Devita, Hellman, and Rosenberg's Cancer

LWBK1006-46 LWW-Govindan-Review December 12, 2011 20:52

578 DeVita, Hellman, and Rosenberg’s CANCER: Principles and Practice of Oncology Review

recommended for cancer pain control. Rib belts help with pain control in

patients with rib metastasis but should not be used continuously because

they can affect respiratory effort. Deep-heat modalities are recommended

for cancer pain control but should not be applied directly over the malig-

nant tumor because they can cause significant tissue damage.

Answer 46.6. The answer is D.

The mainstay for the management of lymphedema is CDT. This consists

of manual lymphatic drainage by gentle massaging and compression ban-

daging. Resistance exercises can be performed safely by patients with lym-

phedema wearing compression garments. Benzopyrones are not approved

in the United States in the management of lymphedema.

Answer 46.7. The answer is C.

Both surgical and nonsurgical treatments are recommended for impending

fracture of spine caused by metastasis. In patients who are not surgical

candidates or refuse surgery, alternatives include thoracolumbar corset

and gait aids such as walkers. However, bed rest is not recommended

because this can result in further functional loss and increased risk for

DVT.

Answer 46.8. The answer is A.

In most patients with foot drop, a ready-made or custom-made posterior

leaf spring orthosis is sufficient. In patients with severe pain caused by

ankle movements, an immobilizing solid ankle-foot orthosis may be more

helpful.

Answer 46.9. The answer is A.

The Americans with Disabilities Act of 1990 protects the employment

rights of patients with cancer. Additional protections are provided in the

Family and Medical Leave Act of 1993, Federal Rehabilitation Act of

1973, and Employee Retirement Income Security Act of 1974.

Answer 46.10. The answer is A.

Studies have shown that the incidence of SCI in patients with cancer

ranges between 0.2% and 7.9%. Autopsy studies indicate that SCI from

metastasis is present in 5% of all patients diagnosed with cancer. Epidural-

based tumors are the most common cause of SCI. Patients with SCI above

T6 level are at risk for autonomic dysreflexia that is characterized by a

more than 20 mmHg rise in baseline blood pressure.

Answer 46.11. The answer is A.

The indications for rehabilitation in patients with cancer are as

follows: 76% with deconditioning, 58% with mobility impairment,

43% with reduced ROM, and 22% with impaired activities of daily

living.