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Occupational Therapy in Cancer Care


What is Cancer?


Cancer is a group of diseases characterized by the uncontrolled growth and spread of abnormal cells. These cells divide and grow in an uncontrolled way, forming tumours or masses of tissue. Cancer can affect any body part and can be benign or malignant. A benign tumour is a noncancerous growth that does not spread (metastasize) to other body parts. Benign tumours are generally less aggressive and less dangerous than malignant tumours, which are cancerous and can spread to other parts of the body. In contrast, A malignant tumour is a type of cancerous growth that can spread (metastasize) to other body parts. Malignant tumours are generally more aggressive and dangerous than benign tumours, which do not spread to other parts of the body and are usually not life-threatening.



There are many different types of cancer, each with its characteristics and treatment options. Some common types of cancer affect the lungs, prostates and colon. It is important to note that cancer is not a single disease but rather a group of diseases with different causes and behaviours. The specific treatment and prognosis for a person with cancer depend on the type and stage of cancer and the person's overall health.



Cancer remains the leading cause of death in Canada. An estimated 2 in 5 Canadians will be diagnosed with cancer in their lifetime and about 1 in 4 will die from cancer. - Government of Canada


What is the difference between cancer cells and normal cells?


There are several key differences between cancer cells and normal cells:


Growth and division: Cancer cells divide and grow much more rapidly than normal cells and do not stop growing when they should. Normal cells have a specific lifespan and will stop dividing and die off when they reach the end of their lifespan.

DNA damage and repair: Cancer cells often have damaged DNA that is not repaired correctly, which can lead to the development of more abnormal cells. Normal cells have mechanisms to repair damaged DNA, which helps prevent cancer development.


Lack of specialization: Cancer cells are often less specialized than normal cells, meaning they do not have a specific function in the body. On the other hand, normal cells have a specific function, such as producing hormones, carrying oxygen, or helping fight infection.

Ability to spread: Cancer cells can spread, or metastasize, to other parts of the body, while normal cells do not have this ability. This is one of the main reasons cancer can be so challenging to treat and are life-threatening.


Response to treatment: Cancer cells often resist treatment, such as chemotherapy and radiation therapy. Normal cells are often more sensitive to these treatments and may be damaged or killed.



How does cancer develop?

Cancer develops when changes, or mutations, in a cell's DNA cause uncontrolled cell duplication. These mutations can occur for various reasons, including exposure to certain chemicals, radiation, viruses, and inherited genetic mutations. Cells that divide and grow uncontrollably may develop into a tumour or mass of abnormal cells.


It is important to note that not all mutations lead to cancer. In many cases, the body's immune system or other repair mechanisms can recognize and repair the damaged DNA before it can cause cancer. However, if the mutations are not repaired or occur in specific key genes that regulate cell growth and division, they can lead to cancer development.


Many factors can increase a person's risk of developing cancer, including tobacco use, exposure to certain chemicals and substances, a family history of cancer, certain infections, and specific inherited genetic mutations. However, it is also important to note that many people who develop cancer have no known risk factors and that cancer can occur in people of all ages and backgrounds.



Lung, breast, colorectal and prostate cancers are expected to remain the most commonly diagnosed cancers, accounting for 46% of all diagnoses in 2021.


How does cancer spread?


Cancer can spread, or metastasize, to other parts of the body through a process called invasion and metastasis. Cancer cells break away from the primary tumour during invasion and enter the bloodstream or lymphatic system. These cancer cells can then travel to other body parts and form new tumours.


Cancer cells often spread through one of several ways, including the lymphatics system, bloodstream or by direct invasion. The lymphatic system is a network of vessels and nodes that helps to drain excess fluid from the body and helps to fight infection. Cancer cells can enter the lymphatic system and spread to nearby lymph nodes. Cancer cells can enter the bloodstream and travel to other body parts like the liver, brain, or bones. Cancer cells can also spread by directly invading nearby tissues and organs.


