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1st. Department of Oncology

Time schedule- Practicals 4th class General Medicine- summer semester 2021/2022

Time schedule - Practicals 4th class General Medicine - summer semester 2021/2022

Please not that all practicals will be held online, the invitation for scheduled date with link to teams will be sent to studen’ts uniba email.

The practicals from radiotherapy with MUDr. Martin Chorváth, PhD., MPH are marked as sessions A and B. For substitution of practical, please contact the lecturer at least 2 days ahead via Teams chat-only substitution of identical session is possible.

The practicals from medical oncology with MUDr. Bela Mrinakova, PhD., MPH are marked as sessions A, B and C. For substution of practical, please contact the lecturer at least 2 days ahead via Teams chat - only substution of identical session is possible

 

RADIOTHERAPY:
25. 02. 2022 - Group 1 and 2 - Radiotherapy  A - Dr. Chorvath
28. 02. 2022 - Group 8 - Radiotherapy A - Dr. Chorvath
07. 03. 2022 - Group 3 - Radiotherapy A - Dr. Chorvath
21. 03. 2022 - Group 2 - Radiotherapy B - Dr. Chorvath
25. 03. 2022 - Group 6 - Radiotherapy A - Dr. Chorvath
01. 04. 2022 - Group 9 - Radiotherapy A - Dr. Chorvath
08. 04. 2022 - Group 5 - Radiotherapy A - Dr. Chorvath
13. 04. 2022 - Group 1 and 9 - Radiotherapy B - Dr. Chorvath

19. 04. 2022 - Group 4 and 6 - Radiotherapy B - Dr. Chorváth
29. 04. 2022 - Group 4 - Radiotherapy A - Dr. Chorvath
02. 05. 2022 - Group 7 - Radiotherapy A - Dr. Chorvath
16. 05. 2022 - Group 7 and 8 - Radiotherapy B - Dr. Chorvath
18. 05. 2022 - Group 3 and 5 - Radiotherapy B - Dr. Chorvath


MEDICAL ONCOLOGY:
16. 02. 2022 - Group 3 - Medical oncology A 
17. 02. 2022 - Group 4 - Medical oncology B 
23. 02. 2022 - Group 6 - Medical oncology B
02. 03. 2022 - Group 2 - Medical oncology A 
03. 03. 2022 - Group 7 - Medical oncology A 
09. 03. 2022 - Group 1 and 6 - Medical oncology A 
17. 03. 2022 - Group 9 - Medical oncology A
18. 03. 2022 - Group 2 - Medical oncology B - Dr. Mrinakova
21. 03. 2022 - Group 7 - Medical oncology B - Prof. Špánik
31. 03. 2022 - Group 1 and 5 - Medical oncology B
05. 04. 2022 - Group 4 - Medical oncology C - Dr. Mrinakova
07. 04. 2022 - Group 1 and 2 - Medical oncology C - Dr. Mrinakova
12. 04. 2022 - Group 8 - Medical oncology A 
21. 04. 2022 - Group 3 - Medical oncology B 
26. 04. 2022 - Group 9 - Medical oncology B 
27. 04. 2022 - Group 6 and 8 - Medical oncology C - Dr. Mrinakova
03. 05. 2022 - Group 8 - Medical oncology B 
04. 05. 2022 - Group 4 and 5 - Medical oncology A 
12. 05. 2022 - Group 3 and 5 - Medical oncology C - Dr. Mrinakova
13. 05. 2022 - Group 7 - Medical oncology C - Dr. Mrinakova
17. 05. 2022 - Group 9 - Medical oncology C - Dr. Mrinakova

 

 

 

 

 

 

The exam from the Oncological propedeutics 2022

The exam from the Oncological propedeutics in the current exam period (summer semester 2022) is organized test. For the exam term it is compulsory to sign up in AIS. The exam will take place in computer room (IT) at the Medical Faculty on the floor above the Immunology department. The test will be executed via Moodle platform. Students will use their AIS account information to log in.

