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Oncology Rehabilitation: Web-based Learning for Physical Therapists
Who Provide Rehabilitation to Patients with Breast Cancer
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Table of Contents
Introduction
Presenter’s Notes
Oncology Rehabilitation: Web-based
Learning for Physical Therapists Who
Provide Rehabilitation to Patients
with Breast Cancer
Submitted by: Michael Coleman
University of Maryland School of Medicine
Department of Physical Therapy and Rehabilitation Sciences
Doctor of Science in Physical Therapy
Project approval by advisor, Frances E. Huber, EdD, PT, OCS
And the Committee assigned to the Project
Table of Contents
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Cover Sheet……………………….……File #1……..……………………………………………….02
Table of Contents……………………..……………………………………………………………….03
Program objectives…………………………..………………………………………………………..06
Presenter’s introduction…………………………..…………………………………………………..08
Pre / Post test…………………………………………..………………………………………….…..11
Presenter’s Notes…………………………………Use folder entitled DScPT Notes…………14-15
Basic Breast Cancer………………..….File #2…..…………..………………………………….…02
Statistics…………………………………………………………………..……………………………04
Cancer defined………………………………………………………………………………………..06
Tissue Evaluation……………………………………………………………………………………..12
Signs of cancer and risk factors…….……………………………………………..…………….…..20
Differential diagnosis…………………………………………………………………..………….…..24
Breast cancer diagnosis and protection…….…………………………………………..…………..26
Pathology and tumor staging……………………………………………………………….………..35
Survival…………………………………………………………………………………………………40
Time Out Test………………………………………………………………………………………….41
The Cancer Team………………………..File # 3……………………...……………………….….…02
Medical interventions……………………………………………………………………………….....08
Chemotherapy…………………………………………………………………………………………09
Hormone Therapy…………………………………………………………………………………….16
Radiation…………………………………………………………….…………………………………19
Surgery………………………………………………………………………………………………....28
Time Out Test………………………………………………………………………………………….48
Bone Marrow Transplants……………………………………………………………………………49
Immunotherapy……………………………………………………………………………………..…57
Intervention side effects………………………………………………………………………………61
Clinical trials and Tumor Markers……………………………………………………………………73
Time Out Test………………………………………………………………………………………….83
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Breast Cancer Rehabilitation…………………File #4……………....……………………………..…..……….02
Statistics………………………………………………………………………………………..………..04
Niche practice………………………………………………………………………………..………….08
Health Care Reform & ICD 9 Codes……………………………………………………..…………..13
Psychology and Support Issues…………………………………………………….…..……….…... 18
Pain……………………………………………………………………………….……..…..……..……29
Time Out Test………………………………………………………………………..…………………39
Quality Life through Rehabilitation…………………..…………………………..…….……………...40
Rehabilitation options…………………………………………….….…………..……………………..43
Evaluation scales…………………………………………………….….……..……………………….46
Lab Values…………………………………………………………………………………………….…51
General Breast Cancer Exercise Programs…………………….….…..…………………………….56
Documentation……………………………………………………………………………………..…...70
Post-Surgical Rehabilitation Examples……..…………………………….……………………….…74
Out-Patient example………………………………………………………………………….………...99
Research…………………………………………………………………………………………….…108
Modality contraindications………………………………………………………………………….…121
Oncologic Emergencies……………………………………………………………………………….129
Time Out Test………………………………………………………………………………………….135
Complications and Alternatives………………File #5…..…………………………………...…………….…...01
Lymphatic System……………………………………………………………………..….………….....02
Nutrition………………………….………………………………………………………,,….…………..14
Holistic Alternatives…………….…………………….………………………..…………..……………24
Recurrence………………………..…………………….………………………..…………,,………….32
Presentation Conclusion……………………….File #6……………..………….…………..…………...……….02
Case studies………………………………………………….…………….………..……….…...……..03
Survival………………………………………………………………………….……..……………...….08
Physical therapy cancer education…………………………….…..………………..………..…….….11
Conclusion………………………………………………………….…..………………..………..……...16
Answers to Pre / Post Test………………………………………………………..……..……………….…..….…20
References
……………………………File #7….Use folder entitled DScPT Reference List…..… 02
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Program Directions
Objectives
&
Introduction
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How to complete this presentation
• This doctoral level presentation is designed
to be “user friendly” as well as motivating to
promote regular referrals to physical therapy
for all patients diagnosed with breast cancer.
