STATE EDUCATIONAL ESTABLISHMENT OF HIGHER PROFESSIONAL EDUCATION OF FEDERAL AGENCY OF PUBLIC HEALTH AND SOCIAL DEVELOPMENT KURSK STATE

MEDICAL UNIVERSITY

METHODOLOGICAL RECOMENDATION FOR STUDENTS TO BE USED IN PREPARATIONS FOR TUTORIALS IN ONCOLOGY

KURSK 2011

UD: LBC: 1

Author's code:

It is published under the decision of the Central methodical advice of Kursk state medical university

Methodological recommendation to be used in preparations for teachers to be used for tutorials in oncology/ Sichov M.D., Kudentsova G.V., Chvostovoy V.V., Mishina J.A. - Kursk, KSMU. 2011.

Explanatory note ncology diseases occupy special place in structure of common morbidity. Occult and atypical pathologies increase. That is way any physician must have knowledge, which help him to exclude ore to suspect malignant disease.

This program includes questions, which students can study in oncology department. Also, it foresees measures to have practical skills for defining malignant tumors. The aim of studding is formation at students the base of oncology outlook. It includes: - knowledge of the base of theoretical oncology; - study of the future doctors actions, when they suspect oncology diseases at the patient; - study the mane forms of malignant diseases, their prophylactic measures; - acquaintance with peculiarities of oncology service of people in Russia and with modern principles treatment of oncology patients. Working program is composed due to standart study program by 1996. It has any changing. They are connect with peculiarity of epidemiology of the oncology diseases of Kursk region and scientific direction of the oncology department. At the finish study of oncology cycle, students must know: 1.to make up an anamnesis, to do clinical and special methods of examination of patients, to formulate the preliminary diagnosis; 2. to compose plan conducting laboratory and instrumental methods examination of patients, to analyses of their results; 3. to formulate the detailed clinical diagnosis with tumor localization, stage and clinical group; to ground diagnosis; 4. to determine treatment action of oncology patients; 5. to write down medical documents correctly and exactly. Students must have knowledge, when they win finish to study oncology: etiology, pathogenesis and measures of prophylaxis of the most frequently malignant tumors of organs and systems;
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modern methods of clinical, laboratory and instrumental examination of oncology patients;

2. 3. 4.

clinical picture of these diseases and their complications; methods of treatment, indications and contraindications for their. At the end of the oncology cycle, students must be acquaint with:

questions of organization of oncology aid in Russia;

1. 2. 3.

methods of skrining examination to reveal the early form of cancer; groups of high risk to malignant diseases; palliative aid to oncology patients;
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scientific examination to improve the early diagnostic and result of treatment of oncology patients.
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The topic: Cancer of the esophagus Reason: Cancer of the esophagus is widespread malignant diseases. Males suffer more often then females. The average age of these patients are 65 year. Many patients admitted to the doctor having III or IV stage, that is why they can not receive radical treatment. That is why all physicians should diagnose these pathology and to prevent these disease. Purpose: after study the topic of the esophagus cancer student must: 1) know etiology and epidemiology of the esophagus cancer; 2) know clinical features and examination patients with suspicion on the esophagus cancer; 3) know stages of the esophagus cancer; 4) know main principles of therapy. Questions for independent study: 1. Definition of the esophagus cancer; 2. Epidemiology and etiology of the esophagus cancer; 3. Pathogenesis of the esophagus cancer; 4. Localization of the esophagus cancer; 5. Macroscopical types of the esophagus cancer; 6. Histological types of the esophagus cancer; 7. The ways of metastases of the esophagus cancer; 8. TNM classification of the esophagus cancer; 9. Complications of the esophagus cancer; 10. Clinical pictures of the esophagus cancer; 11. Signals of the anxiety of the esophagus cancer; 12. Examination of patients suspected to have the esophagus cancer: a) main X-ray symptoms of the esophagus cancer; b) main endoscopical symptoms of the esophagus cancer; 13. Differential diagnosis symptoms of the esophagus cancer; 14. Treatment symptoms of the esophagus cancer: a) radical and palliative therapy; b) surgical therapy; c) X-ray therapy; d) chemotherapy; 15. Prognosis of the esophagus cancer.
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Plan of the student`s work during unit: 1) to collect the anamnesis; 2) to palpate the abdominal cavity end peripheral lymph nodes; 3) to make the plan of investigation of the patients; 4) to estimate roentgenograms of the esophagus; 5) to prescribe treatment patients with the esophagus cancer. Literature: Lectures, Cancer. Principles and practice of oncology. /Ed.: V.T. De Vita, S. Hellnan, S.A. Rosenberg. 2 nd ed. London; J.B. Lippincott Company.-2117p.
Harrisons Principles of internal medicine. 2v. /Ed.:E. Braunwald, A.S. Fauci,, D.L. Hauser. 15. th ed. N.J.: Mccroow Hill. V. 1,2 2000.

