Differential Diagnosis for Physical Therapy: Cancer, Hepatic/Biliary, and Renal Disease: Summary 93
3. Chondrosarcoma: Most common malignant cartilage tumor
or high titers of Epstein–Barr virus have increased incidence of disease • Symptoms: Lumps under skin, fever (which can come and go over several days or weeks) without an infection, drenching night sweats, weight loss without trying (at least 10% of body weight over six months), fatigue, loss of appetite Non-Hodgkin’s Lymphoma More aggressive form of lymphoma, usually less symptomatic and with greater involvement of extranodal sites • Symptoms: Appetite loss, drenching night sweats, fatigue, fever, weight loss • Infectious mononucleosis–related Epstein– Barr virus (EBV) infection has been associated with increased risk • Possible causes: Genetic and environmental triggers (e.g., fertilizers, hair dyes) Sarcoma Refers to large variety of tumors arising in connective tissues (i.e., bone, cartilage, muscle, fat, synovium); sarcoma is named according to the specific tissues they affect (e.g., chondrosarcoma affects cartilage) • Increased risk: Exposure to food preservatives • Symptoms: Occur in soft tissue that is easily pushed out of the way by the growing tumor, and soft tissue sarcomas often do not cause early symptoms; first noticeable symptom usually is a painless lump 1. Osteosarcoma: Most common type of bone CA ■ Occurs in individuals between ages 10 and 25 years ■ Aggressive: Mets quickly ■ More common in boys 2. Ewing’s sarcoma: Rare malignant bone tumor occurring in children between the ages of 5 and 16 years ■ Can affect any bone but typically seen in pelvis, femur, tibia, ulna, and metatarsals
■ Occurs most commonly in pelvis, shoulder girdle, sternum, scapula, and long bones ■ Slow growing ■ Symptoms: Persistent pain that increases with time, is not relieved with rest, and worse at night ■ Prognosis: Depends on stage and location Brain Tumors • Symptoms may mimic cerebrovascular accident (CVA) • Bioccipital/bifrontal headaches present in 30% to 50% of clients with brain CA • Headaches due to brain tumors worsen with positional changes or activities that increase intercranial pressure (ICP) Spinal Cord Tumors Most common in young and middle-aged adults; occur mostly in thoracic spine • Symptoms depend on location, type of tumor, and the general health of the person—can include back pain, weakness or paralysis, and impaired sensation Cancer Risk Factors • Genetic (family history) • Viruses (previous medical history; e.g., HPV) • Radiation (sun exposure, radiation) • Chemicals (asbestos, dyes) • Biologic factors (previous medical history—immune system) • Age • Diet (high fat, smoked foods) • Hormones (estrogen) Treatment Curative —if tumor is small and localized • Surgery • Chemotherapy: Used alone or in combination ○ Usually given six weeks after surgery ○ Targets most rapidly reproducing cells
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