The test serves as a sole exam of Oncological propedeutics for students of the General Medicine 4th and 5th of the Medical Faculty of Comenius University in Bratislava.

The test includes 60 multiple choice questions, with one correct answer. The questions are based on syllabus provided on website - Oncological propedeutics. After choosing the answer, or advancing to the next question, no back coming is permitted, overall time provided for the text is 45 minutes. After completion of time frame, the test will be sent and evaluated automatically. Once the student has signed up for the test and entered it, this counts as an attempt and will be evaluated. Following the test submission, student will be provided with the result, that will be transferred into AIS. In order to pass the exam, student needs to achieve at least 60% correct answers. In the case, that student would fail the attemp (grade Fx), the exam can be repeated in the next provided terms after AIS registration for the term. The maximum attempts per student in the exam period are three.

For students who have transferred Oncological propedeutics to the higher grade - 5th grade students - same rules for exam apply, please see above. 

Regarding the Erasmus students - same rules for testing apply. The result will be transferred into AIS and consequently the Erasmus coordinator will provide the certificate about completion of Oncological propedeutics for home university.

Conditions for evaluation of the results:

Grade A 95 - 100% correct answers

Grade B 90 - 94% correct answers

Grade C 80 - 89% correct answers

Grade D 70 - 79% correct answers

Grade E 60 - 69% correct answers

Grade Fx < 60% correct answers

 

 

SYLLABUS

1. Cancer Biology

The process of carcinogenesis (genes, organization, expression and regulation). Cell cycle, its regulation and possibilities of therapeutic intervention. Cell kinetics - growth and proliferation, mechanism of apoptosis, metastasis. The complexity of changes in tumour biology and interaction with the microenvironment. Molecular analysis of DNA and other examinations focused on tumour biology.

 

2. Tumour immunology

The inter-relationship between the tumour and host immune system - tumour antigenicity, humoral and cellular antitumour cytotoxicity of innate and adaptive immune system, immunoediting. Immunotherapy.

 

3. Aetiology, epidemiology, screening and prevention

Process of oncogenesis, genetic and environmental factors (physical, chemical, biological). Tumour epidemiology - collection, analysis and interpretation of epidemiological data. Basic terms used in tumour epidemiology. Epidemiological studies, statistical evaluation, comparison and assessment of causality. Principles of primary, secondary and tertiary prevention in oncology. Screening: organization, tools. Interventions to reduce the incidence and mortality of cancer. Follow up and surveillance of oncological patients.

 

4. Medical documentation in oncology

Medical documentation, sources of information, categorization and use. Informed consent of patient. Good clinical practice, source documentation. Information systems, smart technologies in oncology, telemedicine. Reporting - cancer registries. 

 

5. Clinical research in oncology

Design and principles of clinical trials. Preclinical research and clinical studies of phases I, II, III and IV. Overview of ethical, organizational and legal issues of clinical research. Criteria for defining response to therapy - outcome evaluation, application of biomarkers, mechanisms and importance of quality of life assessment. Statistical analysis, data sources, interpretation of results. Impact on registration and availability of treatment in clinical practice. 

 

6. Basic principles in the management of malignant diseases

Local and general manifestations of cancer, differential diagnosis. Possibilities of pathological examination and subsequent use in clinical management of the patient. Prognostic and predictive biomarkers, molecular pathology: standard requirements for the diagnosis of different types of tumours. Laboratory tests in oncology. Translational research, evaluation of biomarkers, liquid biopsy. Principles of personalized medicine. Imaging and molecular imaging in oncology. Clinical and pathological classification, TNM and other classification systems. Multidisciplinary tumour boards for diagnosis and treatment of cancer. 

 

7. Evaluation of the treatment response

RECIST, iRECIST. Complete remission, partial remission, stabilization, relapse, progression, generalization. Performance status. Treatment toxicity and assessment of the quality of life impact. 

 

8. Surgical oncology

Indications and contraindications of surgical treatment. The role of surgery in the diagnosis, treatment and palliation of patients with cancer. Sequence of surgical treatment with other treatment modalities. Indications of the extent of surgery based on EBM.