The topic: Cancer of the stomach Reason: Cancer of the stomach occupies the second place among all malignant pathology. It is noted, that sick rate of the bowel cancer increase in last years, especially in USA, Europe, Russia. The average age of the bowel cancer is 40 - 60. Prognosis depends on stage. That why all physicians can diagnose these pathology and prevent development of this diseases. Purpose: after study the topic of the stomach cancer student must: 1) know etiology and epidemiology of the stomach cancer; 2) know clinical features and examination patients with suspicion on the stomach cancer; 3) know stages of the stomach cancer; 4) know main principles of therapy of the stomach cancer; Questions for independent study: 1. Definition of the stomach cancer; 2. Epidemiology and etiology of the stomach cancer; 3. Pathogenesis of the stomach cancer; 4. Localization of the stomach cancer; 5. Macroscopical types of the stomach cancer; 6. Histological types of the stomach cancer; 7. The ways of metastases of the stomach cancer; 8. TNM classification of the stomach cancer; 9. Complications of the stomach cancer; 10. Clinical pictures of the esophagus cancer; 11.Signals of the anxiety of the stomach cancer;
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12. Examination of patients suspected to have the stomach cancer: a)main X-ray symptoms of the stomach cancer; b)main endoscopical symptoms of the stomach cancer; 13. Differential diagnosis symptoms of the stomach cancer; 14. Treatment symptoms of the stomach cancer: a) radical and palliative therapy; b) surgical therapy; c) X-ray therapy; d) chemotherapy; 15. Prognosis of the stomach cancer. Plan of the student`s work during unit: 1) to collect the anamnesis; 2) to palpate the abdominal cavity end peripheral lymph nodes; 3) to make the plan of investigation of the patients; 4) to estimate roentgenograms of the stomach cancer; 5) to prescribe treatment patients with the stomach cancer. Literature: Lectures, Cancer. Principles and practice of oncology. /Ed.: V.T. De Vita, S. Hellnan, S.A. Rosenberg. 2 nd ed. London; J.B. Lippincott Company.-2117p.
Harrisons Principles of internal medicine. 2v. /Ed.:E. Braunwald, A.S. Fauci,, D.L. Hauser. 15. th ed. N.J.: Mccroow Hill. V. 1,2 2000.

The topic: Cancer of the bowel Reason: Cancer of the bowel occupies the second or third place among all malignant pathology of the gastro-intestinal tract. It is noted, that sick rate of the bowel cancer increase in last years, especially in USA, Europe, Russia. The average age of the bowel cancer is 40 - 60. Prognosis depends on stage. That why all physicians can diagnose these pathology and prevent development of this diseases.

