Occupational health related diseases CANCER

a.Etiology: 1.Carcinogens: chemical( asbestos, smoking) Radiation, viral(herpes, aids) 2. Genetic : hereditary 3. Dietary: obesity, high-fat diet, diet low in vitamins A,C,E b. Early warning signs 1.Unusual bleeding or discharge 2. A lump or thickening of any area 3. A sore that does not heal 4. A change in bladder or bowel habits

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5. Hoarseness or persistent cough 6. Indigestion or difficulty swallowing 7. Change in size or appearance of wart or mole 8. Unexplained weight loss PROGNOSIS: aggressive treatments have resulted in higher cure rates, increased survival times QUALITY OF LIFE: Maintaining normal function and lifestyles is an important issue

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Physical therapy examination

1. Detailed systems assessment dependent upon cancer history 2. Pain: a. Ca pain syndrome:ca-related pain is a common experience,eg. Nerve or nerve root compression, ischemic response to blockage of blood supply, bone pain. Symapathetic sighs and symptoms may accompany moderate to severe pain, eg. Tachy cardia, hypertension, tachypnea, nausea, vomiting b. Pain at site distal to initial tumor site may suggest metastasis c. Iatrogenic pain may result from surgery, radiation, or chemotherapy

3. Lung, breast, prostate, thyroid, and lymphatic cancers commonly metastasize to bone. Pathological fractures, pain, and muscle spasms may result 4. RED FLAGS: Adverse side effects of ca treatment. a. With immunosppressed pt, monitor vital signs, physiological responses to monitor vital signs, physiological responses to exercise carefully; may see elevated HR and BP, dyspnea, pallor, sweating, fatigue. Pt is easily fatigued with minimal exertion. b. Muscle atrophy and weakness: secondary to high doses of steroids in many chemotherapy protocols; weakness may also result from disuse or tumor compression/invasion c. ROM deficits: particularly with high-dose radiation around joints bluezilch

 Hematological disruptions. 1. WBC suppression(leukopenia); increase susceptibility to infection 2. Platelet suppression( thrombocytopenia): increased bleeding 3. RBC suppression( anemia): diminished aerobic capacity. PHYSICAL THERAPY GOALS, OUTCOMES, AND INTERVENTIONS 1. Educate pt and family about disease process , rehabilitation goals, proscess and expected outcomes 2. Identify and support pt and family a. Assist in coping mechanisms b. Assist through the grieving process

3. Provide for proper positioning to prevent or correct deformities, maintain skin integrity; provide for over all pt comfort 4. Edema control: elevation of extremities, active ROM, massage; postoperative compression(elastic bandages, pressure garments) 5. Pain control a. TENS stimulation: may not control deep ca pain effective for postoperative pain b. Massage 6. Maintain or correct loss of ROM: active-assisted, stretching, AROM

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7. Maintain or correct loss of muscle mass and strength a. Isometric and lightweight isotonic strengthening exercises safe for most pt with ca b. Red flags: pt with significant bony metastases, osteoporosis, or low platelet counts (<20, 000) 1. AROM, ADL exercise only 2. Wt bearing may be restricted, provide appropriate ambulatory aids, orthoses 3. High risk of vertebral compression and fractures with metastatic disease. Use light exercises only

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