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1st. Department of Oncology

Syllabus

Part: Medical Oncology

Objectives:
The students will get the information about the epidemiology of the most important and most frequent oncological diseases in the population, about the risk factors, etiology, pathogenesis,  diagnosis and main principles of the  therapy of these diseases. The main objective is to elucidate the aspects of practical care about oncological patients

Theoretical part:

  • The main groups of oncological diseases
  • The managment of health care in oncological patients
  • Epidemiology, risk factors and classification of oncological diseases
  • Screening possibilities and methods of early diagnosis of oncological diseases
  • Diagnosis – laboratory diagnostic methods, imaging and endoscopic techniques
  • Histology, genetic and molecular analyses of malignant diseases
  • Differential diagnosis of oncological diseases
  • Main principles of the therapy of oncological diseases (surgical therapy, radiotherapy, chemotherapy)
  • Possibilities of prevention of  oncological diseases

Practical part:

  • Examination of oncological patient
  • History
    • focused on family history and risk factors
  • Physical examination
    • Focused on palpable tumor, lymph nodes, liver, spleen, digital rectal exmaination
  • Evaluation of infomation
    • Possible diagnosis of malignant disease
  • Diagnosis
    • Proposed diagnostic procedures
    • Sequence of tests and examinations
  • Differential diagnosis
  • Therapy strategy proposal
    •  General therapeutic strategy

 

Part: Radiation Oncology

Theoretical part:

  • definition of radiation therapy
  • role of radiotherapy in multimodal treatment
  • radiosensitivity
  • dose prescription
  • dose constraints
  • sources for teletherapy
  • sources for brachytherapy
  • treatment planning
  • acute and late side effects of irradiation
  • follow up
  • literature

Practical part:

  • demostration of treatment planning (real cases of patients) with treatment planning systems
  • patient irradiation on linear accelerator  with demostration of different treatment techniques
  • visiting inpatients with demostration of different types and degrees of acute reactions
  • final  discussion

Oncological propedeutics - Frame questions for oral examination

1. Cancer epidemiology (incidence, prevalence, mortality, methods of data collection, global cancer statistics trends);

2. Primary, secondary, tertiary prevention (explanation, principles, organization);

3. Biological agents in carcinogenesis (bacteria, viruses, parasites - mechanism of carcinogenesis, cancer types, epidemiology and prevention);

4. Chemical agents in carcinogenesis ( mechanism of action, cancer types, epidemiology, professional risk and prevention );

5. Physical factors in carcinogenesis ( ionizing, non-ionizing radiation, mechanical irritation-cancer types, epidemiology and prevention );

6. Hereditary and familiar cancer (HBOC, FAP, HNPCC, VHL, MEN, Li-Fraumeni syndrome-involved genes, cancer spectrum, lifetime cancer risk, prevention );

7. Process of carcinogenesis ( initiation, promotion, progression );

8. Genes involved carcinogenesis ( proto-oncogenes, tumor suppressor genes, genes involved in cell cycle regulation ), epigenetic changes;

9. Differences between healthy and cancer cell in morphology and function;

10. Malignant vers. benign tumors, biological characteristics, infiltrative vers. expansion growth;

11. Sustaining proliferative signaling in cancer;

12. Evading growth suppressors in cancer;

13. Resisting cell death and enabling replicative immortality in cancer;

14. Angiogenesis in cancer;

15. Invasion metastatic cascade;

16. Epithelial to mesenchymal transition ( EMT, MET - role in dissemination );

17. Energy metabolism in cancer;

18. Evading immune destruction in cancer;

19. Prognostic and predictive markers in cancer (definition, use, examples );

20. Sérum tumor markers, types - role in cancer monitoring, liquid biopsy;

 

21. Diagnostic procedures in oncology ( invasive and noninvasive examinations, role of biopsy, pathological examination and imagining studies );