Purpose: after study the topic of the bowel cancer student must: 1) know etiology and epidemiology of the bowel cancer; 2) know clinical features and examination patients with suspicion on the bowel cancer; 3) know stages of the bowel cancer; 4) know main principles of therapy of the bowel cancer; Questions for independent study: 1.Definition of the bowel cancer; 2.Epidemiology and etiology of the bowel cancer; 3.Pathogenesis of the bowel cancer; 4.Localization of the bowel cancer; 5.Macroscopical types of the bowel cancer; 6.Histological types of the bowel cancer; 7.The ways of metastases of the bowel cancer; 8.TNM and Duke`s classification of the bowel cancer; 9.Complications of the bowel cancer; 10.Clinical pictures of the bowel cancer; 11.Signals of the anxiety of the bowel cancer; 12.Examination of patients suspected to have the bowel cancer: a) main X-ray symptoms of the bowel cancer; b) main endoscopical symptoms of the bowel cancer; 13. Differential diagnosis symptoms of the bowel cancer; 14. Treatment symptoms of the bowel cancer: a) radical and palliative therapy; b) surgical therapy; c) X-ray therapy; d) chemotherapy; 15. Prognosis of the bowel cancer. Plan of the students work during unit: 1) to collect the anamnesis; 2) to palpate the abdominal cavity end peripheral lymph nodes; 3) to make the plan of investigation of the patients; 4) to estimate roentgenograms of the bowel cancer; 5) to prescribe treatment patients with the bowel cancer. Literature: Lectures, Cancer. Principles and practice of oncology. /Ed.: V.T. De Vita, S. Hellnan, S.A. Rosenberg. 2 nd ed. London; J.B. Lippincott Company.-2117p.
Harrisons Principles of internal medicine. 2v. /Ed.:E. Braunwald, A.S. Fauci,, D.L. Hauser. 15. th ed. N.J.: Mccroow Hill. V. 1,2 2000. 7

The topic: Cancer of the lung Reason: Cancer of the lung occupies the first place among all malignant pathology. It is noted, that sick rate of the lung cancer increase in last years in all world. The average age of the bowel cancer is 40 - 60. Prognosis depends on stage. That why all physicians can diagnose these pathology and prevent development of this diseases Purpose: after study the topic of the lung cancer student must: 1) know etiology and epidemiology of the bowel cancer; 2) know clinical features and examination patients with suspicion on the bowel cancer; 3) know stages of the bowel cancer; 4) know main principles of therapy of the bowel cancer; Questions for independent study: 1.Definition of the lung cancer; 2.Epidemiology and etiology of the lung cancer; 3.Pathogenesis of the lung cancer; 4.Localization of the lung cancer; 5.Macroscopical types of the lung cancer; 6.Histological types of the lung cancer; 7.The ways of metastases of the lung cancer; 8.TNM classification of the lung cancer; 9.Complications of the lung cancer; 10.Clinical pictures of the lung cancer; 11..Examination of patients suspected to have the lung cancer: a)main X-ray symptoms of the lung cancer; b)main endoscopical symptoms of the lung cancer; 12. Differential diagnosis symptoms of the lung cancer; 13. Treatment of the lung cancer: a) radical and palliative therapy; b) surgical therapy; c) X-ray therapy; d) chemotherapy; 14. Prognosis of the lung cancer. Plan of the students work during unit: 1) to collect the anamnesis; 2) to palpate peripheral lymph nodes; 3) to make the plan of investigation of the patients;
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4) to estimate roentgenograms of the lung cancer; 5) to prescribe treatment patients with the lung cancer.
Literature: Lectures,

Cancer. Principles and practice of oncology. /Ed.: V.T. De Vita, S. Hellnan, S.A. Rosenberg. 2 nd ed. London; J.B. Lippincott Company.-2117p. Harrisons Principles of internal medicine. 2v. /Ed.:E. Braunwald, A.S. Fauci,, D.L. Hauser. 15. th ed. N.J.: Mccroow Hill. V. 1,2 2000.

