation Side Effects and Syndromes|Radiation Side Effects and Syndromes]]
*[[Chemotherapy Side Effects & Syndromes|Chemotherapy Side Effects &amp; Syndromes]]
== Outcome Measures  ==
[https://physio-pedia.com/Visual_Analogue_Scale Visual Analogue Scale (VAS)]


Using the International Classification Framework Model for Assessment in Oncology Rehabilitation<ref>International Classification of Functioning, Disability and Health: ICF. Geneva,Switzerland: World Health Organization; 2001</ref><ref>Gilchrist LS, Galantino ML, Wampler M, et al. A Framework for Assessment in Oncology Rehabilitation. Physical Therapy . 89 (3 ):286–306. Available at: http://ptjournal.apta.org/content/89/3/286.abstract.</ref>
[https://physio-pedia.com/Quality_of_Life Quality of Life Questionnaire (QoL)]
 
&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; by&nbsp; Gilchrist LS, Galantino ML, Wampler M, et al.
 
<br>
 
=== I. &nbsp;Mental Function, Pain &amp; Somatorsensory Screening  ===
 
Mental function can be affected by radiation and chemotherapy through the changes in the central nervous system<ref name="Breast Cancer Cognitive Dysfunction">Ahles T, Saykin A. Breast cancer chemotherapy-related cognitive dysfunction. Clin Breast Cancer.2002;3:S84–S90.</ref>&nbsp;<ref>Castellon S, Ganz P, Bower J, et al. Neurocognitive performance in breast cancer survivors exposed to adjuvant chemotherapy and tamoxifen. J Clin Exp Neuropsychol. 2004;26:955–969.</ref><ref>Stewart A, Bielajew C, Collins B, et al. A meta analysis of the neuropsychological effects of adjuvant chemotherapy treatment in women treated for breast cancer. Clin Neuropsychol. 2006;20:76–89.</ref>&nbsp;Mental impairments can be indusced by inflammation, destructive autoimmune responses, toxicity levels and oxidative damage<ref>Ahles T, Saykin A, Furstenberg C, et al. Neuropsychologic impact of standard dose systemic chemotherapy in longterm survivors of breast cancer and lymphoma.J Clin Oncol. 2002;20:485–493</ref>. &nbsp;Emotional Functions may alos affect the ability of our patients to respond to and/or participate in physical therapy.
 
==== Diagnostic &amp; Screening Measures  ====
 
===== 1. &nbsp;Mental Status  =====
 
&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;&nbsp;The Mini-Mental State Examination<ref>Folstein M, Folstein S, McHugh P. Mini-Mental State: a practical method for grading the state of patients for the clinician J Psychiatr Res. 1975;12:189–198.</ref>&nbsp;
 
&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;read more about the [http://www.rehabmeasures.org/lists/rehabmeasures/dispform.aspx?id=912 Mini-Mental State Examination Measure &amp; Link]
 
&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; Profile of Mood States<ref>Cella D, Tross S, Orov E, et al. Mood states of patients after the diagnosis of cancer. J Psychosoc Oncol. 1989;7:45–53.</ref>
 
&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;read more about the [http://www.mhs.com/product.aspx?gr=cli&prod=poms&id=overview POMS]
 
===== 2. &nbsp;Pain Assessment  =====
 
&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;1. &nbsp;Visual Analog Scale
 
&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;2. &nbsp;Numeric Rating Scale
 
&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;3. &nbsp;Faces Pain Scale
 
&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;4. &nbsp;[http://medicine.iupui.edu/RHEU/Physicians/bpisf.pdf Brief Pain Inventory]<ref>Cleeland C. Measurement and prevalence of pain in cancer. Semin Oncol Nurs. 1985;1:87–92.</ref>
 
&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;
 
===== 3. &nbsp;Neurological Assessment Measure  =====
 
====== a) '''&nbsp;Vestibular'''  ======
 
May be affected by neoplasms such as a&nbsp;<span style="line-height: 1.5em;">Vestibular schwannoma which may cause unilateral dysfunction&nbsp;</span><span style="line-height: 1.5em;">or chemotherapy &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; drugs such as&nbsp;</span>Cisplastin
 
