1. Interrelated Concepts
1.1. Immunity
1.1.1. 2/2 chemo or radiation
1.1.1.1. Immunity
1.2. Infection, Perfusion, Bleeding/Clotting
1.2.1. 2/2 bone marrow suppression
1.2.1.1. Pancytopenia
1.3. Fatigue
1.3.1. 2/2
1.3.1.1. Medications
1.3.1.1.1. e.g., chemotherapy
1.3.1.2. Anemia
1.3.1.2.1. Bone marrow suppression
1.3.1.3. Anorexia/weight loss
1.3.1.4. Depression
1.3.1.5. Terminal illness
1.4. Nutrition
1.4.1. 2/2 CA or treatment
1.4.1.1. Xerostomia (dry mouth)
1.4.1.2. Dysgeusia (taste alteration)
1.4.1.3. Dysphagia (difficulty swallowing)
1.4.1.4. Mucositis (inflammation of the mucosa)
1.4.1.5. Chemo-induced N/V
1.4.1.6. Protein and calorie malnutrition
1.4.1.6.1. Weight loss
1.4.1.7. Inability to eat post-surgery
1.4.1.7.1. e.g., oral cancer surgery
1.5. Fluid Balance
1.5.1. 2/2 CA or treatment
1.5.1.1. Dehydration
1.5.1.1.1. Due to A/N/V
1.6. Electrolyte Balance
1.6.1. 2/2 Oncologic emergencies
1.6.1.1. SIADH
1.6.1.1.1. Dilutional hyponatremia
1.6.1.2. Hypercalcemia
1.6.1.2.1. "Bones, Stones, Groans, Overtones"
1.7. Elimination (GI or GU)
1.7.1. Lower GI
1.7.1.1. 2/2 CA or treatment
1.7.1.1.1. Ascites
1.7.1.1.2. Constipation
1.7.1.1.3. Diarrhea
1.7.1.1.4. Bowel obstruction
1.7.2. Renal and bladder
1.7.2.1. Urinary incontinence
1.7.2.2. Renal dysfunction
1.8. Gas Exchange
1.8.1. 2/2 CA or treatment
1.8.1.1. Dyspnea
1.8.1.2. Pleural effusion
1.9. Cognition
1.9.1. Chemo-induced delirium
1.9.1.1. "Chemo brain"
1.10. Sensory perception & Pain
1.10.1. Chemo-induced peripheral neuropathy
1.10.1.1. Pain
1.10.2. Bone metastasis
1.10.2.1. Bone pain
1.10.2.2. Spinal cord compression
1.10.2.3. Hypercalcemia
1.10.3. Chronic CA pain
1.11. Immobility
1.11.1. 2/2 CA or treatment
1.11.1.1. Immobility
1.11.1.2. Muscle weakness
1.11.1.3. Unsteady gait
1.12. Sexuality
1.12.1. 2/2 CA or treatment
1.12.1.1. Sexual dysfunction
1.12.1.2. Infertility
1.12.1.3. Impotence
1.13. Skin integrity
1.13.1. 2/2 CA or treatment
1.13.1.1. Erythema and desquamation
1.13.1.2. Pruritus
1.14. Body image
1.14.1. 2/2 treatment
1.14.1.1. Alopecia
1.14.1.2. Scarring or disfigurement
1.15. Stress, Anxiety, Coping
2. Cellular Regulation & Growth
2.1. Cell Cycle
2.1.1. Chemotherapy works at different stages of the cell cycle
2.2. Cancer Development
2.2.1. Replication (Proliferation)
2.2.1.1. Rate of cellular regeneration = Rate of cellular degeneration
2.2.1.1.1. Rate of cellular regeneration > Rate of cellular degeneration
2.2.1.1.2. Rate of cellular regeneration < Rate of cellular degeneration
2.2.2. Differentiation
2.2.2.1. Well differentiated CA cells
2.2.2.1.1. Grow and spread slow
2.2.2.2. Poor differentiated or undifferentiated cells
2.2.2.2.1. Grow and spread fast
2.3. Cancer Progression
2.3.1. Metastasis
3. Neoplasm
3.1. Benign
3.1.1. Obstruct or press on other body structures
3.1.1.1. May lead to...
3.1.1.1.1. Pain
3.1.1.1.2. Physiologic dysfunction
3.1.1.1.3. Tissue or organ death
3.1.1.2. e.g.
3.1.1.2.1. Prostate CA
3.1.1.2.2. Brain tumor
3.2. Malignant
3.2.1. Grading system
3.2.2. Staging
3.2.2.1. Factors
3.2.2.1.1. T = Tumor (size and invasiveness)
3.2.2.1.2. N = Nodes (Regional lymph nodes involvement)
3.2.2.1.3. M = Metastasis (to distant organ)
3.2.2.2. TNM staging