Rehabilitation Medicine Quick Reference RM Rehabilitation Medicine Quick Reference QR Ralph M. Buschbacher, Md Ralph M. Buschbacher SR SeRieS editoR ea SeRieS editoR rielp sh E M d ito. B CanCer ru s CanCer c h b a c h e Ki Y. Shin, MD r Become more efficient in your practice RM QR 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, C 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, r 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, pharmaceutical companies, health care organizations, and other qualifying groups. For details, please contact: Special Sales Department Demos Medical Publishing, LLC 11 West 42nd Street, 15th Floor New York, NY 10036 Phone: 800-532-8663 or 212-683-0072 Fax: 212-941-7842 E-mail: [email protected] 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