[http://www.southamptonhospital.org/Resources/10355/FileRepository/Forms/Dizziness%20Hanicap%20Inventory%20-%20English.pdf Dizziness Handicap Inventory Questionnaire]--25 items assess the impact of disequilibrium on functional activities.<ref>Jacobson G, Newman C, Hunter L, Balzer G. Balance function test correlates of the Dizziness Handicap Inventory. J Am Acad Audiol. 1991;2:253–260.</ref>
 
====== b) &nbsp;Somatosensory  ======
 
====== c) &nbsp;Neuromusculoskeletal  ======
 
1. &nbsp;Peripheral Neuropathies--Chemotherapy induced
 
&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; modified Total Neuropathy Score<ref>Cavaletti G, Bogliun G, Marzorati L, et al. Grading of chemotherapy-induced peripheral neurotoxicity using the Total Neuropathy Scale. Neurology. 2003;61:fckLR1297–1300.</ref>
 
2. &nbsp;Anesthesia/Dysesthesias
 
&nbsp; &nbsp; &nbsp; &nbsp; &nbsp;with compression or surgical dissection of nerves
 
3. &nbsp;Motor Function Loss
 
&nbsp; &nbsp; &nbsp; &nbsp; &nbsp;Radiation Plexopathy
 
=== II. Neuromusculoskeletal Function (Movement Related Functional Assessment) ===
 
'''Posture'''
 
'''ROM'''
 
*Scar tissue formation after surgical resections, chemotherapy or radiation therapy. &nbsp;
*Fibrosis after irradiation.
 
'''Strength'''
 
*Muscle weaknesses from inflammatory intermediates produced by the tumor that are catabolic and cause muscle wasting (cachexia).
*Surgical denervation or damage
*Radiation &amp; Chemotherapy can damage muscle or nerve tissue. &nbsp;(Vinca alkaloids, taxanes and platinum agents)
*Grip dynamometers
*MMT
 
'''Balance'''
 
Balance Dysfunction can be caused from any of the following
 
*sensory input
*central processing of balance-related information
*ROM limitations
*orthostatic hypotension
*muscle weakness
*peripheral neuropathies from taxane
 
<br>
 
Balance Measures
 
*Functional Reach
*Berg Balance Scale
*Standard Romberg Test
*Tandem Romberg Test
*Timed Get up &amp; Go Test
 
'''Gait'''
 
*Kinetmatic Analysis
*Gait Speed Measurements<br>
 
Gait Measures
 
*Tinetti Balance &amp; Gait Scale
 
=== III. &nbsp;System Screening  ===
 
'''Cardiovascular'''


*Cardiotoxicity can be a late effect of chemotherapy due damage o fthe cardiac myoctyes ultimately resulting in congestive heart failure.
European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORTC QLQ-C30)<ref>Aaronson NK, Ahmedzai S, Bergman B, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 1993;85:365–76.</ref>
*Radiation may scar the cardiac and coronary arteries resulting in restrictive coronary disease
 
Measures
 
#Echocardiogram to assess ventricular function, cardiac motion and output.
 
'''Hematologic'''
 
'''Immunologic'''
 
*Damage to lymph vessels by tumor obstruction, surgical resection of lymph nodes, radiation leading to fibrosis of the lymph vessels
 
Measures
 
#Limb Circumfrence Measurements Pre-op and Post-op
#Water Displacement Method of measuring limb volume
 
'''Integumentary'''
 
*With lymphedema, skin breakdown or infection can occur. &nbsp;
*[http://www.eortc.be/services/doc/ctc/CTCAE_4.03_2010-06-14_QuickReference_5x7.pdf National Cancer Institue's Common Termonology Criteria for Adverse Events] (Lymphatic, Integumentary Systems)
 
&nbsp; &nbsp; &nbsp; &nbsp;Uses Grades to assess severity of different conditions for example Lymphedema
 
'''Respiratory'''
 
*Lung tumors may limit thoracic cavity expansion, compress the airways or reduce the surface area of the lung. &nbsp;
*Chemotherapy agents (beomycin, methotrexate and docetaxel may damage pneumocytes. &nbsp;This reduces alveoli and air exchange.
*Patients are then at risk for pneumonitis or fibrosis.
 
