Cancer

181 Pages·2013·3.062 MB·English

by  Ki Shin MD, Ralph Buschbacher MD

Rehabilitation Medicine Quick Reference RM Rehabilitation Medicine Quick Reference
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Become more efficient in your practice
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with Rehabilitation Medicine Quick Reference
Designed for the busy practitioner, Cancer provides succinct coverage of the assessment and treat-
ment of a multitude of rehabilitation issues as they uniquely affect cancer patients. Broken into four
sections with 66 alphabetically arranged topics, this go-to reference addresses the key concerns C
in cancer rehabilitation ranging from basic principles, exercise, and therapy interventions to acu-
puncture, massage, and end-of-life care. Primary conditions covered include bone marrow trans- a
plant, brain disease and tumors, hematologic cancer, metastatic bone disease, neurofibromatosis,
and spinal cord compression. The largest section of the book is devoted to the myriad disease- or
n
treatment-related symptoms and medical issues endemic in the cancer population such as pain,
anemia, anorexia, cognitive dysfunction, chemotherapy-related problems and radiation effects,
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lymphedema, fatigue, malnutrition, sleep disorders, spasticity, and much more.
every entry is standardized for quick look-up in the office or clinic, and features description, e
etiology, risk factors, clinical features, natural history, diagnosis, red flags, treatment, prognosis,
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helpful hints, and suggested readings.
all Rehabilitation Medicine Quick Reference titles provide:
n Consistent Approach and organization — at-a-glance outline format allows readers to find
the facts they need instantly
n Concise Coverage — of must-know information broken down into easy-to-locate topics
n Fast Answers to Clinical Questions — diagnostic and management criteria for problems
commonly encountered in daily practice
n Hands-on Practical Guidance — for all types of interventions and therapies S
h
n Multi-Specialty Perspective — ensures issues of relevance to all rehabilitation team
i
members are addressed n
Recommended
Shelving Category
Physical Medicine
& Rehabilitation,
Oncology

Ki Y. Shin
11 W. 42nd Street
New York, NY 10036
www.demosmedpub.com
9 781936 287048
Cancer
Rehabilitation Medicine Quick Reference
Ralph M. Buschbacher, MD
Series Editor
Professor, Department of Physical Medicine and Rehabilitation
Indiana University School of Medicine
Indianapolis, Indiana
n Spine
Andre N. Panagos
n Spinal Cord Injury
Thomas N. Bryce
n Traumatic Brain Injury
David X. Cifu and Deborah Caruso
n Pediatrics
Maureen R. Nelson
n Musculoskeletal, Sports, and Occupational Medicine
William Micheo
n Geriatrics
Kevin M. Means and Patrick M. Kortebein
n Cancer
Ki Y. Shin
n Neuromuscular
Nathan D. Prahlow and John C. Kincaid
Cancer
Rehabilitation Medicine Quick Reference
Editor
Ki Y. Shin, MD
Associate Professor
Department of Palliative Care and Rehabilitation Medicine
The University of Texas MD Anderson Cancer Center
Houston, Texas
Associate Editors
Jack B. Fu, MD Amy Ng, MD, MPH
Assistant Professor Instructor
Department of Palliative Care and Rehabilitation Medicine Department of Palliative Care and Rehabilitation Medicine
The University of Texas MD Anderson Cancer Center The University of Texas MD Anderson Cancer Center
Houston, Texas Houston, Texas
Ying Guo, MD, MS Rajesh R. Yadav, MD
Associate Professor Associate Professor
Department of Palliative Care and Rehabilitation Medicine Department of Palliative Care and Rehabilitation Medicine
The University of Texas MD Anderson Cancer Center The University of Texas MD Anderson Cancer Center
Houston, Texas Houston, Texas
Benedict Konzen, MD
Associate Professor
Department of Palliative Care and Rehabilitation Medicine
The University of Texas MD Anderson Cancer Center
Houston, Texas
NEW YORK
Visit our website at www.demosmedpub.com
ISBN: 9781936287048
e-book ISBN: 9781617050008
Acquisitions Editor: Beth Barry
Compositor: Exeter Premedia Services Private Ltd.
© 2014 Demos Medical Publishing, LLC. All rights reserved. This book is protected by copyright. No part of it may be reproduced,
stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or
otherwise, without the prior written permission of the publisher.
Medicine is an ever-changing science. Research and clinical experience are continually expanding our knowledge, in particular
our understanding of proper treatment and drug therapy. The authors, editors, and publisher have made every effort to ensure
that all information in this book is in accordance with the state of knowledge at the time of production of the book. Nevertheless,
the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from application of the
information in this book and make no warranty, expressed or implied, with respect to the contents of the publication. Every reader
should examine carefully the package inserts accompanying each drug and should carefully check whether the dosage schedules
mentioned therein or the contraindications stated by the manufacturer differ from the statements made in this book. Such
examination is particularly important with drugs that are either rarely used or have been newly released on the market.
Library of Congress Cataloging-in-Publication Data
Cancer: rehabilitation medicine quick reference / Ki Y. Shin, MD, associate professor, Department of Palliative Care and
Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas ; associate editors, Jack Fu, MD,
assistant professor, Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer
Center, Houston, Texas, Ying Guo, MD, MS, associate professor, Department of Palliative Care and Rehabilitation Medicine,
The University of Texas MD Anderson Cancer Center Houston, Texas, Benedict Konzen, MD, associate professor, Department
of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, Amy Ng,
MD, MPH, instructor, Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer
Center, Houston, Texas, Rajesh Yadav, MD, associate professor, Department of Palliative Care and Rehabilitation Medicine, The
University of Texas MD Anderson Cancer Center, Houston, Texas.
p. ; cm
ISBN 978-1-936287-04-8—ISBN 978-1-61705-000-8 (ebook)
1. Cancer—Patients—Rehabilitation—Handbooks, manuals, etc. 2. Oncology—Handbooks, manuals, etc.
I. Shin, Ki Y., editor of compilation.
RC262.C29163 2014
616.99’4—dc23
2013034862
Special discounts on bulk quantities of Demos Medical Publishing books are available to corporations, professional associations,
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Demos Medical Publishing, LLC
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Printed in the United States of America by Bradford and Bigelow.
13 14 15 16 17 / 5 4 3 2 1
This book is dedicated to our patients, whose courage, perseverance, and gratitude
help inspire us to do what we do. Many of us have been touched by cancer, either
in loved ones or as patients ourselves. All deserve the best possible care to help
improve their survival. All deserve basic, thoughtful rehabilitation efforts to minimize
the effects of the disease and its treatment. We have been fortunate to see and
be part of an increased acceptance and growth in the field of cancer rehabilitation.
We hope that the clinical information in these chapters will be used as a
practical resource to help clinicians offer more rehabilitation care for
their cancer patients.
Special thanks to Ms. Marilyn Lyles, whose significant efforts allowed for the completion
of this project and to Dr. Theresa Gillis, who created the Rehabilitation Medicine program
at the MD Anderson Cancer Center in Houston, Texas.

