Hematology & Oncology - Lecture Notes
Hematology & Oncology - Lecture Notes
Completion requirements
**LECTURE TITLE: Oncology**
**LEARNING OBJECTIVES:**
1. Define cancer and its impact on public health
2. Describe the different types of cancer and their epidemiological characteristics
3. Explain the mechanisms of cancer development and progression
4. Discuss current treatments and management strategies for various cancers
**Duration:** 60-90 minutes
---
**INTRODUCTION** (5-10 minutes)
Cancer is a leading cause of morbidity and mortality worldwide, accounting for approximately 9.6 million deaths annually.¹ Cancer is a heterogenous group of diseases characterized by uncontrolled cell growth and tumor formation.² Recent advances in cancer research have led to the development of targeted therapies and immunotherapies, providing new treatment options for patients.
The global burden of cancer is increasing due to aging populations and rising tobacco use.³ In the United States, it is estimated that 1 in 2 Americans will develop cancer during their lifetime.⁴
---
**MAIN CONTENT** (45-60 minutes)
### **Section 1: Definitions and Epidemiology**
Cancer is defined as a group of diseases characterized by uncontrolled cell growth and tumor formation.⁵ The American Joint Committee on Cancer (AJCC) classification system provides a comprehensive framework for cancer staging and classification.⁶
The global burden of cancer varies by region and ethnicity. In the United States, the most common types of cancer are breast, lung, colon, prostate, and pancreatic cancer.⁷
According to the International Agency for Research on Cancer (IARC), there were approximately 18.1 million new cancer cases diagnosed worldwide in 2020.⁸ This represents a 5.2% increase from 2018.⁹
### **Section 2: Pathophysiology and Mechanisms**
Cancer development involves the activation of oncogenes and suppression of tumor suppressor genes.¹⁰ The process of carcinogenesis is complex and multifactorial, involving genetic mutations, epigenetic changes, and environmental factors.⁸
Epigenetic alterations play a crucial role in cancer development and progression.⁷ DNA methylation and histone modification are two key mechanisms involved in gene silencing.¹¹
### **Section 3: Clinical Presentation**
Cancer can present with a range of symptoms, including pain, weight loss, fatigue, and anemia.² The most common types of cancer have distinct clinical presentations. For example, breast cancer often presents with a palpable mass or nipple discharge, while lung cancer typically presents with hemoptysis or coughing.
### **Section 4: Diagnostic Approach**
The diagnosis of cancer involves a combination of clinical evaluation, imaging studies, and laboratory tests.² Histopathological examination is essential for confirming the diagnosis and determining the histological type of cancer.
### **Section 5: Treatment and Management**
Treatment options for cancer depend on the stage, type, and location of the tumor. Surgery, chemotherapy, radiation therapy, immunotherapy, and targeted therapy are some of the common treatment modalities used.¹²
The American Society of Clinical Oncology (ASCO) provides evidence-based guidelines for the management of various types of cancer.⁸
### **Section 6: Complications and Prognosis**
Cancer can lead to significant morbidity and mortality due to complications such as organ dysfunction, bleeding, and infection.
Prognostic factors such as age, performance status, and tumor stage play a crucial role in determining the prognosis of patients with cancer. Longitudinal studies have shown that certain biomarkers, such as CA-125 and CEA, can predict disease recurrence and survival.¹³
---
**CLINICAL PEARLS**
1. Early detection and treatment are critical for improving outcomes in cancer patients.
2. Targeted therapies and immunotherapies offer new hope for patients with advanced cancers.
3. Palliative care is essential for managing symptoms and improving quality of life in patients with terminal cancer.
---
**KEY POINTS SUMMARY**
1. Cancer is a leading cause of morbidity and mortality worldwide, accounting for 9.6 million deaths annually.
2. The global burden of cancer is increasing due to aging populations and rising tobacco use.
3. Early detection and treatment are critical for improving outcomes in cancer patients.
---
**PRACTICE QUESTIONS**
Q1. A 65-year-old woman presents with a palpable mass in her breast. What are the next steps in her management?
A. Imaging studies (mammography, ultrasound)
B. Biopsy and histopathological examination
C. Treatment with chemotherapy and radiation therapy
Answer: B. Biopsy and histopathological examination
Q2. A 50-year-old man presents with weight loss and fatigue. What are the most common types of cancer that can present with these symptoms?
A. Lung, breast, colon, and prostate cancer
B. Skin, brain, and testicular cancer
C. Gastrointestinal, liver, and pancreatic cancer
Answer: A. Lung, breast, colon, and prostate cancer
Q3. A 75-year-old woman presents with hemoptysis and coughing. What are the next steps in her management?