Measures
 
#Vital signs (RR, HR, BP)
#Oxygen Sautration
#&nbsp;Aerobic Test--6 Minute Walk
#Dyspnea Scale
#Borg Rating of Perceived Exertion<br>
 
<br>
 
=== IV. &nbsp;Red and Yellow Flag Measures &amp; Risk Patterns  ===
 
Sites at Risk for Neural Compression
 
Brachial Plexus: &nbsp;Breast &amp; Lung Tumors
 
Lumbosacral Plexus: &nbsp;Colorectal &amp; Gynecological Tumors, Sarcomas &amp; Lymphomas
 
Symptoms: &nbsp;Unrelenting pain, worse at night progressing to focal sensory loss or weakness
 
Cancers that often metastasize to the Spine
 
*Prostate
*Breast
*Lung&nbsp;
*Colon
 
Cancers that often present in the femur
 
*Sarcoma
 
Cancer and Cancer Treatment increases risk for Osteonecrosis
 
*Proximal or Distal Femur
*Proximal Humerus
*Jaw
*Metatarsals
 
Other Risks
 
*Osteoporosis
*Neutropenia
*Thrombocytopenia
 
=== V. &nbsp;Functional Activities, Mobility &amp; Self-Care  ===
 
'''Measures'''
 
*Functional Mobility Assessment
 
&nbsp; &nbsp; &nbsp;requires patients to physically perform specific tasks and to answer questions, quantifying their level of function.
 
*The Toronto Extremity Salvage Score, lower-extremity version
 
&nbsp; &nbsp; &nbsp;is a self administered questionnaire that asks&nbsp;patients to indicate the level of difficulty they experience in dressing,grooming, mobility, work, sports, and leisure
 
<br>
 
Mobility Assessment
 
*changing and maintaining body positions
*carrying
*moving and handling objects
*walking
*moving around using transportation
 
<br>
 
Self Care&nbsp;Measures
 
includes grooming, bathing and dressing
 
*Karnofsky Performance Scale
 
&nbsp; &nbsp; &nbsp;&nbsp;A standard measure of the ability of adult patients with cancer to perform ordinary tasks. scores range from 0 to 100. A higher score &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; means the patient is better able to carry out daily activities
 
*Barthel Index &nbsp;includes multiple components and diverse self-care activities. May be more responsive in rehabilitation.<br>&nbsp; Performance or self-report measure of independence in basic activities of daily living<br>
 
=== VI. &nbsp;Psychosocial  ===
 
Consider the patients domestic life, interpersonal relations and major life areas. &nbsp;<br>
 
assess participation in or attending&nbsp;community activities, reduced job expectations etc
 
'''Measures'''
 
*Reintegration to Normal Living Index
 
&nbsp; &nbsp; &nbsp;Measures adults' perception o ftheir ability to resume life roles after trauma or illness
 
== Medical Management  ==
 
=== '''Oncological Emergencies'''  ===
 
Physical Therapists need to be aware that certain oncologic emergencies may develop over time and it is important to know the primary systems affected or causes as well as signs and symptoms for referral<ref>Higdon M et. al.  Treatment of Oncologic Emergencies. Am Fam Physician 2006; 74: 1873-80</ref>.
 
==== I. &nbsp;Metabolic<br>  ====
 
#Tumor Lysis Syndrome
#Hypercalcemia of Malignancy
#Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
 
==== II. Hematologic  ====
 
#Febrile neutropenia
#Hyperviscosity syndrome
 
==== III. Structural&nbsp;  ====
 
#Epidural Spinal Cord Compression
#Malignant Pericardial Effusion
#Superior Vena Cava Syndrome
 
==== IV. Side Effects from Chemotherapy  ====
 
#Diarrhea
#Extravasations
#Obstipation
 
== Physiotherapy Intervention  ==
 
[http://ptjournal.apta.org/content/82/10/1009.full Physical Therapy Intervention Following Surgical Treatment of Carpal Tunnel Syndrome in an Individual With a History of Postmastectomy] Lymphedema by Julie E Donachy and Emily L Christian. &nbsp;Physical Therapy 2002 Vol. 82&nbsp;  
 
<br>
 
== Outcome Measures  ==
 
== Recent Research from [http://www.physiospot.com Physiospot]  ==
<div class="researchbox"><rss>http://feeds.feedburner.com/physiospot/oncology|charset=UTF-8|short|max=10</rss></div>
<br>  


Functional Assessment of Cancer and Therapy – General measure (FACT-G)<ref>Cella DF, Tulsky DS, Gray G, et al. The Functional Assessment of Cancer Therapy scale: development and validation of the general measure. J Clin Oncol 1993;11:570–9</ref>
== References  ==
== References  ==
<references />
[[Category:Oncology]]
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Latest revision as of 07:31, 19 January 2023

