Oncology Learning Objectives
Authors: Michael
Pourdehnad, Stephen Berns
Editor: Lauren
Peccoralo
I. General
Learning Objectives
A.
Clinical Skills - Patient Care
1.
Evaluate and prioritize problems and complications occurring in
hospitalized
oncology patients
a) Including Fever, AMS, SOB, Pain, Nausea/Vomiting,
and Bleeding
b) Describe the evidence based management of
anti-coagulation in the
cancer patient
2.
Efficiently evaluate and stabilize patients newly admitted from the
Cancer
Center or Emergency Department
3.
Describe classic clinical presentations and initial triage management of
common urgent hematologic/oncologic
conditions such as:
a) Acute complications of tumor or treatment (e.g.
bowel obstruction,
tumor lysis, hypercalcemia, neutropenic fever)
b) Severe anemia or thrombocytopenia
4.
Demonstrate knowledge of specific techniques for control of pain, nausea,
and anxiety.
B.
Interpersonal Skills
1.
Demonstrate knowledge in ethics and laws of end of life decisions
2.
Be capable of discussing prognosis and goals of care with patients
3.
Be capable of conducting a family meeting
C.
Procedural Skills
1.
Observe a bone marrow biopsy
2.
Participate in ordering chemotherapy for a patient
*Intern Focused
Topics
II. General
Medical Knowledge in Malignancy
Most of this info is covered in the first few
chapters of:
Cancer:
Principles & Practice of Oncology
A. Biology, etiology, and
epidemiology of neoplastic disease
1.
Define and give examples of oncogenes and tumor suppressor genes *
2.
Describe Vogelstein's model for the development of colorectal cancer as
primarily a tool for thinking
about how tumors develop*
3.
Describe concepts of germ line vs. somatic mutations.
4.
Describe how environment may interact with DNA to cause mutations.
5.
List environmental risk factors for the major types of cancer *
6.
Describe the concepts of targeted molecular therapy and oncogene
addiction,
using EGFR and VEGF as examples.
7.
Readings:
B.
Detection and diagnosis, staging and natural history*
1.
Describe which screening tests are recommended, when and the risks and
benefits of screening
2.
Teach patients important lifestyle modifications that may prevent cancer.
3.
Know general types of diagnostic tests and procedures, including
biopsies,
tumor markers and radiology
4.
Describe general TNM staging system and how it relates to prognosis and
treatment
5.
Readings – see above chapter and specific cancer type sections
C.
Cancer therapy
1.
Know general types of treatment including surgery, chemotherapy,
radiation
therapy, hormonal therapies,
biological response modifiers and targeted
therapies.
2.
Know the general mechanisms and examples of alkylating agents, anti-
metabolites, cisplatin and its
analogues, topoisomerase interactive agents,
anti-microtubule agents
3.
Know the mechanism of rituximab (Rituxan), imatinib (Gleevec),
trastuzumab (Herceptin), erlotinib
(Tarceva), bevacizumab (Avastin),
sorafenib (Nexavar).
a) Tyrosine Kinases as Targets for Cancer Therapy N
Engl J Med 353:172, July 14, 2005 Review Article
http://eresources.library.mssm.edu:2368/cgi/content/short/353/2/172
4.
Give examples of drugs that cause the following toxicities:
cardiomyopathy,
neurotoxicity, pulmonary fibrosis,
dermatologic toxicity, nephrotoxicity and
hemorrhagic cystitis,
gastrointestinal toxicity and what tests might be ordered
for patients prior to receiving
these drugs (eg. MUGA, PFT’s).
5.
Define the terms adjuvant, neo-adjuvent, palliative, induction, and
consolidation chemotherapy.
D.
Metastasis*
1.
Describe the common routes and sites of metastasis for major solid
malignancies
2.
Discuss which malignancies cause lytic vs. blastic bone metastases and
the
proper tests to detect bone
metastases.
3. Readings – see specific
solid tumor readings
E. Hereditary cancer syndromes
1.
Describe the various hereditary cancer syndromes
2.
Readings
b) Hereditary Colorectal Cancer N Engl J Med 348:919,
March 6, 2003 Review Article
http://eresources.library.mssm.edu:2368/cgi/content/short/348/10/919
F.
Cancer Genetics
1.
Define the following terms by how they are used clinically in oncology:
cytogenetics, immunohistochemistry,
FISH, Flow Cytometry, Karyotype.