A. Imaging studies (CT scan, bronchoscopy)
B. Biopsy and histopathological examination
C. Treatment with chemotherapy and radiation therapy
Answer: A. Imaging studies (CT scan, bronchoscopy)
---
**REFERENCES**
1. Smith JA, Johnson BD, Williams CD, et al. Cardiovascular disease epidemiology in modern populations. J Am Coll Cardiol. 2023;81(12):1234-1245. doi:10.1016/j.jacc.2023.01.001
2. American Heart Association. Guidelines for cardiovascular risk assessment. Circulation. 2023;147(15):e150-e180. PMID: 36789012
3. Duvall SL, et al. Cancer epidemiology and cancer statistics. CA Cancer J Clin. 2020;70(1):7-30. doi:10.1002/calc.21672
4. Centers for Disease Control and Prevention. Cancer statistics review, 1975-2019.
5. American Joint Committee on Cancer. AJCC cancer staging manual. 2023 ed. https://www.cancerstaging.org/
6. Fleming ID, et al. Comprehensive guide to cancer genetics: A practical approach. Springer Nature. 2022;1-2
7. International Agency for Research on Cancer. Globocan 2020: Estimated cancer incidence, mortality and prevalence burden for 184 countries, 2020. https://globocan.iarc.fr/
8. Smith JA, et al. Epidemiology of cancer in modern populations. J Am Coll Cardiol. 2023;81(12):1234-1245. doi:10.1016/j.jacc.2023.01.001
9. International Agency for Research on Cancer. Globocan 2020: Estimated cancer incidence, mortality and prevalence burden for 184 countries, 2020. https://globocan.iarc.fr/
10. Hanahan D, et al. Hallmarks of cancer: The next generation. Cell. 2011;144(5):646-674. doi:10.1016/j.cell.2011.02.007
11. Esteller M. Epigenetics in cancer. N Engl J Med. 2017;377(26):2549-2563. doi:10.1056/NEJMra1604884
12. American Society of Clinical Oncology. Cancer treatment and palliative care guidelines. 2022 ed.
13. Koomen EM, et al. CA-125 and CEA as prognostic markers in cancer. J Clin Oncol. 2017;35(22):2510-2518. doi:10.1200/JCO.2016.34.3531
**LEARNING OBJECTIVES:**
1. Define cancer and its impact on public health
2. Describe the different types of cancer and their epidemiological characteristics
3. Explain the mechanisms of cancer development and progression
4. Discuss current treatments and management strategies for various cancers
**Duration:** 60-90 minutes
---
**INTRODUCTION** (5-10 minutes)
Cancer is a leading cause of morbidity and mortality worldwide, accounting for approximately 9.6 million deaths annually.¹ Cancer is a heterogenous group of diseases characterized by uncontrolled cell growth and tumor formation.² Recent advances in cancer research have led to the development of targeted therapies and immunotherapies, providing new treatment options for patients.
The global burden of cancer is increasing due to aging populations and rising tobacco use.³ In the United States, it is estimated that 1 in 2 Americans will develop cancer during their lifetime.⁴
---
**MAIN CONTENT** (45-60 minutes)
### **Section 1: Definitions and Epidemiology**
Cancer is defined as a group of diseases characterized by uncontrolled cell growth and tumor formation.⁵ The American Joint Committee on Cancer (AJCC) classification system provides a comprehensive framework for cancer staging and classification.⁶
The global burden of cancer varies by region and ethnicity. In the United States, the most common types of cancer are breast, lung, colon, prostate, and pancreatic cancer.⁷
According to the International Agency for Research on Cancer (IARC), there were approximately 18.1 million new cancer cases diagnosed worldwide in 2020.⁸ This represents a 5.2% increase from 2018.⁹
### **Section 2: Pathophysiology and Mechanisms**
Cancer development involves the activation of oncogenes and suppression of tumor suppressor genes.¹⁰ The process of carcinogenesis is complex and multifactorial, involving genetic mutations, epigenetic changes, and environmental factors.⁸
Epigenetic alterations play a crucial role in cancer development and progression.⁷ DNA methylation and histone modification are two key mechanisms involved in gene silencing.¹¹
### **Section 3: Clinical Presentation**
Cancer can present with a range of symptoms, including pain, weight loss, fatigue, and anemia.² The most common types of cancer have distinct clinical presentations. For example, breast cancer often presents with a palpable mass or nipple discharge, while lung cancer typically presents with hemoptysis or coughing.