Original Editor - Elaine Lonnemann

Top Contributors - Elaine Lonnemann, Admin, Lucinda hampton, Fasuba Ayobami, Kim Jackson, Rachael Lowe, George Prudden, WikiSysop and Nicole Hills

Introduction[edit | edit source]

National-cancer-institute-0YBIMOqQzt0-unsplash.jpg

Oncology is a branch of medicine that specialises in the diagnosis and treatment of cancer. It includes

  • Medical oncology (the use of chemotherapy, immunotherapy, hormone therapy, and other drugs to treat cancer),
  • Radiation oncology (the use of radiation therapy to treat cancer)
  • Surgical oncology (the use of surgery and other procedures to treat cancer)[1].

Cancer is the second leading cause of death globally

  • Responsible for an estimated 9.6 million deaths in 2018. Globally, about 1 in 6 deaths is due to cancer.
  • Approximately 70% of deaths from cancer occur in low- and middle-income countries.
  • Around one third of deaths from cancer are due to the 5 leading behavioral and dietary risks: high body mass index, low fruit and vegetable intake, lack of physical activity, tobacco use, and alcohol use[2].

Physiotherapy are involved in care, management and rehabilitation of cancer patients from diagnosis to the end of life. They:

  • Conduct ongoing assessment of the needs of this patient group and their carers, in order to apply skilled interventions, which are vital for patients’ independence, functional capacity and quality of life.
  • Are an essential member of the multi-disciplinary team, which is the key to successful rehabilitation and management of patients with cancer and palliative care.
  • The absence of physiotherapy intervention would be detrimental to patient care and the ability of the patient/family to cope with the effects of the disease or its treatment on their functional capacity and quality of life[3].

The following 5 minutes video is entitled "What causes cancer and how is it treated"

[4]

Pathophysiology[edit | edit source]

National-cancer-institute-sIqWYiNLiJU-unsplash.jpg

Oncology is the branch of medicine that involves the prevention, diagnosis, treatment, and study of cancer. Cancer describes the abnormal growth of cells that results in a large mass known as a tumour.

  • Malignant tumours can spread into and invade surrounding tissues and in some cases the cells can break off and travel to other areas of the body, which is known as metatstasis.
  • Benign tumours do not invade surrounding tissues and do not continue to grow once they have been removed.
  • The regulation of cells is controlled by genetics and it takes changes to genes to create abnormal cancerous cells.
  • Genetic changes can be due to either the loss or gain of chromosomes through mitosis (the process of cell duplication) or due to mutations, changes in the nucleotide sequence of genomic DNA.

Causes[edit | edit source]

Smoking-1026556 960 720-2.jpg

There are several causes of cancer, the most common being genetic mutations due to environmental and lifestyle factors, which account for between 90-95% of cases. The remaining are due to inherited genetics[5]. There are many known environmental factors that increase the risk of developing cancer:

  • Carcinogens: There are many known carcinogens with the most obvious one being tobacco.
  • Tobacco: Each year tobacco is responsible for than 7 million deaths worldwide, more than 6 million of those can be attributed to direct tobacco use, but there are approximately 890,000 that are the result of second-hand tobacco smoke[6]. Recent decreases in the numbers of people smoking has led to a decrease, in many countries, of cancer deaths related to lung cancer 1990.[7]
  • Radiation: Radiation has long been known to be carcinogenic. Initially studies focused on incidents that involve large amounts of radiation and it was evident that large doses of radiation were at a higher risk of developing cancer.[8] It is now known that even low doses of radiation emitted by an X-ray machine can put a person at risk, especially if exposure starts young and is repeated often.[9]
  • Pollution: Air pollution has been identified as a contributing risk factor for developing cancer and also for lowering the rates of a positive prognosis [10]
  • Diet, Exercise and Obesity: Obesity has been recognised as a contributing factor, in relation, to cancer; both in terms of risk and mortality.[11] As well as controlling obesity diet an exercise also have role to play in preventing and managing cancer. The World Health Organisation estimated a 20% to 40% decrease in the risk of developing breast cancer amongst physically active women.[12] And in another study, published in 2008, a group of 2987 women participated in a study, via questionnaire, that showed physical activity was associated with an improved prognosis.[13] As much as physical activity can have a positive effect on preventing and improving prognosis, lack of physical activity can be detrimental
  • Infections: It has long been recognised that infections are a cause of cancer and in 2002 it was estimated that approximately 18% of of malignant cancers could be attributed to an infection.[14]
  • Stress: There is evidence that stress has a detrimental effect on the immune response and may be a contributing factor to the initiation and in some cases progression of cancer.[15]