Contents
Series Foreword � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � xi
Preface � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �xiii
Contributors � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � xv
I: Background, Evaluation, and Interventions
1. Cancer Rehabilitation: Basic Ideas and Principles . . . . . . . . . . . . . . . . . . . . . .2
2. Exercise . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4
3. Occupational Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
4. Performance Measures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
5. Physical Impairments and Guidelines for Therapy Interventions
and Assessments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
6. Pulmonary Rehabilitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
II: Primary Concerns or Conditions
7. Bone Marrow Transplantation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
8. Brain: Leptomeningeal Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20
9. Brain: Metastatic Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22
10. Brain: Primary Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .24
11. Hematologic Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26
12. Metastatic Bone Disease: Physiatric Perspective . . . . . . . . . . . . . . . . . . . . . .28
13. Metastatic Bone Disease: Surgical Perspective . . . . . . . . . . . . . . . . . . . . . . .31
14. Neurofibromatosis Type 1 and Type 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35
15. Spinal Cord Compression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .37
III: Cancer- or Treatment-Related Symptoms
16. Anemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .42
17. Anorexia–Cachexia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .44
18. Asthenia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
19. Autonomic Nervous System Dysfunction . . . . . . . . . . . . . . . . . . . . . . . . . . . .49
20. Chemotherapy: Cardiomyopathy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
21. Chemotherapy: Chemobrain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .53
22. Chemotherapy: Peripheral Neuropathy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .55
vii
viii Contents
23. Cognitive Dysfunction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .57
24. Cranial Nerve XI Injury Associated With Radical Neck Dissection . . . . . . . . .60
25. Dyspnea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .62
26. Emergency Medical Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .64
27. Fatigue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .66
28. Febrile Neutropenia in Acute Leukemia Patients . . . . . . . . . . . . . . . . . . . . . . .69
29. Free Tissue Transfer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .71
30. Gastrointestinal: Constipation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .72
31. Gastrointestinal: Dysphagia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74
32. Gastrointestinal: Nutritional and Bowel Management . . . . . . . . . . . . . . . . . . .76
33. Gout . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .78
34. Hypercalcemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .80
35. Lymphedema: Lower Extremity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .82
36. Lymphedema: Upper Extremity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .84
37. Malnutrition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .87
38. Mastectomy: Reconstruction Concerns . . . . . . . . . . . . . . . . . . . . . . . . . . . . .89
39. Mastectomy: Treatment Complications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .91
40. Mental Health: Behavioral Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .93
41. Mental Health: Depression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .95
42. Pain: Conservative Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .98
43. Pain: Interventional Techniques . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
44. Paraneoplastic Syndromes Affecting the Nervous System . . . . . . . . . . . . . .104
45. Plexopathy: Brachial . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .106
46. Plexopathy: Lumbosacral . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .108
47. Pressure Ulcers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
48. Pulmonary: Pleural Effusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114
49. Radiation Effects: Central Nervous System . . . . . . . . . . . . . . . . . . . . . . . . . . 116
50. Radiation Effects: Myelitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118
51. Sacrectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120
52. Sexuality Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122
53. Sleep Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125
54. Spasticity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128
55. Steroid Myopathy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130
56. Thromboembolic Disease and Prophylaxis . . . . . . . . . . . . . . . . . . . . . . . . . . 132
IV: Special Concerns
57. Advanced Care Planning and Advance Directives. . . . . . . . . . . . . . . . . . . . . 136
58. Alcohol Use in the Cancer Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138
59. Difficult Conversations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 140
Contents ix
60. Disability and the Return to Work in Cancer Patients . . . . . . . . . . . . . . . . . . 142
61. Nontraditional Treatments: Acupuncture . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144
62. Nontraditional Treatments: Complementary, Alternative,
and Integrative Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145
63. Nontraditional Treatments: Massage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147
64. Prognostication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149
65. Rehabilitation Chaplain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151
66. Rehabilitation at the End of Life . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 154
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157