• This program has been divided into 7 files to
make online learning beneficial.
• File 1 Introduction
• File 2 Basic Breast Cancer Information
• File 3 The Cancer Team
• File 4 Breast Cancer Rehabilitation
• File 5 Complications / Alternatives
• File 6 Conclusion
• File 7 References
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Program Objectives
Upon completion the therapist will be able to:
• demonstrate an in-depth understanding of breast cancer.
• understand medical interventions and side effects of
•
•
•
•
•
cancer care.
have an awareness of the emotional aspects of a breast
cancer diagnosis.
gain knowledge to establish treatment goals for breast
cancer.
understand how the lymphatic system can influence
breast care.
understand how survivorship leads to rehabilitation.
explore opportunities in breast cancer rehabilitation.
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Introduction:
• I would like to welcome you to a self study program
for physical therapists who provide or would like to
provide rehabilitation to patients diagnosed with
breast cancer. With over 30 years experience as a
physical therapist, I have found that many patients
have not received quality rehabilitation after the
cancer diagnosis.
• I believe the physical therapist plays a vital role in
promoting a higher quality life for the breast cancer
patient. Due to early detection, diagnostic techniques,
treatment plans and increased exercise research, we
are able to promote realistic goals for the increased
number of cancer survivors.
• This program has been designed to promote
confidence and expertise in the treatment of breast
cancer. I personally feel that anyone that treats
breast cancer patients, must have a complete
understanding of cancer.
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• Again, I welcome you to
this program. I hope it will
be a stimulating
experience and will
motivate you in a very
rewarding specialty of
rehabilitation for the
patient diagnosed with
breast cancer.
Thank you.
Michael S. Coleman, PT
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Pre / Post Test
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PRE / POST STUDY TEST (Answer on a separate sheet of paper)
Oncology / Breast Cancer Review
1.Define cancer:
______________________________________________________________________
2.List the seven warning signs of cancer.
C_____________________________________________________________________
A_____________________________________________________________________
U_____________________________________________________________________
T_____________________________________________________________________
I______________________________________________________________________
O_____________________________________________________________________
N_____________________________________________________________________
3.List 5 risk factors of breast cancer.
______________________________________________________________________
4.What does TNM mean in the diagnosis of breast cancer?
______________________________________________________________________
5.List the professionals that make up the Cancer Team.
______________________________________________________________________
______________________________________________________________________
6.Where would you go for update physical therapy information concerning breast
cancer?
______________________________________________________________________
7.Why should physical therapy be involved with breast cancer patients?
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8.Where is the best location to treat a breast cancer patient?
A. Hospital
B. Out-patient facility C. Home care
D. All facilities listed
9.List five benefits of exercise after medical interventions for breast cancer.
_______________________________________________________________
10.Describe the types of surgery completed for cancer.
Diagnostic_______________________________________________________
Curative________________________________________________________
Palliative________________________________________________________
Prophylactic_____________________________________________________
11.What medical intervention might follow a lumpectomy?
_______________________________________________________________
12.What modalities would you choose to treat lymphedema?
_______________________________________________________________
13.Where are two of the three major lymph node regions?
_______________________________________________________________
14.List five contraindications of exercise following breast cancer.
_______________________________________________________________
15.How would you market breast cancer rehabilitation to physicians and the
general public?
_______________________________________________________________
Comments: _____________________________________ (Answers: File #6)
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SUPPORT THE ONCOLOGY SECTION of the A.P.T.A.
Presenter’s Notes
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DScPT Presenters Notes
• Open folder entitled DScPT Notes
• Each file corresponds with presentation
slides according to file and slide numbers.
• Copy each set of notes to follow along
with slide show presentation.
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