 

9. Radiation oncology

The role of radiation therapy in multidisciplinary management of patients with cancer. Mechanism of the effect of radiation on a cancer cell. Radiosensitivity law, therapeutic ratio, tumorous lethal dose, radiotherapy planning. Irradiation techniques used in radiotherapy (3D, 4D conformal radiotherapy, IMRT, IGRT, VMAT, SRS, fSRT, brachytherapy, X-ray therapy). Importance and indications of adjuvant, neoadjuvant, concomitant radiotherapy. Principles and indications of palliative radiotherapy. Side effects of treatment and their management. 

 

10. Systemic treatment of cancer

Mechanisms of action of the systemic treatment modalities, indications and contraindications. Chemotherapy, hormonal treatment, biological and targeted treatment, tumour immunotherapy. Pharmacokinetics and pharmacodynamics of anticancer agents, dose calculation and choice of treatment regimen. Possibilities of treatment combinations. Prevention and treatment of toxicity of systemic therapy. Symptoms, diagnosis and management of serious adverse events (pancytopenia, febrile neutropenia and others).

 

11. Supportive and palliative care

Management of symptoms, complications of cancer and side effects of multimodal anticancer treatment from the time of diagnosis until death or rehabilitation and survivorship of the patient. Indications for supportive and symptomatic treatments based on EBM and their limitations. Pathophysiology of cancer symptoms and possibilities of intervention. Complex and multidisciplinary treatment in palliative medicine. Psychosocial support, communication with the cancer patient and relatives. Principles of nursing care, rehabilitation and maintaining the patient's self-sufficiency. Treatment of the terminally ill and end-of-life care (home-based care, inpatient care and hospice care). Social work in oncology.

 

12. Head and neck cancers

Etiopathogenesis and risk factors for head and neck cancers. Diagnosis, treatment and prognosis of various types of tumours - e.g. nasopharyngeal carcinoma, salivary gland tumours, squamous cell carcinoma and others. Assessment of nutritional status, respiratory barriers and adaptation of the treatment. Multidisciplinary treatment, response evaluation and toxicity of therapy.

 

13. Cancers of the respiratory organs and mediastinum

Etiopathogenesis and risk factors for cancers of the respiratory organs and mediastinum. Diagnosis, treatment and prognosis of various types of tumours - e.g. small cell, non-small cell lung cancer, mesothelioma, thymoma and thymic carcinoma. The importance of staging: the impact on the choice of treatment modality. Multidisciplinary treatment, response evaluation and toxicity of therapy.

 

14. Gastrointestinal cancers

Oesophageal, gastric, intestinal, colon, rectal and anal cancer. Tumours of the pancreas, liver, gallbladder and bile ducts. Etiopathogenesis and risk factors, possibilities of prevention and screening. Diagnosis, classification of diseases, prognostic and predictive biomarkers - importance in the selection of treatment. Sequence of treatment modalities in individual tumours.

 

15. Genitourinary cancers

Renal cancer, cancer of ureters, bladder, urethra. Prostate tumours, testicular tumours, penile cancer. Etiopathogenesis of the diseases, importance of prognostic categories. Diagnostics, classification, serum tumour markers. Treatment, evaluation of treatment response and prognosis, monitoring of patients and follow-up.

 

16. Gynaecological malignancies

Ovarian, endometrial, cervical, vulvar and vaginal cancer. Gestational trophoblastic neoplasia. Etiopathogenesis, epidemiology and risk factors, prevention and screening. Diagnosis, classification of diseases and multidisciplinary treatment.

 

17. Breast cancer

Etiopathogenesis and epidemiology of the disease, sub-types of tumours (defined by IHC and genomic testing), prevention and screening. Comprehensive diagnosis of breast cancer, staging, predictive and prognostic factors. Multidisciplinary management and treatment of breast cancer, personalization of systemic treatment, evaluation of treatment response and prognosis, monitoring of patients and follow-up.

 

18. Bone and soft tissue tumours

Soft tissue sarcomas, bone sarcomas, GIST. Specialized multidisciplinary approach to diagnosis and treatment. Basic concept of diseases management, prognosis.