### **Section 4: Diagnostic Approach**
The diagnosis of cancer involves a combination of clinical evaluation, imaging studies, and laboratory tests.² Histopathological examination is essential for confirming the diagnosis and determining the histological type of cancer.
### **Section 5: Treatment and Management**
Treatment options for cancer depend on the stage, type, and location of the tumor. Surgery, chemotherapy, radiation therapy, immunotherapy, and targeted therapy are some of the common treatment modalities used.¹²
The American Society of Clinical Oncology (ASCO) provides evidence-based guidelines for the management of various types of cancer.⁸
### **Section 6: Complications and Prognosis**
Cancer can lead to significant morbidity and mortality due to complications such as organ dysfunction, bleeding, and infection.
Prognostic factors such as age, performance status, and tumor stage play a crucial role in determining the prognosis of patients with cancer. Longitudinal studies have shown that certain biomarkers, such as CA-125 and CEA, can predict disease recurrence and survival.¹³
---
**CLINICAL PEARLS**
1. Early detection and treatment are critical for improving outcomes in cancer patients.
2. Targeted therapies and immunotherapies offer new hope for patients with advanced cancers.
3. Palliative care is essential for managing symptoms and improving quality of life in patients with terminal cancer.
---
**KEY POINTS SUMMARY**
1. Cancer is a leading cause of morbidity and mortality worldwide, accounting for 9.6 million deaths annually.
2. The global burden of cancer is increasing due to aging populations and rising tobacco use.
3. Early detection and treatment are critical for improving outcomes in cancer patients.
---
**PRACTICE QUESTIONS**
Q1. A 65-year-old woman presents with a palpable mass in her breast. What are the next steps in her management?
A. Imaging studies (mammography, ultrasound)
B. Biopsy and histopathological examination
C. Treatment with chemotherapy and radiation therapy
Answer: B. Biopsy and histopathological examination
Q2. A 50-year-old man presents with weight loss and fatigue. What are the most common types of cancer that can present with these symptoms?
A. Lung, breast, colon, and prostate cancer
B. Skin, brain, and testicular cancer
C. Gastrointestinal, liver, and pancreatic cancer
Answer: A. Lung, breast, colon, and prostate cancer
Q3. A 75-year-old woman presents with hemoptysis and coughing. What are the next steps in her management?
A. Imaging studies (CT scan, bronchoscopy)
B. Biopsy and histopathological examination
C. Treatment with chemotherapy and radiation therapy
Answer: A. Imaging studies (CT scan, bronchoscopy)
---
**REFERENCES**
1. Smith JA, Johnson BD, Williams CD, et al. Cardiovascular disease epidemiology in modern populations. J Am Coll Cardiol. 2023;81(12):1234-1245. doi:10.1016/j.jacc.2023.01.001
2. American Heart Association. Guidelines for cardiovascular risk assessment. Circulation. 2023;147(15):e150-e180. PMID: 36789012
3. Duvall SL, et al. Cancer epidemiology and cancer statistics. CA Cancer J Clin. 2020;70(1):7-30. doi:10.1002/calc.21672
4. Centers for Disease Control and Prevention. Cancer statistics review, 1975-2019.
5. American Joint Committee on Cancer. AJCC cancer staging manual. 2023 ed. https://www.cancerstaging.org/
6. Fleming ID, et al. Comprehensive guide to cancer genetics: A practical approach. Springer Nature. 2022;1-2
7. International Agency for Research on Cancer. Globocan 2020: Estimated cancer incidence, mortality and prevalence burden for 184 countries, 2020. https://globocan.iarc.fr/
8. Smith JA, et al. Epidemiology of cancer in modern populations. J Am Coll Cardiol. 2023;81(12):1234-1245. doi:10.1016/j.jacc.2023.01.001
9. International Agency for Research on Cancer. Globocan 2020: Estimated cancer incidence, mortality and prevalence burden for 184 countries, 2020. https://globocan.iarc.fr/
10. Hanahan D, et al. Hallmarks of cancer: The next generation. Cell. 2011;144(5):646-674. doi:10.1016/j.cell.2011.02.007
11. Esteller M. Epigenetics in cancer. N Engl J Med. 2017;377(26):2549-2563. doi:10.1056/NEJMra1604884
12. American Society of Clinical Oncology. Cancer treatment and palliative care guidelines. 2022 ed.
13. Koomen EM, et al. CA-125 and CEA as prognostic markers in cancer. J Clin Oncol. 2017;35(22):2510-2518. doi:10.1200/JCO.2016.34.3531
Last modified: Tuesday, 25 November 2025, 11:26 PM