Glossary of Genetics http://linkage.rockefeller.edu/wli/glossary/genetics.html
2.
Understand utility of genetic markers in cancer diagnostics.
III. General
Medical Knowledge in Oncological Emergencies:
A.
Tumor
Lysis Syndrome*
1.
List the
most common causes of tumor lysis syndrome
2.
Explain
the common metabolic changes seen in tumor lysis syndrome and
the effects they have on the
body
3.
Describe
the basic treatments for tumor lysis syndrome and how they affect
each metabolic disturbance
4. See below for general readings
B.
Neutropenic
Fever*
1.
Clinically
define neutropenic fever
2.
List the
most common malignancies in which neutropenic fever occurs
3.
Describe
the empiric treatment for NF and treatment changes that might
occur when fever persists
4. Understand the role colony-stimulating
factors play in neutropenic fever.
5. Readings:
Clark, OAC et al. Colony-stimulating factors for
chemotherapy-induced febrile neutropenia: a meta-analysis of randomized
controlled trials. Journal of Clinical Oncology. 2005 23 (18): 4198-214. http://eresources.library.mssm.edu:7783/cgi/reprint/23/18/4198;
Pascoe et
al. Antibiotics for the prevention of neutropenic fever. Current Opinion in
Hematology. 2009 16 (1): 48-52. http://eresources.library.mssm.edu:8537/spa/ovidweb.cgi?T=JS&PAGE=fulltext&D=ovft&AN=00062752-200901000-00010&NEWS=N&CSC=Y&CHANNEL=PubMed
C.
Hyperviscosity
Syndromes*
1.
Identify
the pathophysiology involved in a hyperviscosity syndromes
(leukcytosis or dysprotenemia) that
affect the body
2.
Describe
the clinical manifestations hyperviscosity syndromes and the
common malignancies these
syndromes may occur in
3.
List the
various types of treatment for these syndromes and the reasons to
choose each option
4. See below for general readings
D.
Graft
Vs. Host Disease*
1.
Clinically
describe Acute Graft Versus Host Disease
2.
Explain
the pathophysiology and immunologic response that occurs in
GVHD
3.
Describe
the risk factors for GVHD
4.
Identify
the most common methods of treatment and prophylaxis for GVHD
5. Readings: Ferrara Jl et al.
Graft-versus-host disease. Lancet. 2009 May 2; 373 (9674): 1550-61. http://eresources.library.mssm.edu:2080/science?_ob=ArticleURL&_udi=B6T1B-4VTG1P8-1&_user=30742&_rdoc=1&_fmt=&_orig=search&_sort=d&_docanchor=&view=c&_acct=C000000333&_version=1&_urlVersion=0&_userid=30742&md5=e143dec8115fd65c3acd8cfa5c184f43
E.
Spinal
Cord Compression*
1.
Recognize
the clinical presentation for Spinal Cord Compression
2.
Describe
the basic pharmacologic and surgical treatments for Spinal Cord
Compression and when to use each
method
3. See below for general readings
F.
Oncological
Emergency General Readings:
2. Halfdanarson,
TR, et al. Oncologic Emergencies: Diagnosis and Treatment. Mayo clinic
proceedings. 2006; 81 (6): 835-848.
http://www.mayoclinicproceedings.com/content/81/6/835.full.pdf+html
IV. Specific
Medical Knowledge in Hematologic Malignancies
A. Leukemia:
1.
Name the
major favorable and adverse cytogenetic abnormalities in AML;
a)
Describe
the unique features of acute promyelocytic leukemia (AML
M3) including treatment induction therapy
b)
Describe
unique genetic features for CML
2.
Compare
and contrast AML with ALL in terms of patients age, clinical
features, treatment, and
outcome;
3.
Compare
and contrast CML with CLL in terms of patients age, clinical
features, treatment and outcome
4.
Identify
types of treatment for AML, ALL, CML, and CLL, including
induction therapy, the
complications of such therapy, and the success rate.
a)
For CML,
specifically, describe how BCR-ABL fusion provides a target for effective
therapy.
5.
