Oncology: Special Therapies and Rehabilitation

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Special Therapies
1.     Hyperthermia to treat cancer :
·        Cells in the body are exposed to higher than normal temperatures, changes take place inside the cells.
·        Very high temperatures can kill cancer cells outright.

2 different types:
·        Local hyperthermia or thermal ablation: Very high temperature is used to destroy a small area of (tumour).
·        Regional hyperthermia or whole-body hyperthermia: The temperature of a part of the body (or even the whole body) can be raised a few degrees higher than normal. Done under general anaesthesia .
2.     Radiofrequency ablation
·        Uses high-energy radio waves for treatment.
·        A thin, needle-like probe is put into the tumour for a short time, usually about 10 to 30 minutes
·        Placement of the probe is guided using ultrasound, MRI, or CT scans.
·        The tip of the probe puts out a high-frequency current that creates heat (between 122-212 degree F) and destroys the cells within a certain area.
3.     Photodynamic Therapy
·        A treatment that uses special drugs, called photosensitizing agents, along with light to kill The drugs only work after they have been activated or "turned on" by certain kinds of light. Also be called photo-radiation therapy, phototherapy, or photo-chemotherapy.
4.     Lasers in Cancer Treatment
·        Laser light has a single wavelength and can be focused in a very narrow beam.
·        This makes it both powerful and precise.
·        Lasers can be used instead of blades (scalpels) for cutting through body tissue.
·        Lasers are named for the liquid, gas, solid, or electronic substance that's used to creat the light.
·        Types of lasers commonly used in cancer treatment: carbon dioxide (CO2), argon, neodymium-doped yttrium aluminium  garnet (Nd:YAG).


Rehabilitation
Meaning : Cancer rehabilitation is the maximum restoration of physical, psychological, social,vocational, recreational and economic functions within the limits imposed by the malignancy and its treatment.
 Need for cancer rehabilitation
·        Improving physical strength to help offset any limitations from cancer treatment.
·        Helping the person with cancer become more independent and less reliant on caregivers.
·        Helping the person to adjust to actual, perceived and potential losses due to treatment
·        Reducing sleep-problems.
·        Lowering the number of hospitalizations.
General Principles of rehabilitation care
Functional status is influenced by psychological aging changes, acute and chronic illness, and adaption to the physical environment.
 Evaluate the underlying causes of functional decline when a change in functional status is noted.
Emphasize the function rather than dysfunction and capabilities rather than disabilities.
Rehabilitation is an individual process and it requires a multidisciplinary team for optimal results
Demonstration hope, optimism, interest, determination, patience, and humour; these encourage patients in their rehabilitation efforts.
Recognize and praise the accomplishments
 Include patient and family in multidisciplinary team conference
 Do not equate functional loss with loss of maturity, intelligence or independence. Continue to individual as an adult with goals and preferences.
Educate the client and family on the value of independent functioning and causes and consequences of functional decline.
Prevent and treat complications of functional loss such as skin breakdown, muscle weakness, pulmonary compromise, social isolation and depression.
Manage pain and other symptoms.
Balance activity with rest periods
Design environment to facilitate access with handrails, wide doorways, raised toilet seats, shower seats ,enhanced lighting and chairs of various types and height

Cancer rehabilitation team
Oncologist
Dietician
Chaplain
psychiatrist
psychologist
Speech-language pathologist
 Rehabilitation nurse
Physical therapist
Social worker
Case manager
Recreational therapist
Vocational counsellor


Cancer rehabilitation services:-
·        Pain management techniques and medications
·        Patient and family education and counselling
·        Nutritional counselling
·        Smoking cessation programs
·        Gait and /or balance training
·        Provision of assistive ambulatory devices
·        Ambulation on different types of surface (stairs, ramps)
·        Provision and/or modification of shoe gear and orthotics
·        Education and provision of bracing and splinting
·        ROM, coordination and strengthening exercises
·        Sensory integration
·        Positioning posturing
·        Berating exercises
·        Chest physiotherapy
·        Relaxation exercises
·        Modalities to decrease the pain and oedema
·        Alternative interventions: Yoga aquatics, acupressure, acupuncture
·        Patient and family education for home management
·        Training activities of daily living
·        Transfer training (toilet, bathtub, car)
·        Energy conservation training
·        Training to compensate for visual – perceptual problems.
·        Activities to enhance the function of upper extremities
·        Interventions to improve and/or normalize language production
·        Use of amplifiers and//or alternate communication devices
·        Reading, writing, and math retraining
·        Therapy for swallowing disorder
·        Oral muscular training

 Rehabilitative services
Assistive technology:
·        Benefits individual with physical, sensory and cognitive impairments.
·        Includes aids such as mobility aids, grasping aids, devices forr blindness and low vision, assistive listening devices, alternative and augmented devices for communication.
·        Transfer devices such as transfer boards, transfer benches
Exercise and activity:
·        To optimize and preserve functional status
·        Improves the psychological health, preserve cognitive function, reduces the symptoms of depression and fatigue.
·        Strengthens the sense of wellbeing, personal control and self-efficacy.
·        Low to moderately intense exercises: ambulation, bicycling and muscle strengthening
·        Non-weight bearing aerobic exercise for bone metastasis patients.

Bowel and bladder continence:
Can lead to infection, skin breakdown, falls, anorexia, depression.
Rehabilitative approaches to promote urinary and faecal continence,
Nutrition
Emotional support
Caregiver support

Enhancing body image

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notes.nursium.com: Oncology: Special Therapies and Rehabilitation
Oncology: Special Therapies and Rehabilitation
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