The topic: Cancer of the thyroid gland Thyroid gland cancer is more common among women than men and accounts for only 1 percent of all cancer diseases. Most thyroid cancers grow slowly but certain types can be aggressive. Purpose: after study the topic of the thyroid gland cancer student must: 1) know etiology and epidemiology of the thyroid gland cancer; 2) know clinical features and examination patients with suspicion on the thyroid gland cancer; 3) know stages of the thyroid gland cancer; 4) know main principles of therapy of the thyroid gland cancer; Questions for independent study: 1.Definition of the thyroid gland cancer; 2.Epidemiology and etiology of the thyroid gland cancer; 3.Pathogenesis of the thyroid gland cancer; 4.Localization of the thyroid gland cancer; 5.Macroscopical types of the thyroid gland cancer; 6.Histological types of the thyroid gland cancer; 7.The ways of metastases of the thyroid gland cancer; 8.TNM classification of the thyroid gland cancer; 9.Complications of the thyroid gland cancer; 10.Clinical pictures of the thyroid gland cancer; 11..Examination of patients suspected to have the thyroid gland cancer: 12. Differential diagnosis of the thyroid gland cancer; 13. Treatment of the thyroid gland cancer:
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a) radical and palliative therapy; b) surgical therapy; c) X-ray therapy; d) chemotherapy; 14. Prognosis of the thyroid gland cancer. Plan of the students work during unit: 1) to collect the anamnesis; 2) to palpate the thyroid gland and peripheral lymph nodes; 3) to make the plan of investigation of the patients; 4) to estimate roentgenograms of the thyroid gland cancer; 5) to prescribe treatment patients with the thyroid gland cancer. Literature: Lectures, Cancer. Principles and practice of oncology. /Ed.: V.T. De Vita, S. Hellnan, S.A. Rosenberg. 2 nd ed. London; J.B. Lippincott Company.-2117p. Harrisons Principles of internal medicine. 2v. /Ed.:E. Braunwald, A.S. Fauci,, D.L. Hauser. 15. th ed. N.J.: Mccroow Hill. V. 1,2 2000. The topic: Cancer of the breast Reason: Cancer of the breast is widespread malignant diseases in female. The average age of these patients are 65 year. Many patients admitted to the doctor having III or IV stage that is why they can not receive radical treatment. That is why all physicians should diagnose these pathology and to prevent these disease. Purpose: after study the topic of the breast cancer student must: 1) know etiology and epidemiology of the breast cancer; 2) know clinical features and examination patients with suspicion on the breast cancer; 3) know stages of the breast cancer; 4) know main principles of therapy of the breast cancer; Questions for independent study: 1. Definition of premalignant diseases of the breast; 2. Classification of premalignant diseases of the breast; 3. Epidemiology and etiology of premalignant diseases of the breast; 4. Investigation of the breast; 5. Treatment of premalignant diseases of the breas;
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6.Definition of the breast cancer; 7.Epidemiology and etiology of the breast cancer; 8.Pathogenesis of the breast cancer; 9.Localization of the breast cancer; 10..Macroscopical types of the breast cancer; 11..Histological types of the breast cancer; 12..The ways of metastases of the breast cancer; 13..TNM classification of the breast cancer; 14..Complications of the breast cancer; 15.Clinical pictures of the breast cancer; 16..Examination of patients suspected to have the breast cancer: a)main X-ray symptoms of the breast cancer; b)main US symptoms of the breast cancer; 17. Differential diagnosis symptoms of the breast cancer; 18. Treatment of the breast cancer: a) radical and palliative therapy; b) surgical therapy; c) X-ray therapy; d) chemotherapy; 19. Prognosis of the breast cancer. Plan of the students work during unit: 1) to collect the anamnesis; 2) to palpate peripheral lymph nodes and breast; 3) to make the plan of investigation of the patients; 4) to estimate roentgenograms of the breast cancer; 5) to prescribe treatment patients with the breast cancer. Literature: Lectures,
Cancer. Principles and practice of oncology. /Ed.: V.T. De Vita, S. Hellnan, S.A. Rosenberg. 2 nd ed. London; J.B. Lippincott Company.-2117p. Harrisons Principles of internal medicine. 2v. /Ed.:E. Braunwald, A.S. Fauci,, D.L. Hauser. 15. th ed. N.J.: Mccroow Hill. V. 1,2 2000.

The topic: Tumours of the skin Reason: Tumours of the skin occupies the second place among all malignant pathology. It is noted, that sick rate of the skin tumours increase in last years in all world. The average age of the bowel cancer is more than 60 years. Prognosis depends on stage. That why all physicians can diagnose these pathology and prevent development of this diseases.