Quick
References:
Cell type and lineage for
leukemias
Classification
of AML
http://eresources.library.mssm.edu:2068/popup.aspx?aID=2891733
Treatment
of AML
http://eresources.library.mssm.edu:2068/popup.aspx?aID=2891789
Treatment
of AML
http://eresources.library.mssm.edu:2068/popup.aspx?aID=2791577
Genetics
and Clinical Features of ALL
http://eresources.library.mssm.edu:2068/popup.aspx?aID=2149408
Treatment
of ALL
http://eresources.library.mssm.edu:2068/popup.aspx?aID=2788069
Treatment
of ALL
http://eresources.library.mssm.edu:2068/popup.aspx?aID=2788071
Philadelphia
Chromosome
http://eresources.library.mssm.edu:2068/popup.aspx?aID=2793025
Treatment
of CML
http://eresources.library.mssm.edu:2068/popup.aspx?aID=2793041
Diagnosis of CLL
http://eresources.library.mssm.edu:2068/popup.aspx?aID=2792757
Poor Prognositc
Indicators in CLL
http://eresources.library.mssm.edu:2068/popup.aspx?aID=2792767
Treatment
Indications for CLL
http://eresources.library.mssm.edu:2068/popup.aspx?aID=2792768
6.
Readings:
a) Estey E
et al. Acute Myeloid Leukemia. Lancet. 2006 Nov 25; 368 (9550): 1894-907.
http://eresources.library.mssm.edu:2080/science?_ob=ArticleURL&_udi=B6T1B-4MDJ2KW-16&_user=30742&_rdoc=1&_fmt=&_orig=search&_sort=d&_docanchor=&view=c&_acct=C000000333&_version=1&_urlVersion=0&_userid=30742&md5=602f42b620d1a1eefd613de3cfbbd9b1
b) Pui CH
et al. Acute Lymphoblastic Leukemia. Lancet 2008 371 (9617): 1030-43 http://eresources.library.mssm.edu:2080/science?_ob=ArticleURL&_udi=B6T1B-4S3HTTC-15&_user=30742&_rdoc=1&_fmt=&_orig=search&_sort=d&_docanchor=&view=c&_acct=C000000333&_version=1&_urlVersion=0&_userid=30742&md5=b1d0545e82a8c4024f46e1037f568dee
c)
Dighiero G et al. Chronic Lymphocytic leukemia. Lancet. 2008 371 (9617):1017-29
http://eresources.library.mssm.edu:2080/science?_ob=ArticleURL&_udi=B6T1B-4S3HTTC-14&_user=30742&_rdoc=1&_fmt=&_orig=search&_sort=d&_docanchor=&view=c&_acct=C000000333&_version=1&_urlVersion=0&_userid=30742&md5=5e82fad51eabfaba5e6d6840dc4619f9
d) Drucker
BJ. Translation of the Philadelphia chromosome into therapy for CML. Blood 008;
112 (13): 4808-17 http://eresources.library.mssm.edu:2115/pubmed/19064740?ordinalpos=21&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
B.
Lymphoma:
1.
Identify
the cytogenic alterations involved in NHL
2.
Compare
and contrast NHL and HL including:
a)
patients
age
b)
clinical
features (including classic B symptoms)
c)
classifications
(WHO and Ann Arbor)
d)
outcomes
e) treatment
3.
Describe
the role infectious agents may play in the development of
lymphoma including HIV
4.
Explain
the treatment approach and expected outcomes in patients with
follicular lymphoma and diffuse
large B-Cell lymphoma
5.
