ABPTS Oncology cheat sheet

TNM staging: T = primary tumor size/invasion, N = regional node involvement, M = distant metastasis; higher combined stage generally indicates worse prognosis.

Performance status scales (ECOG 0-4, Karnofsky 0-100) quantify functional capacity and guide treatment intensity and rehabilitation eligibility.

Red flags for metastatic disease: unexplained weight loss, night pain unrelieved by rest, new neurologic deficits, pathologic fracture signs, hypercalcemia symptoms.

Common oncologic emergencies: spinal cord compression, superior vena cava syndrome, tumor lysis syndrome, febrile neutropenia, hypercalcemia of malignancy.

Neutropenic precautions typically apply when absolute neutrophil count falls below 500-1000 cells/mcL; fever with neutropenia is an emergency.

Cancer-related fatigue is distinguished from normal fatigue by persistence, disproportionate severity to activity, and lack of relief with rest.

Lymphedema staging (ISL 0-III) and measurement: limb circumference or water displacement; a 2 cm interlimb difference is a common diagnostic threshold.

Cancer staging informs prognosis and treatment but does not by itself determine exercise tolerance; assess cardiopulmonary and musculoskeletal capacity directly.

Modifiable risk factors: tobacco use, alcohol, obesity, physical inactivity, UV radiation, HPV/HBV infection, occupational carcinogens.

Physical activity is associated with reduced risk of colon, breast, and endometrial cancers and improved survival in several survivors.

Estimated 5-year relative survival varies widely by site and stage; localized disease survival substantially exceeds distant metastatic disease.

Tobacco cessation reduces lung cancer risk progressively over years; risk declines but does not return to never-smoker levels.

HPV vaccination prevents infection with high-risk types linked to cervical, oropharyngeal, and anal cancers.

Screening evidence: mammography for breast, colonoscopy/FIT for colorectal, low-dose CT for high-risk smokers, Pap/HPV for cervical.

Prognosis modifiers include stage, histologic grade, performance status, comorbidity burden, and response to initial therapy.

Secondary prevention includes surveillance for recurrence and screening for second primary cancers in survivors.

Surgery types: diagnostic biopsy, curative resection, debulking/cytoreduction, palliative, and reconstructive procedures.

Chemotherapy is cell-cycle phase-dependent or -independent; common toxicities include myelosuppression, mucositis, neuropathy, and cardiomyopathy (anthracyclines).

Radiation therapy toxicities are site- and dose-dependent: skin reaction, fibrosis, fatigue, and late effects such as lymphedema or radiation pneumonitis.

Hormone therapy (e.g., tamoxifen, aromatase inhibitors) can cause arthralgia, hot flashes, and bone loss; aromatase inhibitors increase fracture risk.

Immunotherapy (checkpoint inhibitors) can produce immune-related adverse events including colitis, pneumonitis, and arthritis.

Targeted therapies vary by pathway; trastuzumab (HER2) carries cardiotoxicity risk requiring cardiac monitoring.

Post-surgical precautions: respect flap/graft protection, drain care, and surgeon-specific weight-bearing or range-of-motion restrictions.

Bone marrow transplant and high-dose regimens produce prolonged cytopenias, requiring activity precautions during nadir periods.

Screen for metastatic bone disease before aggressive manual therapy or resistive exercise: pain at rest, night pain, and prior bone lesions are red flags.

Axillary lymph node dissection increases lymphedema risk relative to sentinel node biopsy; assess both limbs at baseline.

Chemotherapy-induced peripheral neuropathy screening: monofilament, vibration, proprioception, and gait/balance testing.

Cardiotoxicity risk warrants monitoring heart rate, blood pressure, and exertional symptoms during aerobic assessment.

Cancer-related fatigue assessment includes severity, pattern, and impact on function; use validated scales rather than informal report.

Post-mastectomy and post-radiation shoulder range of motion and strength deficits are common; measure goniometry and dynamometry.

Osteoporosis and fracture risk from androgen deprivation or aromatase inhibitors warrant bone density and fall-risk screening.

Outcome measures should be reliable and validated in oncology populations; document baseline before intervention for comparison.

Exercise prescription for cancer survivors: aerobic and resistance training at moderate intensity, individualized to fatigue and symptom burden.

Resistance training is safe and beneficial in breast cancer survivors, including those with lymphedema, when progressed gradually.

Lymphedema management: complete decongestive therapy includes manual lymphatic drainage, compression, exercise, and skin care.

Cancer-related fatigue is best managed with a combination of aerobic exercise, education, and energy conservation; rest alone worsens deconditioning.

Prehabilitation before surgery or chemotherapy improves functional reserve and may reduce postoperative complications.

Neuropathy interventions: balance training, sensory re-education, and fall prevention; no strong evidence for a single pharmacologic cure.

Bone metastases: avoid high-impact or torsional loading; use supported positions and monitor for fracture signs.

Palliative rehabilitation focuses on function, comfort, and quality of life rather than disease modification.

Validated oncology outcome measures include EORTC QLQ-C30, FACT-G, and site-specific modules for quality of life.

The 6-minute walk test and timed up and go assess functional capacity in cancer survivors.

Minimal clinically important difference values should be used to interpret change scores, not statistical significance alone.

Evidence hierarchy: systematic reviews and randomized controlled trials provide strongest support for intervention decisions.

Physical activity guidelines for survivors: 150 minutes moderate aerobic activity plus 2 resistance sessions weekly, adjusted to tolerance.

Patient-reported outcomes capture symptoms and function not detected by clinical measures.

Documentation should link examination findings to intervention selection and measurable goals.

Critically appraise study validity, applicability, and sample characteristics before applying findings to an individual patient.

Scope of practice: physical therapists manage movement and function; medical management of cancer remains with the oncology team.

Informed consent requires disclosure of risks, benefits, alternatives, and the patient's right to refuse.

Confidentiality applies to all protected health information; share only with authorized members of the care team.

Interprofessional collaboration includes oncology, nursing, rehabilitation, and palliative care; refer when findings exceed PT scope.

Patient autonomy and shared decision-making guide goal setting, particularly in advanced disease.

Report suspected abuse, neglect, or unsafe conditions per legal and institutional requirements.

Advocacy includes addressing access barriers and environmental factors affecting participation.

Documentation must be accurate, timely, and objective; avoid unsubstantiated claims about prognosis.

Patient education improves adherence when delivered in plain language, reinforced, and tailored to health literacy.

Teach-back is a validated method to confirm comprehension of instructions.

Exercise education for survivors should include pacing, symptom monitoring, and when to stop and seek care.

Research designs in oncology rehabilitation include RCTs, cohort studies, and qualitative methods for patient experience.

Informed consent for research includes voluntariness, risks, benefits, and the right to withdraw.

Evidence-based practice integrates best evidence, clinical expertise, and patient values.

Outcome measurement and data collection support quality improvement and program evaluation.

Continuing education and critical appraisal maintain competence in a rapidly changing oncology field.