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Clinical Content Update -Cancer

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Clinical Content Update: Cancer
John Horton, M.B., Ch.B.
October, 2004
Clinical Content Update
-CancerReasons:
1. Important cause of mortality and
morbidity
2. Will remain important during the
next 10 years.
3. Medical care is effective in
reducing mortality and morbidity.
Significant Causes of Cancer
incidence and Mortality in
Central Asia
1. Lung and upper respiratory passages
2. Colorectal
3. Breast
4. Cervix
5. Others
Information/experiences needed for
students to address problems in oncology:
1. Knowledge of etiologic factors
(including genetic) and progression of
cancer from pre-cancerous lesions
through metastasis
2. Identification of persons at high risk for
cancer
3. Promotion of healthy lifestyles to
minimize cancer risk
4. Organization/implementation of effective
cancer screening
Information (continued):
5. Knowledge of presenting symptoms and
signs of cancer
6. Referral techniques and resources for
diagnosis and treatment of established
cancer
7. Cancer treatment methods
8. Recognition and management of
symptoms, i.e., pain, nausea, constipation
9. Capability of providing/assisting with
terminal care.
Approaches/techniques to consider in
addressing objectives in Oncology
1. Link basic science closely with clinical
examples.
2. Do not attempt to “cover” all types of
cancer. Use only the most common ones
in Central Asia,
3. Identify the key issues regarding 3 or 4
types of cancer chosen to illustrate the
basic science and clinical approaches
used.
Possible tumor-types to serve as
examples:
1. Lung
2. Breast
3. Cervix
4.
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Summary of interventions known to
impact most on various cancer types:
Intervention
•Prevention
•Early detection/
Screening
•Treatment
Lung Breast Cervix
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Describe and demonstrate diagnostic
methods for cancer:
• Biopsy
• Needle aspiration
• Imaging
• Limitations of clinical-only diagnosis
Describe and demonstrate cancer
treatment techniques:
1. Surgery
2. Radiation therapy
3. Systematic therapy-chemotherapy
-hormone therapy
-targeted therapy
4. Support-medical
-psychological
Note: Importance of multimodal approach
Examples of linkages between basic
science and clinical education:
a. Primary preventionCarcinogenic sequence and progression with smoking
prevention and cessation
b. Early detection/screeningi) Etiology (papilloma/cervix) with cytology screening
programs for cervix cancer
ii) Biases and limitations of screening programs with
breast cancer
c. Clinical presentation and progressioni) Use any/all to illustrate typical symptoms of initial tumor
eg. regional and distant (metastatic) spread
ii) Emphasize pathology/genetics/molecular oncology.
Issues to emphasize:
1. Design the objectives/competencies to
address the future needs of the country.
2. Link basic science with clinical
education and experience in the key tumor
types.
3. Emphasize primary and secondary
prevention, presenting
symptoms/findings, and symptom control.
4. Evaluate the competencies.
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