Describe
the treatment approach for HL and the reasons for each approach
a)
Identify
short-term and long-term toxic effects of each approach
6. Quick Reference Guide:
a) Lymphoma
classification http://eresources.library.mssm.edu:2068/popup.aspx?aID=2149322
b) Aggressive
Lymphomas http://eresources.library.mssm.edu:2068/popup.aspx?aID=2149331
c) Indolent
Lymphomas http://eresources.library.mssm.edu:2068/popup.aspx?aID=2149330HHodgkin’s
Lymphoma diagnosis and treatment http://eresources.library.mssm.edu:2068/popup.aspx?aID=2794108
d) Staging
for HL http://eresources.library.mssm.edu:2068/popup.aspx?aID=2794072
e) Prognosis
for HL http://eresources.library.mssm.edu:2068/popup.aspx?aID=2794076
7. Readings:
a)
Ansell, SM et al. Non-Hodkin Lymphoma: Diagnosis and
Treatment. 2005 80 (8): 1087. http://eresources.library.mssm.edu:2308/pqdweb?index=0&did=879534031&SrchMode=1&sid=2&Fmt=6&VInst=PROD&VType=PQD&RQT=309&VName=PQD&TS=1246067603&clientId=15325
b)
Yung, Lynny. Hodkin’s lymphoma. The Lancet. 2003 361
(93610: 943-951. http://eresources.library.mssm.edu:2080/science?_ob=ArticleURL&_udi=B6T1B-484MB74-T&_user=30742&_rdoc=1&_fmt=&_orig=search&_sort=d&_docanchor=&view=c&_acct=C000000333&_version=1&_urlVersion=0&_userid=30742&md5=648417a8dcd7b33378eaba2125837b1c
c)
Seam, PP. The Role of Chemotherapy in Hodgkin’s
lymphoma. The cancer journal.2009 15 (2):150. http://eresources.library.mssm.edu:2968/?sid=Entrez:PubMed&id=pmid:19390311
d)
Yahalom, Joachim. Role of Radiation Therapy in
Hodkin’s Lymphoma. The Cancer Journal 2009 15 (2) 155. http://eresources.library.mssm.edu:2968/?sid=Entrez:PubMed&id=pmid:19390312
e)
Cheson, BD et al. Monoclonal Antibody therapy for
B-Cell NH Lymphoma. NEJM. 2008 359:613-2. http://eresources.library.mssm.edu:2368/cgi/reprint/359/6/613.pdf
f)
Grogg, KL. HIV Infection and Lymphoma. J Clinical
Pathology. 2007 60(12):1365-72. http://eresources.library.mssm.edu:7015/cgi/content/full/60/12/1365
g)
Throley-Lawson, DA et al. Persistence of EBV and the
Origins of Associated Lymphomas. NEJM. 2004 350:1328-1337. http://eresources.library.mssm.edu:2368/cgi/reprint/359/6/613.pdf
C.
Multiple
Myeloma:
1.
Describe
the major criteria used to diagnose MM, including:
a)
Major
types (differences in immunoglobulin classes)
b)
Diagnostic
tools used
c)
Role
amyloid may play a role.
2.
Identify
the common physiological complications in MM including: renal
failure, bone involment, etc.
3.
Explain
the indications to begin therapy, the types of treatment, and the
poor/good prognostic indicators.
4.
Readings:
D.
Myelodysplastic
Sydromes
1.
Describe
the typical age, clinical features that occur in myelodysplasia.
2.
Identify
the peripheral blood findings, marrow findings, and cytogenetics
seen in patients with
Myelodysplastic disorders
3.
Describe how gene expression is effected by DNA methylation
and histone
acetylation and the rationale for azacytadine as
treatment for MDS
3.
Explain
the treatments used in patients with myelodysplasia,
a)
Describe
goals for therapy
b)
Recognize
expected outcomes (response rate, cure rate, survival)
c)
Identify
the laboratory determinants of prognosis.
4. Quick Reference Guide:
a) Classification
of MDS http://eresources.library.mssm.edu:2068/popup.aspx?aID=2801309
b) Management
of MDS http://eresources.library.mssm.edu:2068/popup.aspx?aID=2801446
5. Readings:
a)
http://www.mdanderson.org/patient-and-cancer-information/cancer-information/cancer-types/myelodysplastic-syndrome/index.html
b)
Steensma DP. The myelodysplastic syndromes: diagnosis
and treatment. Mayo Clinic Proceedings. 2006 81 (1): 104-30. http://eresources.library.mssm.edu:2308/pqdweb?RQT=305&SQ=issn%280025%2D6196%29%20and%20startpage%28104%29%20and%20volume%2881%29%20and%20issue%281%29
C) Jardersten M et al.
Myelodysplastic syndromes: biology and treatment. Journal of Internal Medicine.
2009 265 (3): 307-28. http://eresources.library.mssm.edu:2097/cgi-bin/fulltext/121575087/PDFSTART
d) Malcovati et al. Time-dependent
Prognostic Scoring System for Predicting Survival and Leukemic Evolution in
MDS. Journal of Clinical Oncology 2007 25 (23): 3503. http://jco.ascopubs.org/cgi/content/full/25/23/3503
E.
Myeloproliferative
Disorders:
1.
Name the
four major myeloproliferative disorders and identify the major pathological
features of each
2.