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Purpose: after study the topic of the skin tumours student must: 1) know etiology and epidemiology of the skin cancer and melanoma; 2) know clinical features and examination patients with suspicion on the skin cancer and melanoma; 3) know types of the nevus; 3) know symptoms of malignization of the nevus; 4) know stages of the skin cancer and melanoma; 5) know main principles of therapy of the skin cancer and melanoma . Questions for independent study: 1.Definition of the skin cancer and melanoma 2.Epidemiology and etiology of the skin cancer and melanoma; 3.Pathogenesis of the skin cancer and melanoma; 4.Localization of the skin cancer and melanoma ; 5.Macroscopical types of growth the skin cancer; 6.Histological types of the skin cancer; 7. Level invasion of melanoma by Clark; 8.The ways of metastases of the skin cancer and melanoma; 9.TNM classification of the skin cancer and melanoma; 10.Clinical pictures of the skin cancer and melanoma; 11.Examination of patients suspected to have the skin cancer and melanoma; 12. Differential diagnosis of the skin cancer and melanoma; 13. Treatment of the skin cancer and melanoma: a) radical and palliative therapy; b) surgical therapy; c) X-ray therapy; d) chemotherapy; 14. Prognosis of the skin cancer and melanoma. Plan of the students work during unit: 1) to collect the anamnesis; 2) to palpate peripheral lymph nodes and skin; 3) to make the plan of investigation of the patients; 4) to prescribe treatment patients with the breast cancer. Literature: Lectures, Cancer. Principles and practice of oncology. /Ed.: V.T. De Vita, S. Hellnan, S.A. Rosenberg. 2 nd ed. London; J.B. Lippincott Company.-2117p.
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Harrisons Principles of internal medicine. 2v. /Ed.:E. Braunwald, A.S. Fauci,, D.L. Hauser. 15. th ed. N.J.: Mccroow Hill. V. 1,2 2000.

The topic: Hodgkins Disease and the Non-Hogkin`s Lymphoma (NHL). Lymphomas is most impotent pathology among all malignant diseases. Average age of lymphoma population is 32 year for Hodgkins disease and 42 year for the other adult lymphomas. The sick rate of this disease is 0.5 till 3.1:100 000 of population. Purpose: after study the topic of Hodgkins disease and the NHL the student must: 1) know etiology and epidemiology of Hodgkins disease and the NHL ; 2) know clinical features and examination patients with suspicion on Hodgkins disease and the NHL; 3) know histology classification of Hodgkins disease and the NHL; 3) know symptoms intoxication of Hodgkins disease and the NHL; 4) know Ann Arbor Staging of Hodgkins disease and the NHL; 5) know main principles of therapy of Hodgkins disease and the NHL. Questions for independent study: 1.Definition of Hodgkins disease and the NHL; 2.Epidemiology and etiology of Hodgkins disease and the NHL 3.Pathogenesis of Hodgkins disease and the NHL; 4.Localization of Hodgkins disease and the NHL; 5. Histology classification of Hodgkins disease and the NHL; 6. The ways of metastases of Hodgkins disease and the NHL; 7. Ann Arbor Staging of Hodgkins disease and the NHL; 10.Clinical pictures of Hodgkins disease and the NHL; 11.Examination of patients suspected to have Hodgkins disease and the NHL; 12. Differential diagnosis of Hodgkins disease and the NHL; 13. Treatment of Hodgkins disease and the NHL due to risk factors: a) radical and palliative therapy; b) X-ray therapy;
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d) chemotherapy; 14. Prognosis of Hodgkins disease and the NHL. Plan of the students work during unit: 1) to collect the anamnesis; 2) to palpate peripheral lymph nodes and skin; 3) to make the plan of investigation of the patients; 4) to prescribe treatment patients with the Hodgkins disease and the NHL. Literature: Lectures, Cancer. Principles and practice of oncology. /Ed.: V.T. De Vita, S. Hellnan, S.A. Rosenberg. 2 nd ed. London; J.B. Lippincott Company.-2117p.
Harrisons Principles of internal medicine. 2v. /Ed.:E. Braunwald, A.S. Fauci,, D.L. Hauser. 15. th ed. N.J.: Mccroow Hill. V. 1,2 2000.