22. Classification of cancer ( TNM, FIGO, DUKES, Clark Breslow, Ann Arbor );

23. Premalignant tissues, pre-cancerous lesions, occurrence, impact in carcinogenesis;

24. Oncological emergencies ( tumor lysis syndrome, brain metastasis, spinal cord compression, hypercalcemia );

25. Chemotherapy ( mechanism of action, classes of drugs, examples );

26. Chemotherapy - routes of administration, dose and schedule;

27. Systemic treatment approach ( monotherapy, sequential, combination - principles, indications );

28. Multimodal treatment of cancer (systemic therapy/chemotherapy, biological and immunotherapy/,radiotherapy, nuclear medicine and surgery-basic principles and roles in patient treatment );

29. Curative intention of systemic therapy ( principle and examples: neoadjuvant, adjuvant, induction, concurrent, consolidation, salvage );

30. Palliative intention of systemic therapy ( principle, goals, role of supportive care );

31. Treatment response evaluation ( RECIST: CR, PR, SD, PD, clinical outcome measures: OS, PFS );

32. Hormonal - antihormonal treatment of tumors ( sensitive cancer types, classes of drugs, mechanism of action );

33. Biological - targeted therapy ( monoclonal antibodies, TKIs, CDKi - principles, mechanism of action, examples );

34. Anti - cancer immunotherapy ( principle, mechanism of action, examples );

35. Organ toxicity of chemotherapy and biological therapy (cardiac, neurological, pulmonary, liver, renal & urological - principle and examples, prevention and treatment );

36. Toxicity of systemic therapy ( extravasation, dermatologic toxicity, gastrointestinal toxicity - mucositis, diarrhea, neusea and vomiting - principle and examples, prevention and treatment );

37. Hemtaological toxicity of systemic therapy ( febrile neutropenia - definition, patients management, treatment, prevention; anemia, thrombocytopenia and impaired immunity );

38. Supportive cancer therapy, indications, role in the multimodal cancer treatment;

39. Management of cancer pain ( principles, classes of analgesics, algorithm, analgesic adjuvants );

40. Psychosocial dimension of cancer. Psychosocial supportive care;

 

41. The role of radiotherapy in the multimodal cancer treatment;

42. Adjuvant, neoadjuvant, concominant radiotherapy, indications;

43. Mechanism of interaction of ionizing radiation;

44. Curative radiotherapy, indications, strategy;

45. External beam radiotherapy, radiation sources for external radiotherapy;

46. Radio sensitivity, radio sensitivity law, SF 2 fraction;

47. Critical structures, maximum tolerable doses;

48. Treatment planing in radiotherapy ( simulation, immobilization of the patients, verification );

49. Radiation therapy techniques 3D CRT, IGRT, IMRT, VMAT;

50. Radiation therapy techniques SRS, fSRT, SABRT;

51. Fractionation schedules for external radiotherapy;

52. Palliative radiotherapy, indications, strategy;

53. Brachytherapy, radiation sources for brachytherapy;

54. Fractionation schedules for brachytherapy;

55. Technologies in radiation therapy ( LINAC, Gamma knife, cyber knife, cyclotron );

56. Dose distributions curves;

57. Brachytherapy and combinations with external beam radiotherapy;

58. Radiodermatitis, radio-mucositis, diagnosis, therapy;

59. Late effects after radiotherapy, iatrogenic tumors;

60. Radiotherapy in benign diseases;

 

 

 

The exam from the Oncological propedeutics 2021

The exam from the Oncological propedeutics in the current exam period (summer semester 2021) is organized via Moodle platform.Please use your AIS account informationto long in and enter the course at https://moodle.uniba.sk - I. Department of oncology.

IMPORTANT!!!!!!! THE ONCOLOGY PROPEDEUTICS EXAM 2020/2021

29. 07. 2021 10,00 a.m - 18,00 p.m

IN CASE OF NEED,PLEASE CONSULT US INDIVIDUALLY BY EMAIL - (mrinakova@gmail.com)

 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 will be active for two consecutive days-each individual student is allowed to sing in and take one test within the active period.

The test includes 55 multiple choice questions, with one correct answer. The questions are based on frame questions for oral examination 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 50% correct answers. In the case, that student would fail the attemp (grade Fx), the exam can be repeated in the next provided term - announced on the website after evaluation of results of the past test 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. The exams should be taken at latest until 18th of June 2021.