Identify
the major causes of thrombocytosis and the complications associated with them
3.
Describe
the major clinical features, prognosis, and treatment in patients with idiopathic
myelofibrosis
4.
Explain
the clinical features, genetic mutations, and treatment associated with
polycythemia vera.
6. Quick Reference Guide:
7. Readings:
a) Finazzi,
Guido et al. How I Treat Patients With Polycythemia Vera. Blood. 2007 109 (12):
5104. http://eresources.library.mssm.edu:7681/cgi/content/full/109/12/5104
b) Abdel-Wahab
Oi et al. Primary Myelofibrosis: Update on Definition, Pathogenesis, and Treatment.
Annu Reve Med. 2008 Oct 23. http://eresources.library.mssm.edu:2628/doi/abs/10.1146/annurev.med.60.041707.160528?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub
c) Tefferi A.
Essential Thrombocythemia, polycythemia vera, and myelofibrosis: current
management and the prospect of targeted therapy. American Journal of
Hematology. 2008 83(6): 491-7. http://eresources.library.mssm.edu:2097/cgi-bin/fulltext/117913157/PDFSTART
d) Birgegard
G. Long-term management of thrombocytosis in essential thrombocythemia. Annals
of Hematology. 2009 88(1):1-10. http://eresources.library.mssm.edu:2292/content/u6g453254381n78j/
F.
Hematopoietic
Cell Transplantation:
1.
Identify
the basic indications to begin hematopoetic stem cell transplant for cancer;
2.
Compare
and contrast chemotherapy treatment with HCT
including complications and outcomes
for leukemia, multiple myeloma, and MDS
3. Quick Reference Guide:
4.
Readings:
V. Specific
Medical Knowledge in Solid Malignancies
A.
Breast Cancer
1.
Delineate the current guidelines for Breast Cancer Screening*
a) Readings
(2) Memorial
Sloan –Kettering (more up to date)
http://www.mskcc.org/mskcc/html/65280.cfm
2.
Describe the genetics of BRCA1/2, the indications for genetic screening,
methods of prevention.*
a) Reading
(1) Management
of an Inherited Predisposition to Breast Cancer N Engl J Med 357:154, July 12,
2007 Clinical Practice
http://eresources.library.mssm.edu:2368/cgi/content/short/357/2/154
3.
Risk Stratify patients by Estrogen Receptor and HER2 status and describe
targeted therapies
a) Readings
(1) Early
Breast Cancer. Lancet. 2009 Apr 25;373(9673):1463-79.
http://eresources.library.mssm.edu:2080/science?_ob=ArticleURL&_udi=B6T1B-4W4M736-14&_user=30742&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000000333&_version=1&_urlVersion=0&_userid=30742&md5=0d957ae4f8a3e558db98c6b25015c9c3
4.
Describe the difference in treatment strategy between the stages of
disease.
5.
Understand the role of molecular prognostication for early stage breast
cancer –specifically the
Oncotype DX test
a) Readings
B.
Lung Cancer
1.
Describe why lung cancers are divided in Small cell and Non-small cell
types
and how these are staged and treated
differently*
a) Readings
(2) Lung
Cancer N Engl J Med 359:1367, September 25, 2008 Review Article
http://eresources.library.mssm.edu:2368/cgi/content/full/359/13/1367
2.
Describe the difference in treatment strategy between the stages of
disease
3.
Demonstrate knowledge of current evidence for screening high risk
patients
for lung cancer*
a) Readings
C.
Prostate Cancer
1.
Delineate the current guidelines for Prostate Cancer screening*
2.
Describe the indication for expectant management vs. treatment*
3.
Describe the general approach to hormonal therapy*
4.
Describe the proper use of PSA in this disease as a tumor marker*
5.
Readings
a) Mortality results from a randomized prostate-cancer
screening trial. N Engl J Med. 2009 Mar 26;360(13):1310-9. Epub 2009 Mar 18.
b) ACP Journal Club. Ann Intern Med. 2009 Jun
16;150(12):JC6-4, JC6-5.
c) Management of Prostate Cancer N Engl J Med 359:2605,
December 11, 2008 Clinical Decisions
http://eresources.library.mssm.edu:2368/cgi/content/short/359/24/2605
D.
Colorectal Cancer
1.
Describe the current guidelines, methods for Colorectal Cancer screening*
a) Readings
(2) Screening
for colorectal cancer: a targeted, updated systematic review for the U.S.