The topic: Cancer of the Hepatobiliary system Reason: The primary cancer of the liver occupies 8 place in the world on prevalence among all oncology diseases. It is distributed in China, Southeast Asia the south of Sahara. In Russia, primary cancer of the liver is revealed in a number of areas Western and Eastern Siberia (from 2,4 up to 8,4: 100 thousand population). Neoplasms of the pancreas can occur at all ages, but most often between ages 50 and 70. More than 50% of the deaths from pancreatic cancer occur in the population aged 65 through 84.

Purpose: after study the topic of the hepatobiliary system cancer student must: 1)know etiology and epidemiology of the hepatobiliary system cancer ; 2) know clinical features and examination patients with suspicion on the hepatobiliary system cancer; 3) know stages of the hepatobiliary system cancer; 4) know main principles of therapy. Questions for independent study: 1.Definition of the Cancer of the Hepatobiliary system 2.Epidemiology and etiology of the Cancer of the Hepatobiliary system;
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3.Pathogenesis of the Cancer of the Hepatobiliary system; 4.Localization of the Cancer of the Hepatobiliary system ; 6.Histological types of the Cancer of the Hepatobiliary system; 7.The ways of metastases of the Cancer of the Hepatobiliary system; 8.TNM classification of the Cancer of the Hepatobiliary system; 10.Clinical pictures of the Cancer of the Hepatobiliary system; 11.Examination of patients suspected to have the Cancer of the Hepatobiliary system; 12. Differential diagnosis of the Cancer of the Hepatobiliary system; 13. Treatment of the Cancer of the Hepatobiliary system: a) radical and palliative therapy; b) surgical therapy; c) X-ray therapy; d) chemotherapy; 14. Prognosis of the Cancer of the Hepatobiliary system; Plan of the students work during unit: 1) to collect the anamnesis; 2) to palpate splen and liver; 3) to make the plan of investigation of the patients; 4) to prescribe treatment patients with the Cancer of the Hepatobiliary system.

Literature: Lectures, Cancer. Principles and practice of oncology. /Ed.: V.T. De Vita, S. Hellnan, S.A. Rosenberg. 2 nd ed. London; J.B. Lippincott Company.-2117p.
Harrisons Principles of internal medicine. 2v. /Ed.:E. Braunwald, A.S. Fauci,, D.L. Hauser. 15. th ed. N.J.: Mccroow Hill. V. 1,2 2000.

The topic: Burkitt's Lymphoma

Burkitt's tumor occurs predominantly in children (peak age 4 to 7 years) in the tropical zones of Africa, New Guinea and South America. In parts of Africa, it accounts for from 30% to over 60% of all the malignant tumors of childhood.

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Purpose: after study the topic of Burkitt's Lymphoma student must: 1) know etiology and epidemiology of Burkitt's Lymphoma; 2) know clinical features and examination patients with suspicion on Burkitt's Lymphoma; 3) know differentiation Burkitt's Lymphoma and Hodgkins disease and the NHL; 4) know main principles of therapy. Questions for independent study: 1.Definition of Burkitt's Lymphoma 2.Epidemiology and etiology of Burkitt's Lymphoma; 3. Tropical and Nontropical Burkitt's tumor; 4.Pathogenesis of Burkitt's Lymphoma; 5.Localization of Burkitt's Lymphoma; 6.Histology picture of Burkitt's Lymphoma; 7.The ways of spreading of Burkitt's Lymphoma; 8.Clinical pictures of Burkitt's Lymphoma depending from localization; 9.Examination of patients suspected to have Burkitt's Lymphoma; 10. Differential diagnosis of Burkitt's Lymphoma and Hodgkins disease and the NH; 11. Treatment of Burkitt's Lymphoma; 12. Prognosis of Burkitt's Lymphoma; Plan of the students work during unit: 1) to collect the anamnesis; 2) to palpate spleen and liver, peripheral lymphnodes; 3) to make the plan of investigation of the patients; 4) to prescribe treatment patients with Burkitt's Lymphoma.

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