 

19. Skin cancers

Non-melanoma cancers, malignant melanoma. Risk factors, health education, prevention. Diagnosis, classification of diseases and multidisciplinary treatment.

 

20. Endocrine and neuroendocrine neoplasms

Tumours of the thyroid gland, adrenal glands, neuroendocrine tumours. Etiopathogenesis, epidemiology, classification. Hereditary syndromes, biological subtypes, particularities of diagnosis and treatment.

 

21. CNS malignancies

Tumours of the brain, spinal cord and peripheral nervous system. Symptomatology, initial management of symptoms, diagnosis and treatment, evaluation of treatment response- RANO.

 

22. Carcinoma of unknown primary 

Characteristics, clinical manifestations, categories according to prognosis. Specifics of diagnostics and multidisciplinary treatment.

 

23. Haematological oncology

Acute and chronic leukaemia, myelodysplastic syndrome, lymphomas, multiple myeloma. Etiopathogenesis, epidemiology, diagnosis and treatment. Multidisciplinary approach, hematopoietic cell transplants, transplant centres, specialized care. Monitoring of the treatment response, management of complications. 

 

24. Rare cancers

Etiopathogenesis, epidemiology of diseases. Awareness of diagnosis and treatment. Centres of reference for rare cancers.

 

25. AIDS-associated malignancies

Spectrum of malignancies in immunodeficiency syndrome: etiopathogenesis, diagnosis and treatment. Risks of co-infection with tumorigenic viral pathogens (KSHV, EBV, HPV, HBV). Preventive strategies, multidisciplinary patient management, specifics of treatment. 

 

26. Tumours of childhood and adolescence 

Spectrum of malignancies, etiopathogenesis, epidemiology, diagnosis and treatment. Multidisciplinary patient management, treatment and monitoring of acute and late toxicity. 

 

27. Cancer and pregnancy

Spectrum of malignancies, diagnosis and multidisciplinary treatment. Multidisciplinary management of patients, specifics of indications of individual modalities in pregnancy with regard to mother and foetus. Changes in pharmacokinetics, correct determination of systemic treatment doses. Prognosis of patients and foetus. Timing of childbirth, possible complications, potential side effects of treatment during childbirth, neonatal risks. Preservation of fertility, treatment of tumours and lactation.

 

28. Geriatric oncology

Spectrum of malignancies, specifics of diagnostics and multidisciplinary treatment. Assessment of the frailty and performance status of a geriatric patient. Optimization and personalization of oncological treatment. Physiological changes associated with aging and their impact on cancer treatment, determining the risk-benefit balance of treatment. Therapy for specific comorbidities, drug interactions. 

 

29. Psychosocial aspects of cancer

Psychological and social characteristics of cancer. Psychosocial conditionality of cancer. Psychosocial factors and the course of cancer. Stages of coping with the disease, coping strategies, characteristics of adaptation to the disease. Psychosocial intervention in patients with cancer-crisis intervention, social and emotional support of the cancer patient, group intervention, self-help and supportive therapeutic groups of cancer patients. Quality of life of cancer patients. Communication in medical care. Counselling for survivors - methods and techniques of counselling, specific problems in counselling for survivors, models of counselling.

 

 

CLINICAL TRAINING:

Clinical training of the study subject Oncological Propedeutics are devoted to the practical management of an oncological patient. History taking, clinical examination of an oncological patient, visit to the ward, acquaintance with individual diagnostic procedures, the process of cancer classification and treatment methods. Indications for radiotherapy, irradiation techniques, planning in radiotherapy, equipment of the department of radiation oncology, monitoring of treatment response and toxicity of treatment. Indications for systemic treatment, chemotherapy, hormonal treatment, biological and targeted treatment, tumour immunotherapy, monitoring of treatment response, treatment toxicity, supportive and symptomatic treatment in oncology. Basic information about individual oncological diagnoses in hospitalized patients in wards, assistance with simple diagnostic and treatment procedures. 

 

Examination - test