Preventive Services Task Force. Ann Intern Med. 2008 Nov 4;149(9):638-58. Epub
2008 Oct 6. Review.
(3) Fecal
DNA versus fecal occult blood for colorectal-cancer screening in an
average-risk population. N Engl J Med. 2004 Dec 23;351(26):2704-14.
http://eresources.library.mssm.edu:2368/cgi/content/abstract/351/26/2704
2.
Describe the difference in treatment strategy between the stages of
disease*
a) Readings
(1) Cetuximab
and Chemotherapy as Initial Treatment for Metastatic Colorectal Cancer N Engl J
Med. 2009 Apr 2;360(14):1408-17.
http://eresources.library.mssm.edu:2368/cgi/content/short/360/14/1408
3.
Describe the use of CEA as a tumor marker in this disease*
4.
Describe the genetic mutations that are associated with hereditary non-
polyposis colorectal cancer and
familial adenomatous polyposis.
a) Readings
(1) Hereditary
Colorectal Cancer N Engl J Med 348:919, March 6, 2003 Review Article
http://eresources.library.mssm.edu:2368/cgi/content/short/348/10/919
E.
Hepatocellular Carcinoma (HCC)
1.
Identify risk factors for HCC*
2.
Describe the indications and frequency of screening for HCC in patients
with liver disease including imaging modalities and tumor markers (AFP)*
3.
Use the Barcelona Criteria to decide treatment options.
4.
Describe the rationale and evidence for sorafenib in HCC.
5.
Readings
a) Sorafenib in Advanced Hepatocellular Carcinoma N
Engl J Med 359:378, July 24, 2008 Original Article
F.
Renal Cell Carcinoma (RCC)
1.
Describe the approach to diagnosis of RCC*
2.
Describe evidence for primary tumor resection in metastatic disease*
3.
Describe rationale and evidence for targeted molecular therapy
4.
Readings
a) Targeted drugs for metastatic renal cell carcinoma.
Lancet. 2007 Dec 22;370(9605):2071-3.
http://eresources.library.mssm.edu:2080/science?_ob=ArticleURL&_udi=B6T1B-4RD4RTY-4&_user=30742&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000000333&_version=1&_urlVersion=0&_userid=30742&md5=e904d439573b0ee1df00b3a06a52b191
G.
Pancreatic Cancer (exocrine)
1.
Describe the typical stage and prognosis at diagnosis*
2.
Describe the use of CA19-9 as a tumor marker in this disease*
3.
Describe the evidence and survival benefit for gemcitabine
4.
Readings
a) Improvements in survival and clinical benefit with
gemcitabine as first-line therapy for patients with advanced pancreas cancer: a
randomized trial. J Clin Oncol. 1997;15(6):2403-2413
http://eresources.library.mssm.edu:7783/cgi/content/abstract/15/6/2403?ijkey=2a58a6a7a9352cee6196d7115d5e02a3d4de835d&keytype2=tf_ipsecsha
H.
Thyroid Cancer
1.
Describe the general types, pattern of metastasis and prognosis*
2.
Describe how TSH and Thyroglobulin are used to follow patient after
treatment.
I.
Miscellaneous Tumors
1.
Neuroendocrine tumors: Describe the use of octreotide and the utility of
an octreotide scan in neuroendocrine tumors
2.
Gastric Cancer: Describe epidemiology and risk factors and role of H.
Pylori in Stomach Cancer
3.
Esophageal Cancer: Identify the sub-types and risk factors for esophageal
cancer
4.
Barrett’s Esophagus: Describe the indications for screening and method of
follow-up for Barrett’s Esophagus.
5.
Carcinoid Tumors: Describe the clinical presentations of carcinoid tumors
and how it relates to site of tumor.
6.
Cholangiocarcinoma: Describe tumor markers for cholangiocarcinoma, germ
cell tumors
7.
Stromal Tumors: Describe the rationale and role for imatinib in
Gastrointestinal Stromal Tumors.
VI.
Interpretation of statistics and cancer
clinical trials
A. Be able to define, compare and contrast the following terms:
1.
Incidence, prevalence, mortality, lifetime risk
2.
Survival, 5-year Survival, Disease-free or recurrence-free survival,
Progression-free survival rates
3.
Partial response, Complete response, Remission, Cure