Conditions[edit | edit source]

Stomach cancer patient.png

There are many types of cancer, see below:

Examination[edit | edit source]

Interventions[edit | edit source]

Outcome Measures[edit | edit source]

Visual Analogue Scale (VAS)

Quality of Life Questionnaire (QoL)

European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORTC QLQ-C30)[16]

Functional Assessment of Cancer and Therapy – General measure (FACT-G)[17]

References[edit | edit source]

  1. ↑ NCI Cancer Available from:https://www.cancer.gov/publications/dictionaries/cancer-terms/def/oncology (last accessed 29.8.2020)
  2. ↑ WHO Cancer Available from:https://www.who.int/news-room/fact-sheets/detail/cancer (last accessed29.8.2020)
  3. ↑ The Role of Physiotherapy for People with Cancer - CSP Position Statement. The Chartered Society of Physiotherapy, July 2003. Available at http://www.csp.org.uk/uploads/documents/csp_statement_physioandcancer.pdf. Retrieved 10/7/2010
  4. ↑ CTCA What is cancer Available from:https://www.youtube.com/watch?v=SGaQ0WwZ_0I (last accessed 29.8.2020)
  5. ↑ Anand P, Kunnumakara AB, Sundaram C, Harikumar KB, Tharakan ST, Lai OS, Sung B, Aggarwal BB. Cancer is a preventable disease that requires major lifestyle changes. Pharmaceutical research. 2008 Sep 1;25(9):2097-116.
  6. ↑ World Health Organization. Tobacco [Internet]. Geneva: World Health Organization; March 2018 [cited 21 May 2019]. Available from: https://www.who.int/news-room/fact-sheets/detail/tobacco
  7. ↑ Islami F, Torre LA, Jemal A. Global trends of lung cancer mortality and smoking prevalence. Translational lung cancer research. 2015 Aug;4(4):327.
  8. ↑ Ron, E. (1998). Ionizing Radiation and Cancer Risk: Evidence from Epidemiology. Radiation Research, 150(5)
  9. ↑ Kleinerman RA. Cancer risks following diagnostic and therapeutic radiation exposure in children. Pediatric radiology. 2006 Sep 1;36(2):121-5.
  10. ↑ Vineis, P., & Husgafvel-Pursiainen, K. (2005). Air pollution and cancer: biomarker studies in human populations †. Carcinogenesis, 26(11), 1846–1855.doi:10.1093/carcin/bgi216 
  11. ↑ Ligibel JA, Alfano CM, Courneya KS, Demark-Wahnefried W, Burger RA, Chlebowski RT, Fabian CJ, Gucalp A, Hershman DL, Hudson MM, Jones LW. American Society of Clinical Oncology position statement on obesity and cancer. Journal of clinical oncology. 2014 Nov 1;32(31):3568.
  12. ↑ Bianchini F, Kaaks R, Vainio H. Weight control and physical activity in cancer prevention. Obes Rev. 2002; 3:5-8.
  13. ↑ Holmes MD, Chen WY, Feskanich D, Kroenke CH, Colditz GA. Physical activity and survival after breast cancer diagnosis. Jama. 2005 May 25;293(20):2479-86.
  14. ↑ Parkin DM. The global health burden of infection-associated cancers in the year 2002. Int J Cancer 2006;118:3030–44
  15. ↑ Reiche, E. M. V., Nunes, S. O. V., & Morimoto, H. K. (2004). Stress, depression, the immune system, and cancer. The Lancet Oncology, 5(10), 617–625. doi:10.1016/s1470-2045(04)01597-9
  16. ↑ Aaronson NK, Ahmedzai S, Bergman B, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 1993;85:365–76.
  17. ↑ Cella DF, Tulsky DS, Gray G, et al. The Functional Assessment of Cancer Therapy scale: development and validation of the general measure. J Clin Oncol 1993;11:570–9
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