It is important to note that not all cancers can spread, and the likelihood of cancer spreading depends on the type and stage. For example, breast cancer is more likely to spread to the lymph nodes or the lungs, while colon cancer is more likely to spread to the liver. Early detection and treatment of cancer can often help prevent or slow the spread of cancer to other body parts.



What cancer treatments are available?


There are several treatment options available for cancer; the specific treatment plan will depend on the type and stage of cancer and the person's overall health. Some standard treatment options for cancer include:


  • Surgery: Surgery is often used to remove the cancerous tumour and some surrounding tissue and may be the only treatment needed in some cases, particularly for early-stage cancers.

  • Chemotherapy: Chemotherapy involves the use of drugs to kill cancer cells. These drugs can be taken orally or injected into a vein and used alone or in combination with other treatments.

  • Radiation therapy uses high-energy beams, such as x-rays, to kill cancer cells. It may be used alone or in combination with other treatments.

  • Targeted therapies: Targeted therapies are drugs that are designed to target specific proteins or genetic mutations that are present in cancer cells. These therapies can be used alone or in combination with other treatments.

  • Immunotherapy: Immunotherapy is a treatment that helps boost the body's immune system to fight cancer. It can be used alone or in combination with other treatments.

  • Hormone therapy blocks the production or action of hormones that can fuel the growth of certain types of cancer, such as breast and prostate cancer.

  • Clinical trials are research studies that test new treatments and therapies in people. Participating in a clinical trial may give a person access to treatments that are not yet widely available.


It is important to note that cancer treatment can be associated with side effects, and the specific side effects will depend on the type and intensity of the treatment. These side effects may include fatigue, nausea, hair loss, and skin changes. Before starting treatment, discussing the potential side effects with a healthcare provider is essential.


What is the role of occupational therapy in cancer care?


Occupational therapy can play a role in the care and treatment of individuals with cancer in several ways. Some of the ways in which occupational therapy may be used in the treatment of cancer include:


  1. Helping individuals to manage physical side effects of cancer treatment: Cancer treatment, such as chemotherapy and radiation therapy, can cause physical side effects that can affect a person's ability to carry out their daily activities. Occupational therapy can help individuals to manage these side effects and to find ways to continue participating in their usual activities.

  2. Improving mobility and function: Cancer and cancer treatment can sometimes affect a person's mobility and ability to perform specific tasks. Occupational therapy can help individuals to improve their mobility and function, such as through the use of adaptive equipment or by teaching them new ways to perform tasks.

  3. Managing pain: Cancer and cancer treatment can cause pain, and occupational therapy can help individuals to manage this pain through the use of techniques such as relaxation, positioning, and assistive devices.

  4. Helping individuals to return to work: Occupational therapy can help them return to work after cancer treatment by addressing any physical or functional limitations and by helping them to develop strategies for managing fatigue and other side effects.

  5. Providing support for individuals with cancer: Occupational therapy can also support individuals with cancer by helping them find ways to continue participating in meaningful activities and providing emotional support and guidance.


Overall, occupational therapy's role in treating cancer is to help individuals manage the physical and functional effects of cancer and cancer treatment and support them in their efforts to continue participating in the activities that are important to them.




References:


Cancer - Symptoms and causes. (2022, December 7). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/cancer/symptoms-causes/syc-20370588


Garcia, L. (2022, May 20). Occupational therapy for cancer patients: What is it, and who needs it? MD Anderson Cancer Center. https://www.mdanderson.org/cancerwise/occupational-therapy-for-cancer-patients--what-is-it--and-who-needs-it.h00-159539745.html


Public Health Agency of Canada. (n.d.). Canadian Cancer Statistics 2021 - Canada.ca. https://www.canada.ca/en/public-health/services/reports-publications/health-promotion-chronic-disease-prevention-canada-research-policy-practice/vol-41-no-11-2021/canadian-cancer-statistics-2021.html

What Is Cancer? (2021, October 11). National Cancer Institute. https://www.cancer.gov/about-cancer/understanding/what-is-cancer

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