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 90 - 100% correct answers

Grade B 80 - 89% correct answers

Grade C 70 - 79% correct answers

Grade D 60 - 69% correct answers

Grade E 50 - 59% correct answers

Grade Fx <50% correct answers

 

 

Time schedule- Practicals 4th class General Medicine- summer semester 2020/2021

Time schedule - Practicals 4th class General Medicine - summer semester 2020/2021

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:
29. 03. 2021 - Group 4 and 13 - Radiotherapy  A - Dr. Chorvath
12. 04. 2021 - Group 10 and 12 - Radiotherapy A - Dr. Chorvath
14. 04. 2021 - Group 9 - Radiotherapy A - Dr. Chorvath
19. 04. 2021 - Group 10 and 12 - Radiotherapy B - Dr. Chorvath
30. 04. 2021 - Group 4 and 13 - Radiotherapy B - Dr. Chorvath
10. 05. 2021 - Group 3 and 8 - radiotherapy A - Dr. Chorvath
12. 05. 2021 - Group 2 - Radiotherapy B - Dr. Chorvath
14. 05. 2021 - Group 9 - Radiotherapy B - Dr. Chorvath
17. 05. 2021 - Group 3 and 11 - Radiotherapy B - Dr. Chorvath
28. 05. 2021 - Group 1 and 11 - Radiotherapy A - Dr. Chorvath
31. 05. 2021 - Group 2 and 7 - Radiotherapy A - Dr. Chorvath
04. 06. 2021 - Group 6 - Radiotherapy A - Dr. Chorvath
07. 06. 2021 - Group 1 - Radiotherapy B - Dr. Chorvath
10. 06. 2021 - Group 5 and 6 - Radiotherapy B - Dr. Chorvath
14. 06. 2021 - Group 7 and 8 - Radiotherapy B - Dr. Chorvath
16. 06. 2021 - Group 5 - Radiotherapy A - Dr. Chorvath

MEDICAL ONCOLOGY:
01. 04. 2021 - Group 1 and 5 - Medical oncology A - Dr. Mrinakova
08. 04. 2021 - Group 2 and 4 - Medical oncology B - Dr. Mrinakova
09. 04. 2021 - Group 3 and 11 - Medical oncology A - Dr. Mrinakova
13. 04. 2021 - Group 6 and 8 - Medical oncology A - Dr. Mrinakova
14. 04. 2021 - Group 4 - Medical oncology A - Dr. Mrinakova
22. 04. 2021 - Group 3 and 6 - Medical oncology C - Dr. Mrinakova
27. 04. 2021 - Group 5 and 9 - Medical oncology B - Dr. Mrinakova
28. 04. 2021 - Group 6 and 8 - Medical oncology B - Dr. Mrinakova
03. 05. 2021 - Group 7 and 12 - Medical oncology A - Dr. mrinakova
04. 05. 2021 - Group 8 and 9 - Medical oncology C - Dr. Mrinakova
05. 05. 2021 - Group 4 and 13 - Medical oncology C - Dr. Mrinakova
13. 05. 2021 - Group 5 and 7 - Medical oncology C - Dr. Mrinakova
14. 05. 2021 - Group 12 - Medical oncology C - Dr. Mrinakova
19. 05. 2021 - Group 1 and 12 - Medical oncology B - Dr. Mrinakova
25. 05. 2021 - Group 2 and 13 - Medical oncology A - Dr. Mrinakova
27. 05. 2021 - Group 9 - Medical oncology A - Dr. Mrinakova
03. 06. 2021 - Group 11 and 13 - Medical oncology B - Dr. Mrinakova
04. 06. 2021 - Group 10 - Medical oncology A - Dr. Mrinakova
11. 06. 2021 - Group 7 and 10 - Medical oncology B - Dr. Mrinakova
15. 06. 2021 - Group 10 and 11 - Medical oncology C - Dr. Mrinakova
16. 06. 2021 - Group 3 - Medical oncology B - Dr. Mrinakova
17. 06. 2021 - Group 1 and 2 - Medical oncology C - Dr. Mrinakova